Health Insurance renewals?

[mikex]

I have another question for the experts here. Say I retire early and get an individual health plan. Then, after a period of time, I get a serious illness (cancer, or pick whatever you wish). My question regards any kind of renewals of health insurance plans. Are these plans sold like car insurance, renewed after a certain amount of time? If I got a serious illness, would there be a chance that the policy would not ne renewed after its term, or is this not applicable to health insurance policies? I want to make sure I know what I am getting into if I do this.

Also, where can I get an actual application form for any health ins. company to look at. I can't get to the forms of any of them on the internet without first entering a lot of personal information. I just want to see what the actual form looks like, how much is there to fill out for my own education. Anyone know how to get one to look at from any company as an example?

[Rich_in_Tampa]

Originally Posted by mikex

I have another question for the experts here. Say I retire early and get an individual health plan. Then, after a period of time, I get a serious illness (cancer, or pick whatever you wish). My question regards any kind of renewals of health insurance plans. Are these plans sold like car insurance, renewed after a certain amount of time? If I got a serious illness, would there be a chance that the policy would not ne renewed after its term, or is this not applicable to health insurance policies?

I'm not an expert but recent responses by others who are tell us that in most states (maybe all), a carrier cannot drop or non-renew you because of a new health problem arising while you were covered.

The carrier can choose to discontinue coverage of the entire group or raise the group' rates, though. And if you move out of area you may be vulnerable to being dropped.

[Martha]

Unless you buy insurance which is specifically sold as a temporary or short term policy, federal law under HIPAA provides that individual insurance is guaranteed renewable, with some exceptions. Here is the statute:

(a) In General.--Except as provided in this section, a health
insurance issuer that provides individual health insurance coverage to
an individual shall renew or continue in force such coverage at the
option of the individual.

``(b) General Exceptions.--A health insurance issuer may nonrenew or
discontinue health insurance coverage of an individual in the individual
market based only on one or more of the following:

``(1) Nonpayment of premiums.--The individual has failed to
pay premiums or contributions in accordance with the terms of
the health insurance coverage or the issuer has not received
timely premium payments.

``(2) Fraud.--The individual has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the coverage.

``(3) Termination of plan.--The issuer is ceasing to offer
coverage in the individual market in accordance with subsection
(c) and applicable State law.

``(4) Movement outside service area.--In the case of a
health insurance issuer that offers health insurance coverage in
the market through a network plan, the individual no longer
resides, lives, or works in the service area (or in an area for
which the issuer is authorized to do business) but only if such
coverage is terminated under this paragraph uniformly without
regard to any health status-related factor of covered
individuals.

``(5) Association membership ceases.--In the case of health
insurance coverage that is made available in the individual market only through one or more bona fide associations, the membership of the individual in the association (on the basis of which the coverage is provided) ceases but only if such coverage is terminated under this paragraph uniformly without regard to any health status-related factor of covered individuals.


There are many ways that insurance companies can try to get around these limitations. Though the practice doesn't seem too common as of yet. One is to increase rates dramatically for everyone for a particular product, but offer a new policy to those who are healthy. Another strategy is when faced with a large claim, go through the application for insurance with a fine tooth comb, looking for any omission which the insurer could claim amounts to an "intentional misrepresentation of a material fact."

Some states limit the amount the rates can increase based on age or health, but many don't.

__________________
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[Gumby]

Originally Posted by mikex

Also, where can I get an actual application form for any health ins. company to look at. I can't get to the forms of any of them on the internet without first entering a lot of personal information. I just want to see what the actual form looks like, how much is there to fill out for my own education. Anyone know how to get one to look at from any company as an example?

Use fake personal information to get the form.

[cute fuzzy bunny]

Heywood Jahblohme rides again...

[Gumby]

Jose Canusi

[Alan]

Originally Posted by Gumby

Use fake personal information to get the form.

That is what I did through eHealth

I recommend you try it just to see everything and get an estimate for a policy you think you could live with in retirement.

FWIW, Health insurance in the long run is my biggest concern for RE as well

[CuppaJoe]

Originally Posted by Alan

FWIW, Health insurance in the long run is my biggest concern for RE as well

Me too! My employer pays $473.00/month for my Kaiser (HMO) individual premiums which I assume I will pick up myself after I leave the job; (the statements are mailed to my home address and I bring them into work for payment). I pay the (non-Kaiser) eye doctor about $1,000/year and the (non-Kaiser) dentist bill runs between $2,000-$3,000/year so I figure on funding a separate account to cover all those expenses in retirement.

Does anyone know how Kaiser Permanente plans work after age 65? Is anyone on the Senior Advantage plan? I’m in Northern California, age 60.

[cute fuzzy bunny]

My dad uses the senior advantage plan. IIRC they're charging him around $90 a month. Pretty much works the same as their regular plan...you pay your co-pays and they cover everything else...no paperwork or other funny business.

There was no health check or complicated application process, pre-existing conditions or any of that hoo-hah.

Check the KP web site for current rates and co-pays, coverage limits and so forth.

[CuppaJoe]

Originally Posted by cute fuzzy bunny

My dad uses the senior advantage plan. IIRC they're charging him around $90 a month. Pretty much works the same as their regular plan...you pay your co-pays and they cover everything else...no paperwork or other funny business.

There was no health check or complicated application process, pre-existing conditions or any of that hoo-hah.

Check the KP web site for current rates and co-pays, coverage limits and so forth.

Thanks, Cute Fuzzy Bunny, I was hoping is was that way, but wanted some confirmation; that helps a lot in figuring how much to put into the insurance/medical expenses bucket.

[teejayevans]

Originally Posted by CuppaJoe

I pay the (non-Kaiser) eye doctor about $1,000/year and the (non-Kaiser) dentist bill runs between $2,000-$3,000/year so I figure on funding a separate account to cover all those expenses in retirement.

What are they charging you for??!! Assuming 2 cleanings/year and
1 cavity, should be about $500 and a eye exam should be about $100.
I know California is expensive, but wow?!
TJ

[CuppaJoe]

Originally Posted by teejayevans

What are they charging you for??!! Assuming 2 cleanings/year and
1 cavity, should be about $500 and a eye exam should be about $100.
I know California is expensive, but wow?!
TJ

Due to a recent $1,000 investment at the eye doctor I can see your post (through my new style frames with progressive coated lens) without double vision but, TJ, you are so right, that is too expensive!!! even in my neighborhood. I tried many doctors who really couldn’t get it right until I asked around and found a big guns opti(whatever) who got it just right; he has since died and his widow referred me to someone who also can do it but charges more since my good referral discount does not interest her.

Oh, and the dentist!! I wanted one close to work so asked around and was referred to a charmer who apparently gave me a fat discount (because of the person who referred me) until he retired and turned me over to what folks at Yelp.com describe as the best but way too expensive. The retiring guy sold me on the idea of investing in my teeth; and I’ve sort of bought it and plan to go there until I retire.

I have recent painful memories of my mom at the end of her 91 years needing a root canal which could not be done for a variety of reasons. When I was young I had a good dentist who charged my family almost nothing because when he was turned down by a dental school my dad showed him how to re-apply. He promised that he would practice in an area that had no other dentists within 20 miles. Most of my life I have had discounted dental care because I knew someone in the office. It’s one of those things I would average over a lifetime, another good example is vet. expenses–-a cat has minimal expenses for years and then I willingly pay the whopper bills toward the end.

I have one or two crowns done each year and I do believe they will last longer because the guy has "steady hands" and should be in business maybe 20 more years. He’s much colder than the old timer but I’m developing some rapport with him slowly. His office is the highest gleaming post-modern tech which put me off, spectacular view, etc. Displays his publications on a lap top in the lobby, x-rays are digital, sends out a newsletter blah blah, this is the future.

I’m thinking of investing in a nice looking bridge, what do you think?