Barretts Esophagous (BE) and Health Ins,

[escoff]

I was advised by insurance agent that some companies will not underwrite individual diagnosed with BE.
Would be curious to know others experience in getting Health Ins and what would be best route to follow.
Looking to ER in 2010 @ age 60.

 

[Martha]

I suggest reading our FAQ on buying private health insurance: http://www.early-retirement.org/forums/f47/buying-private-health-insurance-30756.html.

What state do you live in or plan to retire in? Insurance is primarily regulated by states so there is a lot of difference on what is available depending on the state.

 

[escoff]

I live in and plan to live in Pennsylvania.

 

[Martha]

I suggest working with an independent agent, but if you run into problems because of the pre-existing condition, Blue Cross Blue Shield sells a guaranteed issue plan in PA. I do not know the cost, you might want to ask your agent.

Here is some info on your rights in PA:

http://www.ins.state.pa.us/ins/lib/ins/consumer/brochures/2003_health.pdf

Guaranteed Issue of Health Insurance to Eligible Individuals. New Pennsylvania law also makes it
easier for you to get individual insurance under certain situations, including if you left a job where
you had group health insurance, or had another plan for more than 18 months without a break of
more than 63 days. Specifically, if you meet certain criteria, you are considered an eligible
individual and guaranteed the right to buy individual health coverage from Blue Cross and Blue
Shield plans in Pennsylvania without a pre-existing condition exclusion period.
To be an eligible individual, you must:
1) have had 18 months of continuous credible coverage, at least the last day of which was under a
group health plan;
2) have used up any COBRA continuation coverage for which you were eligible;
3) not be eligible for Medicare, Medicaid or a group health plan;
4) not have other health insurance.
You must apply for health insurance for which you are an eligible individual within 63 days of
losing your prior coverage.


This is PA's HIPAA option when you come off of a group plan. If you are HIPAA eligible, they cannot turn you down for the pre-existing condition AND must cover the condition. If you are not HIPAA eligible because you do not meet the above requirements, you may still be able to purchase the BCBS plan but you will have a waiting period before pre-exisiting conditions are covered.

 

[Rich_by_the_Bay]

Barret's is almost always going to get pre-existing, non-covered status under individual policies. That makes such coverage unacceptable because you virtually must undergo periodic endoscopies and possibly eventual surgery (hopefully preventive).

My advice is to continue unrestricted insurance in any way you can even if it means deferring FIRE. This is not a condition you want to exclude. I am hopeful that health care reform will eliminate pre-existing illness carve-outs, which are inherently unfair and immoral for legitimate conditions (fine with me to exclude cosmetic or similar treatments)

On the bright side, there are some promising procedures under development which can provide treatment without esophagectomy should things start to look funny. They will be available in major centers within a year, I understand.

But insurance-wise, IMHO this needs to be covered whatever it takes.