Healthy? Insurers don't buy it

[Martha]

Originally Posted by astroboy

Just a couple questions on the HIPAA option -
If you are HIPAA eligible, you can't be put on a waiting list for a state's high-risk pool, right?
And in same case, I would guess there is no time limit yo can be in pool as long as pay premiums or waiting times between intervals on it (say if you get a you get a PT job with bennies for a period of time)?

If you are HIPAA eligible you might jump the waiting list on the risk pool, it depends on the state. But, the state could offer other options. For example, in Florida the pool is closed so instead you have to get a conversion policy from your current insurer and if that is not available, you will be able to buy a HIPAA qualified plan from a private insurer. There is no cost limit and coverage may not be as good. But you are right, if you are HIPAA eligible there will be a product for you, you just might not be able to afford it.

[astroboy]

Originally Posted by Martha

If you are HIPAA eligible you might jump the waiting list on the risk pool, it depends on the state. But, the state could offer other options. For example, in Florida the pool is closed so instead you have to get a conversion policy from your current insurer and if that is not available, you will be able to buy a HIPAA qualified plan from a private insurer. There is no cost limit and coverage may not be as good. But you are right, if you are HIPAA eligible there will be a product for you, you just might not be able to afford it.

I understand the affordability issue, but would whatever alternative plan that would have to be offered to you have to be at least no more than the what the risk pool premium would be?

[Martha]

Originally Posted by astroboy

I understand the affordability issue, but would whatever alternative plan that would have to be offered to you have to be at least no more than the what the risk pool premium would be?

This would be a state law issue. I do know that Florida does not restrict the costs of the HIPAA eligible plans to what would be charged in the pool. I don't know about other states. What state are you thinking about?

[tomz]

Originally Posted by Martha

This would be a state law issue. I do know that Florida does not restrict the costs of the HIPAA eligible plans to what would be charged in the pool. I don't know about other states. What state are you thinking about?

According to healthinsuranceinfo.net, however, Fl does restrict the costs of a conversion policy to "not more than 200% of the cost of the typical rate for an individual policy" and the company must offer you two "standardized policies that meet the state requirements for minimum coverage." I plan to retire at the end of 2007, use COBRA, move to FL, and get a conversion policy when COBRA runs out. As my retirement gets closer, I plan to contact the FL Dept of Financial Services and get more info. Megacorp just switched our health insurance again to United so I plan to wait until I get a better handle on COBRA costs before doing more research.

[Martha]

Tomz, I missed that for Florida conversion policies. Sorry! However, if no conversion policy is available there are no cost restrictions that I know of.

I don't know if a conversion policy would be available if you move from your insurance company's service area. Also, the insurance company may not be required to offer a conversion policy, it depends on the state law of the state where you obtained the insurance. For example, if your employer is partially self insured and only buys stop loss insurance, it may not have to offer a conversion policy. So be sure to check to see if you can get a conversion policy. I also don't know if the 200% limit would apply if you were insured in one state and then moved to Florida.

Note that the conversion policy may not offer as good coverage as your original policy so be sure to check the offerings and most importantly, the maximum out of pocket.

[tomz]

Originally Posted by Martha

I don't know if a conversion policy would be available if you move from your insurance company's service area. Also, the insurance company may not be required to offer a conversion policy, it depends on the state law of the state where you obtained the insurance. For example, if your employer is partially self insured and only buys stop loss insurance, it may not have to offer a conversion policy. So be sure to check to see if you can get a conversion policy. I also don't know if the 200% limit would apply if you were insured in one state and then moved to Florida.

Note that the conversion policy may not offer as good coverage as your original policy so be sure to check the offerings and most importantly, the maximum out of pocket.

I just found some more info on FL Guaranteed issue policies. The implication is that a few companies offer guaranteed issue policies if you are HIPAA eligible and they are not necessarily convesion policies. I.e, when your COBRA runs out, you could get a policy from more than one carrier and they couldn't do any exclusions. I plan to call the FL consumer helpline next week to get more info. In any event, I plan to be living in FL before COBRA runs out. Megacorp calls that a significant life change or something along that line and will allow me to continue COBRA in a new state. I'll report back here with what I find.