It's been awhile since I posted here because I have been busy semi-FIREing (yeah!) at age 41 and am trying to find a high deductible (~$5000), HSA-eligible health insurance policy in North San Diego County California. I would like to submit my applications next week. That is also when my 59 day opt in/out COBRA clock will start clicking (my last day is this Friday) and hopefully I can avoid paying any COBRA premiums at all.
Hopefully, these random questions that I have will help other people in the future, too. And at the end of the process, I promise to summarize everything that I have learned. I posted here previously and got some helpful answers, especially from MKLD. I may be out of the country quite a bit the next three years or so, so I am focused on a high deductible HSA policy. I would like to get a policy that will allow me to move across state lines in the future so that I don't become a prisoner of California. But I am weighing this as just one factor.
* I am assuming that negotiated rates apply to my deductible for any policy
* I think that I am mostly healthy, and unlikely to get rejected for a policy and probable but not a shoo-in for the preferred rate. So for how many policies should I simultaneously apply? I have COBRA as a backstop at $400/month. Whereas my health insurance will probably be around $110/month if I get the preferred rate. And I can avoid paying any COBRA if I get this done in the next 2 months. I am thinking I should apply for two policies next week. Comments?
* Can I stop an in-process application -- if I get approved for a policy that I would like to accept, can I stop another application in process for which I have applied? I don't want a rejection on my record.
* Out of Network coverage -- This seems to be a key area of difference among policies. Three policies that I am considering:
1) Aetna: Deductible goes from $5000 to $10000 out-of-network, otherwise identical charges in or out of network.
2) Nationwide: Covers 50% out-of-network professional and doctor charges and has $800 daily MAXIMUM reimbursement for out-of-network hospitalization (and only covers 50%). I asked the agent about that ridiculously low MAX, and he said they had "emergency provisions" and would usually preapprove temporary stays in an emergency (although he does not have much experience with them). I think they do have a nationwide network.
3) Blue Cross of California: Covers all out-of-network charges for hospitalization after deductible EXCEPT $650/day and 50% of professional services and doctor costs.
I don't really have a sense how important thorough out-of-network coverage is or what to look for, any hints? All my local hospitals will be in all three networks.
* Coverage across state lines -- Based on information that I got here and also from my health insurance agent, it seems the following companies offer some portability across state lines without underwriting again (thus, you won't be a prisoner in a certain state if you get a pre-existing condition):
Golden Rule, Humana, Celtic, Nationwide, Assurant Health
Of course, the two policies that are available in my zip code, Nationwide and Assurant Health, do not seem to be as good of a deal as some other policies like Aetna and Blue Cross of California. I am still researching availability for the others in my zip code, although they don't show up in ehealthinsurance.com. Should I try to get portability provisions in writing? Is this possible or is it just an insurance company policy that could be rescinded at any time? I have a call with Nationwide tomorrow asking about cross state portability.
* One policy has a $2000 annual prescription max (and it only covers beyond deductible). I am assuming this is probably too low. Also, Nationwide restricts you to the "Medco" pharmaceutical network for pharmaceuticals. Is this reasonable? So far, I can only query locations by having a member number, so I can't tell how ubiquitous it is.
Kramer (thanks in advance)
Hopefully, these random questions that I have will help other people in the future, too. And at the end of the process, I promise to summarize everything that I have learned. I posted here previously and got some helpful answers, especially from MKLD. I may be out of the country quite a bit the next three years or so, so I am focused on a high deductible HSA policy. I would like to get a policy that will allow me to move across state lines in the future so that I don't become a prisoner of California. But I am weighing this as just one factor.
* I am assuming that negotiated rates apply to my deductible for any policy
* I think that I am mostly healthy, and unlikely to get rejected for a policy and probable but not a shoo-in for the preferred rate. So for how many policies should I simultaneously apply? I have COBRA as a backstop at $400/month. Whereas my health insurance will probably be around $110/month if I get the preferred rate. And I can avoid paying any COBRA if I get this done in the next 2 months. I am thinking I should apply for two policies next week. Comments?
* Can I stop an in-process application -- if I get approved for a policy that I would like to accept, can I stop another application in process for which I have applied? I don't want a rejection on my record.
* Out of Network coverage -- This seems to be a key area of difference among policies. Three policies that I am considering:
1) Aetna: Deductible goes from $5000 to $10000 out-of-network, otherwise identical charges in or out of network.
2) Nationwide: Covers 50% out-of-network professional and doctor charges and has $800 daily MAXIMUM reimbursement for out-of-network hospitalization (and only covers 50%). I asked the agent about that ridiculously low MAX, and he said they had "emergency provisions" and would usually preapprove temporary stays in an emergency (although he does not have much experience with them). I think they do have a nationwide network.
3) Blue Cross of California: Covers all out-of-network charges for hospitalization after deductible EXCEPT $650/day and 50% of professional services and doctor costs.
I don't really have a sense how important thorough out-of-network coverage is or what to look for, any hints? All my local hospitals will be in all three networks.
* Coverage across state lines -- Based on information that I got here and also from my health insurance agent, it seems the following companies offer some portability across state lines without underwriting again (thus, you won't be a prisoner in a certain state if you get a pre-existing condition):
Golden Rule, Humana, Celtic, Nationwide, Assurant Health
Of course, the two policies that are available in my zip code, Nationwide and Assurant Health, do not seem to be as good of a deal as some other policies like Aetna and Blue Cross of California. I am still researching availability for the others in my zip code, although they don't show up in ehealthinsurance.com. Should I try to get portability provisions in writing? Is this possible or is it just an insurance company policy that could be rescinded at any time? I have a call with Nationwide tomorrow asking about cross state portability.
* One policy has a $2000 annual prescription max (and it only covers beyond deductible). I am assuming this is probably too low. Also, Nationwide restricts you to the "Medco" pharmaceutical network for pharmaceuticals. Is this reasonable? So far, I can only query locations by having a member number, so I can't tell how ubiquitous it is.
Kramer (thanks in advance)