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ER health insurance with MS
Old 11-05-2007, 04:57 PM   #1
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ER health insurance with MS

I am trying to understand how I can make early retirement a realty with Multiple Sclerosis. My wife was diagnosed with MS about 10 years ago. Luckily she has the mild type and is not incapacitated at all. She is currently using Copaxone on a daily basis for "just in case". Very expensive drug. My work insurance currently covers the expenses. Will I be able to find independent medical insurance with MS in the picture? If so, what are the premiums. We are both currently 38 and would like to retirement when we are 45 or 50. I am supposedly able to buy insurance from work when I am 50 but not before.

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Old 11-06-2007, 11:01 AM   #2
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Welcome qkayak. Sorry, I don't have an answer to your question, but I wanted to send you greetings anyway. There are some folks on this forum who can answer your specific question, or at least give you guidance in the right direction, so I will bump this post back up top by responding. You certainly have a challenge ahead of you and the health insurance issue is one that you will need to get nailed down before ER.

Does your wife work? You said she has the mild type of MS and is not incapacitated. I was just wondering if she might have retiree insurance benefits. You didn't mention it that as an option so I assume not.

At age 60, I am using COBRA now and when the 18 mos are at an end, I will go back to my company's retiree insurance which is supposed to be "guaranteed" with no health questionnaire or physical exam. If I didn't have that option, it might be somewhat difficult for me to get private coverage just based on a few factors in my health profile that seem very minor to me, but others on the forum have indicated are red flags. I can't imagine how an insurance company would respond to MS.

Again welcome and make yourself at home. Ask as many questions as you want.


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Old 11-06-2007, 12:56 PM   #3
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If you are in Colorado you can, but it would be very expensive with a high deductible (state has a guaranteed high risk pool). Have you ever considered a part time position with benefits? You could ramp down, still be covered and have more free time.
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Old 11-06-2007, 02:08 PM   #4
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When I was applying for individual health insurance, my broker called insurance companies to pre-screen me and get a sense of whether they would cover me and for what amount. If you really want to get a clear idea of what you'd be facing, then there's no reason you can't find a good health insurance broker and ask them to find out for you.

Or you might be able to call the health insurance companies yourself and get your wife pre-screened.
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Old 11-06-2007, 02:50 PM   #5
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I suggest reading this FAQ:

No more lawyer stuff, no more political stuff, so no more CYA

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Old 11-06-2007, 04:49 PM   #6
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Thank you for the replies.

We decided it was best if my wife stopped working when we had our first child in 2000. We currently have two girls. TexasGal, you are correct. She does not have retiree insurance benefits. I work for a "megacorp" and have all the insurance and other benefits we need. One of the big concerns I have is that even if I wait til I am 50 to ER, what will be the cost of the plan at that time. Currently, the group plan is about $1000/mo ($1500 deduct.)for early retirees without medicare. High deductible is really not an option for me because of the cost for copaxone ($11000-$24000)/yr.

A million thanks for the wonderful post with links. I will spend some time and review everthing.
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Best States if You Have a Medical Condition
Old 11-13-2007, 02:42 PM   #7
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Best States if You Have a Medical Condition

Dear qkayak,

You might find that your choice of location will have to do a lot with whether you'll get guaranteed issue health insurance, and how much it'll cost. Since health insurance is mostly regulated by state laws, it varies by state. What I found when researching my book on buying health insurance is that some states have "community rating" which means that with slight variances, people in the state pay the same amount, regardless of health status. A number of states are providing guaranteed issue policies, but the rates are not guaranteed, nor are the amounts of coverage provided. Here in North Carolina, the guaranteed issue plan is up to 7 times the quoted rate, and may not provide "unlimited" coverage like some other plans.

As far as the states with community rating, your retirement destinations might include: Maine, Massachusetts, New York, New Jersey, Oregon, and Vermont. For other states, you may want to inquire at the department of insurance to see when and what is guaranteed issue, and what the rates are like.

-Jonathan Pletzke
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Old 11-13-2007, 07:36 PM   #8
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My understanding is that MS is right up there with cancer/AIDS/ALS etc. as an uninsurable condition, even though AFAIK it affects quality of life and not life expectancy.

I highly doubt your wife will be able to buy any medically underwritten insurance (life, health, LTC, disability, etc.) with a Dx of MS. Its a total show stopper for medical underwriting.

As others have said your best bet for the next couple of years is to get literate with the state laws regarding health insurance regulation...also be careful to find out how "things really work" since from what I've heard even though you live in a state with a "guaranteed" high risk pool, some of these states have waiting periods and/or the pool is "closed to new applicants".

Past the next couple of years I suspect that this problem will be solved by Federal mandates and/or programs. I'll leave the intense discussion of whether or not that results in better healthcare to others, but I would definitely not take any actions with long term effect (like moving to another state) without thinking hard about the effect this may have.

I would ask about asset protection strategies as well ... if you wind up without health insurance the costs of MS will eat you alive, draining whatever you hoped to RE on and/or leave to offspring...

Somewhere I read that copaxone's patent runs out within the next few years, and that several companies are lining up to ship generic versions of it, that may help your situation too.
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Copaxone patent expiration
Old 11-13-2007, 07:57 PM   #9
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Copaxone patent expiration

Originally Posted by FinanceGeek View Post
Somewhere I read that copaxone's patent runs out within the next few years, and that several companies are lining up to ship generic versions of it, that may help your situation too.
2014 (~$20K*7 years = $140K)

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