health insurance, again

[grateful]

hi,
i just posted our introduction on the "hi, i am" board and we already have our first question. i'm 59 and wife is 57. my date is 6/30/07; her's is a year or so later. we both have employer health insurance so can either cobra for 3 years and/or go private policy and/or state (california) high risk pool for a couple of years until medicare. i talked to an agent about private insurance and he was not very encouraging. i want to know if what he told us sounds credible to members here.
we are healthy. for the past twenty years our vacations have been two or three week self supported bicycle tours to new zealand, france and all over the u.s. we get annual physicals. she is taking fosamax for a mild case of osteopenia (sp?) and i take flomax for enlarged prostate, 10mg of paxil for anxiety and half a 10/40 vytorin for cholesterol. the agent went to bc and bs and presented us as a hypothetical. one said wife would be declined for sure and i would be a 50% rate-up and the other said i would be declined and she would be a 50% rate-up. he said our only hope is to cobra to the max and then go high risk pool at $2000 per month. i believe we could get rid of all the meds except maybe the flomax but is it necessary to do so? i don't want to start a health insurance rant so please don't go there. from what i have read here and at other early retirement sites it seems like we should not be uninsurable based only on these meds. does what we are being told ring true with the members of this board?
thanks for being here, grateful

 

[haha]

hi,
i just posted our introduction on the "hi, i am" board and we already have our first question. i'm 59 and wife is 57. my date is 6/30/07; her's is a year or so later. we both have employer health insurance so can either cobra for 3 years

Are you certain you can Cobra for three years? Here it is just 18 months.

Ha

 

[Rich_by_the_Bay]

i'm 59 and wife is 57. my date is 6/30/07; her's is a year or so later. we both have employer health insurance so can either cobra for 3 years ...

COBRA everywhere I've worked is only guaranteed for 18 months. Is 3 years a figure you have verified?

 

[REWahoo]

California provides 36 months COBRA coverage:

Under AB 1401, anyone who goes onto COBRA or Cal-COBRA after January 1, 2003 will automatically be eligible for up to 36 months of continuation coverage.

 

[Martha]

Yes, what your agent says rings true. 

It won't help to stop taking the pills.   The fact you took them and likely need them will be part of your record and will need to be disclosed. 

EDIT:  To add a bit more information, Georgetown University, which sponsors my favorite website www.healthinsuranceinfo.net, published a study about 5 years ago that discussed underwriting standards, which are getting tighter all the time.  Sorry, for some reason I can't find the link right now. Anyway, the researchers found that roughly 90% of applicants for individual insurance who weren't in perfect health were unable to buy individual policies at standard rates, with a significant number rejected from coverage.

This is consistent with the Scientific American information that I see Nords posted when I was gone: http://early-retirement.org/forums/index.php?topic=9553.0

 

[crazy connie]

Here is my 2 cents worth for how to get insurance for a crunch zone... Sign up for intresting classes at the local Community College and pick up student health care. My son is at ASU and I think his premium is about $500 annually. If my former employer goes tits up on my plan I will be in that plan. I currently pay over $200 a month as a single female. That appeals more than a McJob to me right now!

 

[Rich_by_the_Bay]

Here is my 2 cents worth for how to get insurance for a crunch zone... Sign up for intresting classes at the local Community College and pick up student health care. My son is at ASU and I think his premium is about $500 annually. If my former employer goes tits up on my plan I will be in that plan. I currently pay over $200 a month as a single female. That appeals more than a McJob to me right now!

Read the fine print if you go that route. It was touted in a few books and columns for a while (audit a class or two, take out a cheap policy), but many student health plans have limited benefits, caps on certain payouts, etc. Might be fine but caveat emptor.

 

[SecondCor521]

Also, at my university you have to be a full time student to qualify to participate, which is 8 credits or more, which is a somewhat significant tuition expense (unless you are interested in going to school anyhow).

2Cor521

 

[crazy connie]

Very true Rich. But with a basic nuts & bolts plan, then you can add on a major catastrophic for reasonable rates as I understand it.

SecondCor521, here once you turn 60 the Community College tuition is waved. I think that is the case in quite a few states as well.

Not my 1st choice for sure, but properly investigated and informed decisions beat doing without insurance and/or the poorhouse for exclusionary premium coverage.

Also, I believe some of the "social groups" offer group rates to members. Just some different thoughts on ways other than private individual policy rates.

 

[sgeeeee]

Every state is different, but most have a provision that says if you use up COBRA and no one will insure you, then you are guaranteed some kind of coverage. Unfortunately, there is no guarantee on the premium for this coverage in most states.

Stopping the meds is not likely to help. The underwriters ask approximately 50 million questions about your medical history over the past several years as well as your current situation.

If you are a member of any professional organizations or other large groups, you might check and see if they have insurance offerings. Sometimes these group plans are easier to get.

Good luck.

 

[Martha]

The OP is from California.   My recollection is that in California HIPAA eligible people cannot be turned down for individual insurance, cannot be given pre-existing condition exclusion periods, and there also are limitations on the cost of the insurance, but the limits are pretty high. California also has a risk pool.  IIRC, the state moves you off the pool after three years into the individual market.    One source of information for California is http://www.healthinsurance.org/california/default.lasso

Grateful, be sure to ask your agent what rights you have under HIPAA to force a company to sell you insurance and what the cost would be. I forgot to mention your HIPAA options in my first post.