Cobra runs out in June. Where to live?

[JohnnyQuest]

I retired in December 2009 and continue to be living in Texas....although I really have no strong ties here (been in Texas for 4 years). My COBRA coverage runs out in mid June.....so I will need to get private health coverage lined up. I would be interested in a high deductible policy for only myself (I am 51 yo and single).

I do have a few pre-existing conditions which include hypertension (including taking medication for this condition) and a few pre-cancer skin issues that were removed over a year ago.

I am very independent and am somewhat flexible on where I live within the US. I don't really wish to stay in Texas. I am considering Florida (where I have lived before) and also Michigan ( where my aging parents reside) but would consider other states as well if they offer better protection of individuals ability to get health care coverage.

My question is the following: What states are ahead of others in terms of protections of a consumers right to get health insurance? Are some states more rigorous with insurance companies on not allowing refusal to offer insurance due to pre-existing conditions? Is Massachusetts the best option? How do Florida, Michigan, and Texas compare? Any and all thoughts are welcome. Thanks.

 

[REWahoo]

JQ, welcome to the forum.

One of the few positives about living in TX is the availability of the state's high risk insurance pool. I'm no expert but I suspect the conditions you mention will make it difficult for you to buy coverage on the open market. Pool coverage is, by law, 2X the cost of premiums for those without pre-existing conditions, but it should at least be coverage you can get.

Texas Health Insurance Pool Home Page for Texans in Need of a Health Plan.

 

[dgoldenz]

Everything could also change in 2014 if the law isn't repealed....which would make moving a moot point. TX also has a risk pool as mentioned and you would likely qualify for guaranteed-issue HIPAA coverage when your COBRA ends. I don't know if TX requires HIPAA-eligible people to join the risk pool or if they can still get a plan of their choice since every state's HIPAA rules are different.

If all you have is high blood pressure that's controlled w/ meds and what sounds like a history of basal cells, I know Anthem BCBS here in VA would probably accept you for a fully underwritten policy assuming everything else was normal. I'd suggest contacting an independent agent that knows and represents the plans from multiple TX insurance companies including BCBSTX in case you decide to stay there.

 

[Martha]

You might want to read our FAQ on buying private health insurance. http://www.early-retirement.org/forums/f47/faq-archive-buying-private-health-insurance-30756.html

A very helpful website is Health Insurance and Coverage Help for Consumers Everywhere. This site has guides for most states which discuss options for people with pre-existing conditions. Texas uses a risk pool, as REW mentioned. Florida doesn't have an open risk pool, it provides for conversion policies and HIPAA policies if you are coming off of COBRA. IIRC, the cost is about double what a non-HIPAA plan would cost for someone of your age.

Instead of a risk pool, Michigan requires Blue Cross Blue Shield Michigan to be guaranteed issue. I do not know info on cost.

When you look at risk pools and HIPAA plans for states keep in mind that coverage may not be what you expect and there may be low lifetime limits or yearly limits. So, pay attention to the details.

 

[Corporate ORphan]

Premium Cost in high risk pool

To give you an idea of what these high risk pools can cost you in premiums. My cousin and her husband (i their fifty's) are paying about $25,000 a year in Missouri's high risk pool. I don't know what pre-existing conditions they have except that my cousin has high blood pressure. My SIL has sleep apnea so she had to go into it also she is 51 and had her rate upped this year to $849/month.

I have seen some states post their rates for the different plans they have in the high risk pool, you might use google to find them for some of the states you are considering.

The pools are definitely not a "cheap" option. Good luck!

 

[Silver]

I live in Orlando Florida, and have been researching individual health insurance coverage as well. My COBRA ends this summer. Both my husband and I need coverage and we both have pre-existing. I've had a total hip replacement done 7 years ago for osteoarthritis, and my husband has high blood pressure and type 2 DM, both controlled by meds.

In addition to doing lots of research myself I've worked with an independent agent who was extremely helpful, and would be happy to give you her name in a private message if that would help you. I found her by going to the National Assoc. of Health Underwriters website (NAHU.org) and used the "Find an Agent" tool.

The agent tells me that the health insurance industry changes almost daily.....but this is what I know as of today. She tells me that United Health Care is one of the only options for guaranteed issue. Most insurance companies do not offer it in Florida, which I confirmed with Aetna, Cigna, Humana, and BCBS by calling them all directly. Assurant Health is also a possible option, but thus far I haven't been able to find any health care providers that accept this insurance in this area.

The quotes I received for the guaranteed issue from United Health Care are $1,000 a month per person for a $2,500 deductable, or $780 for a $5,000 deductable.

Florida does not currently have a high risk pool that is functioning, although you can spend a lot of time looking at websites that talk about "Cover Florida". It's not up and running at this point.
I hope this helps some.

 

[JohnnyQuest]

Thanks to everyone for the suggestions. I will research some of the websites that you all have linked in here.

dgoldenz made the comment that it could all change (and become easier I assume) in 2014 if the new healthcare law is not repealed. I agree. However, I am going to plan for the worst case scenario (that it is repealed). If it holds together partially or totally, then that will be a bonus.

I do plan to make contact with an independent agent here in Texas next week just to see what the options will be for me and to understand how big of an issue my pre-existing conditions may be.

New question:

I will be transitioning away from COBRA coverage in June. Is it beneficial to do this transition to private coverage (assuming I can get it) within the same state, Texas in my case? Should I move to a different state first, and then transition to private coverage or should I transition first within Texas and then consider moving out of state afterwards? Or does the sequencing not matter at all?

 

[REWahoo]

I will be transitioning away from COBRA coverage in June. Is it beneficial to do this transition to private coverage (assuming I can get it) within the same state, Texas in my case? Should I move to a different state first, and then transition to private coverage or should I transition first within Texas and then consider moving out of state afterwards? Or does the sequencing not matter at all?

Some plans (ie, the TX high risk pool) are not portable. If you plan moving somewhere else it may be advisable do it ASAP before going off COBRA. Since that's only three months away you may run into problems even then as many (most?) states have residency requirements of 6 months or more. Something you definitely want to talk to an agent about.

 

[Martha]

To give you an idea of what these high risk pools can cost you in premiums. My cousin and her husband (i their fifty's) are paying about $25,000 a year in Missouri's high risk pool. I don't know what pre-existing conditions they have except that my cousin has high blood pressure. My SIL has sleep apnea so she had to go into it also she is 51 and had her rate upped this year to $849/month.

I have seen some states post their rates for the different plans they have in the high risk pool, you might use google to find them for some of the states you are considering.

The pools are definitely not a "cheap" option. Good luck!

I am working on taxes today so I am up on my premium cost. Spouse and I paid $10,425 in premiums last year for the Minnesota risk pool. My deductible was $2000 and his was $5000. I upped my deductible to $5000 for this year to reduce the cost. We are in the 55 to 60 age band.

I would not move to Missouri.

 

[Martha]

I will be transitioning away from COBRA coverage in June. Is it beneficial to do this transition to private coverage (assuming I can get it) within the same state, Texas in my case? Should I move to a different state first, and then transition to private coverage or should I transition first within Texas and then consider moving out of state afterwards? Or does the sequencing not matter at all?

Some plans (ie, the TX high risk pool) are not portable. If you plan moving somewhere else it may be advisable do it ASAP before going off COBRA. Since that's only three months away you may run into problems even then as many (most?) states have residency requirements of 6 months or more. Something you definitely want to talk to an agent about.

Many states allow you to move from another state's risk pool to that state's risk pool. For example, I know that if I wanted to move to Texas from Minnesota (I checked) I can go on the Texas pool as soon as I am a resident. The same is true if you want to move the other direction. Otherwise, the residency waiting period REW talked about may very well apply. I certainly would move to the state where you plan on living before expiration of COBRA so that you can be sure to have the coverage that you want. The residency waiting period won't apply if you are getting insurance by exercising your HIPAA rights. (Read the FAQ I linked to if you do not know your HIPAA rights--it is explained there.)

 

[walkinwood]

An article in the NY times addresses the new developments in health insurance for people with pre-existing conditions.
http://www.nytimes.com/2011/03/19/health/19patient.html

 

[JohnnyQuest]

You might want to read our FAQ on buying private health insurance. http://www.early-retirement.org/forums/f47/faq-archive-buying-private-health-insurance-30756.html

A very helpful website is Health Insurance and Coverage Help for Consumers Everywhere. This site has guides for most states which discuss options for people with pre-existing conditions. Texas uses a risk pool, as REW mentioned. Florida doesn't have an open risk pool, it provides for conversion policies and HIPAA policies if you are coming off of COBRA. IIRC, the cost is about double what a non-HIPAA plan would cost for someone of your age.

Instead of a risk pool, Michigan requires Blue Cross Blue Shield Michigan to be guaranteed issue. I do not know info on cost.

When you look at risk pools and HIPAA plans for states keep in mind that coverage may not be what you expect and there may be low lifetime limits or yearly limits. So, pay attention to the details.

Very interesting resource Martha. Interestingly, Michigan seems to have better coverage for folks with pre-existing conditions than Florida does. As you say, BCBS of Michigan is obliged to offer anyone coverage....dont know the cost however. Florida does not look good. Insurance companies are allowed to refuse coverage and also offer policies with exclusions. I think I need to talk to independant agents in Texas and Michigan this coming week. Thanks!!

 

[Corporate ORphan]

One thing you might look into is converting your COBRA policy. I noticed today on a letter from my COBRA provider that they said mine was convertible and if I was interested I should contact the health care provider listed on my insurance card. My guess it would be expensive but maybe cheaper than the state's high risk pool.

Also, another thing to consider. If you end up with private insurance most policies are not portable. Another reason to be in the state where you want to relocate when your COBRA expires.

Another resource for information would be the department of insurance in the states you are interested in. They should be able to tell you about the high risk pools and what insurers are licensed in those states (you might be able to tell a lot just looking at their websites.

We didn't have much luck with insurance agents. We knew more than they did from reading the internet and some gave us incorrect information. The one we used had a clerical error and didn't send our application in for 2 weeks. So far we would have been better to apply online and not used him. That being said some are very good like dgoldenz. He has been very helpful in guiding me through the maze of private insurance. More than the agent we actually used.

 

[67walkon]

This is one near and dear to my heart. If I could figure health insurance out, I could be FIRE'd!

I'm 61, my wife is 56. She doesn't work. I have group insurance at work. Neither of us is on any medications and are generally pretty healthy. But, I have 2 pre-existing conditions.

In 2007, I had a congenitally deformed heart valve replaced with a cow valve. It should last 15 to 20 years, but there are no guarantees. In December, 2009, I had an accident that resulted in a bunch of screws and plates in my pelvis and spent 8 weeks in a wheel chair; the orthopedic guy says I will need a hip replacement someday, but it could be a year, 5 years or 15 years. Except for sciatica issues probably caused by the rehab from the injury, I have no restrictions.

I have generally presumed that an individual policy for me would be almost impossible to get or at least prohibitively expensive. My plan is to try to work something out with my work situation so that I can at least keep group insurance until I'm within 18 months of being eligible for medicare.

But we could afford $780 a month for me, presuming my wife would be less, and that is what Silver says she got quoted in Orlando. If we did that for 3 years, maybe it would work out.

I'm hoping to cut a new deal at work to continue coverage for 2012, without working full time that year. At the end of 2012, I will have just turned 63, so I won't need many more months to get into the 18 months of COBRA if I have to do that.

Maybe it will work! But any of you who get retiree health benefits ought to really be counting your blessings.

 

[lemming]

I transitioned from COBRA last year. The HIPPA qualification plans (not underwritten) were around $850 month. I got a high deductible,Luminous, Blue Cross plan for $332. That works out to less then a $10,000 year possible cost with the majority going to the doctor not to the insurance company. Lets see if it holds up for the next 5 years.

I'm in Virginia.

Have you considered Massachusetts? Ir Canada if your net worth is high enough or you want to open your own Tim Hortons.

 

[JohnnyQuest]

One thing you might look into is converting your COBRA policy. I noticed today on a letter from my COBRA provider that they said mine was convertible and if I was interested I should contact the health care provider listed on my insurance card. My guess it would be expensive but maybe cheaper than the state's high risk pool.

Also, another thing to consider. If you end up with private insurance most policies are not portable. Another reason to be in the state where you want to relocate when your COBRA expires.

Another resource for information would be the department of insurance in the states you are interested in. They should be able to tell you about the high risk pools and what insurers are licensed in those states (you might be able to tell a lot just looking at their websites.

We didn't have much luck with insurance agents. We knew more than they did from reading the internet and some gave us incorrect information. The one we used had a clerical error and didn't send our application in for 2 weeks. So far we would have been better to apply online and not used him. That being said some are very good like dgoldenz. He has been very helpful in guiding me through the maze of private insurance. More than the agent we actually used.

Thanks for the suggestion, but I think this won't work for me as the multinational I worked for had a self-insured program that was administered by UHC. My understanding is that self insured programs cannot be converted to individual policies after COBRA expires.

 

[Corporate ORphan]

Thanks for the suggestion, but I think this won't work for me as the multinational I worked for had a self-insured program that was administered by UHC. My understanding is that self insured programs cannot be converted to individual policies after COBRA expires.

My former company is also self insured and was bought out by a multi-national in 2008 so they must be able to do it. At least in Missouri

 

[JohnnyQuest]

My former company is also self insured and was bought out by a multi-national in 2008 so they must be able to do it. At least in Missouri

Thanks for that. I will check with UHC and see if they can roll over to an individual policy.

 

[nun]

Move to MA. No pre-existing conditions and you can get a 2k deductible 5k annual max policy for $300 to $400 a month

 

[PaddyMac]

We're in Albuquerque, NM, so not too far from TX. I'm 50 but my husband is 49 and his name is on the BCBS policy. We pay $286 a month for a $5000 deductible HSA. I think that's quite good, but that is after a "huge" increase this year (it was $218).

I'm in good health, but my DH takes medication for elevated-high blood pressure.

Overall I think the cost of health care in NM is good value; remember it's not just the cost of the premiums you have to take into account. Plus the cost of living is also low overall. Great weather too (no humidity, no hurricanes, tsunamis or earthquakes either!).

 

[Ally]

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.

 

[JohnnyQuest]

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.

 

[dgoldenz]

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.

 

[nun]

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/portal/site/connector/

 

[JohnnyQuest]

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/portal/site/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.