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Old 03-28-2011, 11:48 PM   #21
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If you are in TX, you might check with the insurance co. We had someone on Cobra at our company and as it was running out, our state representative told her that in TX, that TX extends Cobra another 18 mos. We had to keep her on for 3 years total. That was about 3-4 years ago and could still be the same. If they don't know, maybe call your state representative.
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Old 06-02-2011, 02:36 PM   #22
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Fast forward to June 2. I was the original poster of this thread. My efforts to find an independent agent in Houston failed. From what I could tell, there do not seem to be many. Of the few I could find, one never returned my phone calls and I declined even speaking with the other (his place of work was a run-down house that seemed to serve several businesses including tax preparation, attorney, insurance, etc). I don't know if the one guy did all these things......but it all looked fairly suspect to me so I did not pursue him further.

Therefore, I decided to embark on my mission without an independant agent. Ended up contacting UHC since they are the ones that currently cover me under my group coverage. Application in process, but lots of questions.....including a 40 minute follow up discussion with a nurse regarding my original application. They seem very concerned with my cardiac condition (Hypertention and an ectatic aortic root) as well as some treatment I received from a chiropractor in 2009 for lower back pain. I am concerned I am going to be refused coverage, have a cardiac event rider, or just a rediculously priced premium.

Given yesterdays developments on relaxing the requirements of the high-risk pool in numerous states, I am now considering withdrawing my application from UHC and taking a different path. I have posed the question on the other thread in this forum that deals with the changed rules of the high risk pools. Thanks in advance for responding on that thread.
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Old 06-02-2011, 02:43 PM   #23
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Originally Posted by JohnnyQuest View Post
Fast forward to June 2. I was the original poster of this thread. My efforts to find an independent agent in Houston failed. From what I could tell, there do not seem to be many. Of the few I could find, one never returned my phone calls and I declined even speaking with the other (his place of work was a run-down house that seemed to serve several businesses including tax preparation, attorney, insurance, etc). I don't know if the one guy did all these things......but it all looked fairly suspect to me so I did not pursue him further.

Therefore, I decided to embark on my mission without an independant agent. Ended up contacting UHC since they are the ones that currently cover me under my group coverage. Application in process, but lots of questions.....including a 40 minute follow up discussion with a nurse regarding my original application. They seem very concerned with my cardiac condition (Hypertention and an ectatic aortic root) as well as some treatment I received from a chiropractor in 2009 for lower back pain. I am concerned I am going to be refused coverage, have a cardiac event rider, or just a rediculously priced premium.

Given yesterdays developments on relaxing the requirements of the high-risk pool in numerous states, I am now considering withdrawing my application from UHC and taking a different path. I have posed the question on the other thread in this forum that deals with the changed rules of the high risk pools. Thanks in advance for responding on that thread.
UHC does exclusion riders. Blue Cross/Blue Shield probably does not. Might want to give that a try if UHC doesn't work out. My guess would be they give you an outpatient back exclusion, rate up for the blood pressure. I know Marfan's syndrome (the EAR you described) is an auto-decline with Humana...I'd be surprised if its not an auto-decline with UHC. You probably can't find an independent agent because they don't pay enough commission for the work involved. Lots of health agents changing to other lines of coverage. Commissions were cut 30-70% across the board because of Obamacare.
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Old 06-02-2011, 02:43 PM   #24
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Originally Posted by JohnnyQuest View Post

Given yesterdays developments on relaxing the requirements of the high-risk pool in numerous states, I am now considering withdrawing my application from UHC and taking a different path. I have posed the question on the other thread in this forum that deals with the changed rules of the high risk pools. Thanks in advance for responding on that thread.
I have to repeat my previous advice. Move to MA where we actually have Romney/Obamacare fully implemented. No pre-existing condition or health exclusion if you've had continuous coverage. Here is the state website where you can see all the plans

https://www.mahealthconnector.org/po...ite/connector/
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Old 06-02-2011, 03:05 PM   #25
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I have to repeat my previous advice. Move to MA where we actually have Romney/Obamacare fully implemented. No pre-existing condition or health exclusion if you've had continuous coverage. Here is the state website where you can see all the plans

https://www.mahealthconnector.org/po...ite/connector/
Thanks Nun. I remember your advice......and I was seriously considering it in the event that UHC turned me down or had riders attached. However, given the news yesterday that it will be easier to get into the high risk pool in many states, I am now considering this new path of stopping my UHC application, going uninsured for six months, and then qualifying for the high risk pool in Texas or Florida at say $350/month. Then I am finished with all the worry and hassle related to pre-existing conditions.
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Old 06-02-2011, 03:11 PM   #26
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BCBS is the insurer of last resort here in balmy Michigan. Only requirements when I joined were that you couldn't have access to group insurance and they wouldn't cover pre-existing conditions for six months (but would pay after that).

I know BCBS is different in every state, but they might be worth looking into as well.

In addition to them, the agent I talked to liked Aetna, but the 10 years of detailed medical history turned me off.

Note, all of this was before any sort of health care reform was even being hashed out in congress.
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Old 06-02-2011, 03:20 PM   #27
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UHC does exclusion riders. Blue Cross/Blue Shield probably does not. Might want to give that a try if UHC doesn't work out. My guess would be they give you an outpatient back exclusion, rate up for the blood pressure. I know Marfan's syndrome (the EAR you described) is an auto-decline with Humana...I'd be surprised if its not an auto-decline with UHC. You probably can't find an independent agent because they don't pay enough commission for the work involved. Lots of health agents changing to other lines of coverage. Commissions were cut 30-70% across the board because of Obamacare.
Thanks dgoldenz. I assumed I could not find an independent agent due to it just not being financially worthwhile work for them anymore. Times they are a changin' I guess.

I am actually thinking of abandoning my pursuit of the individual policy with UHC or anyone else and targing the HIPAA as the prime path. Why bother with the others if they can attach riders, uprate due to PECs, or turn me down completely. With the new high risk rules where one does not actually need to be turned down by an insurance company to qualify, why not just go for that......after the 6 month wait period of being uninsured. That way I am guaranteed a reasonable rate of around $350/month once I enroll after the six months.

Other than the risk of some big health event during those 6 months, what are the other downsides to my thought process?

Just to be clear, my plan is the following:
  • Withdraw application with UHC.
  • Cobra runs out June 15
  • Go uninsured for 6 months till December 15
  • Enroll in HIPAA in Texas or Florida Effective December 16th
    at a rate of about $350/month.
It seems like a no-brainer to me......but maybe I am missing something. Please critique my plan and let me know if I am missing something really obvious as a reason not to do this.
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Old 06-02-2011, 03:23 PM   #28
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You can move to MA or Utah. They both have near single payer system. The new PCIP (part of Obamacare) is now available in many states. I know for sure CA is now accepting application. You can qualify if you're not insured for six months and are denied by insurance companies.
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Old 06-03-2011, 08:20 AM   #29
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Originally Posted by JohnnyQuest View Post
Thanks dgoldenz. I assumed I could not find an independent agent due to it just not being financially worthwhile work for them anymore. Times they are a changin' I guess.

I am actually thinking of abandoning my pursuit of the individual policy with UHC or anyone else and targing the HIPAA as the prime path. Why bother with the others if they can attach riders, uprate due to PECs, or turn me down completely. With the new high risk rules where one does not actually need to be turned down by an insurance company to qualify, why not just go for that......after the 6 month wait period of being uninsured. That way I am guaranteed a reasonable rate of around $350/month once I enroll after the six months.

Other than the risk of some big health event during those 6 months, what are the other downsides to my thought process?

Just to be clear, my plan is the following:
  • Withdraw application with UHC.
  • Cobra runs out June 15
  • Go uninsured for 6 months till December 15
  • Enroll in HIPAA in Texas or Florida Effective December 16th
    at a rate of about $350/month.
It seems like a no-brainer to me......but maybe I am missing something. Please critique my plan and let me know if I am missing something really obvious as a reason not to do this.
I would never suggest someone go uninsured for 6 months as I have seen way too many things happen to people who took that chance as well as those who decided against it and were smart to have kept their coverage, even at a high price. HIPAA coverage is only available within 63 days of your COBRA expiring. As soon as your COBRA expires, you would be HIPAA-eligible assuming you satisfy the other requirements. The 6-month wait only applies to the PCIP risk pool, not the state risk pool.
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Disclaimer - I am an independent insurance agent. If the above message contains insurance-related content, it is NOT intended as advice, and may not be accurate, applicable or sufficient depending on specific circumstances. Don't rely on it for any purpose. I do encourage you to consult an independent agent for insurance-related advice if you have a question that is specific in nature.
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Old 06-03-2011, 08:47 AM   #30
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Quote:
Originally Posted by JohnnyQuest View Post
Other than the risk of some big health event during those 6 months, what are the other downsides to my thought process?

Just to be clear, my plan is the following:
  • Withdraw application with UHC.
  • Cobra runs out June 15
  • Go uninsured for 6 months till December 15
  • Enroll in HIPAA in Texas or Florida Effective December 16th
    at a rate of about $350/month.
I assume you mean the new federal risk pool and not HIPAA? You can only get a policy through HIPAA if you've had "continuous coverage," defined as no gaps in coverage of 63 days or more.

Of course, you're playing Russian Roulette by going naked for six months. If you don't have any catastrophic illnesses or injuries, "ciick." If you do.... "bang".
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Old 06-03-2011, 02:25 PM   #31
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Stay away from UHC. We did the same thing you did (liked them with my company). They were terrible when we applied with them. I think I already posted on this board how bad they were just in taking our application. Sent our competed 10 year medical history application with our credit card info to the wrong address, slow, etc.

Bottom line... they didn't give us the quoted rate and put an unacceptable rider on it.

BCBS accepted us in less than a week with the quoted rate, no phone interview and no riders.

Are you sure about the rates on the HIPAA coverage? I checked them in a couple of states we were interested in and the cost was more like $1000 a month for two people.

Also, you probably already thought of this but if you choose to wait 6 month for the national high risk pool and you get into a car accident, the hospital will spend a ton of $ on you that you didn't approve because you were unconscious. They will then take you to court to get it if you refuse to pay.
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