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Old 09-04-2012, 11:34 AM   #41
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Preexisting conditions usually lead insurance companies to deny coverage. In some cases they offer riders or exclude coverage for certain conditions. If you have group or employer policy HIPAA regulations implemented in most states enable you to keep that policy for 18 months if you leave the group.
I believe it's COBRA for 18 months, then only if you haven't let the coverage lapse, HIPAA kicks in. Your other option is to try to convert your COBRA policy to an individual policy (not sure if you would talk to HR or the insurance company), again this only works if you don't let the coverage lapse. Once you have gone 1 day without insurance, your options become limited. HIPPA will run about ~200% of the COBRA rate, so you can guessestimate your costs that way. For those with preexisting conditions, it's still the best deal.
The world is your oyster if you are perfectly healthy.
TJ
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Old 09-04-2012, 01:09 PM   #42
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Dear ALL, thank you so much, for all the information, and advice. I am so fortunate to have found this Forum in 2009. I have learned and continue to learn so much from you ALL! With much gratitude! Retire 2014!
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Old 09-04-2012, 01:14 PM   #43
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I believe it's COBRA for 18 months, then only if you haven't let the coverage lapse, HIPAA kicks in. Your other option is to try to convert your COBRA policy to an individual policy (not sure if you would talk to HR or the insurance company), again this only works if you don't let the coverage lapse. Once you have gone 1 day without insurance, your options become limited. HIPPA will run about ~200% of the COBRA rate, so you can guessestimate your costs that way. For those with preexisting conditions, it's still the best deal.
The world is your oyster if you are perfectly healthy.
TJ
I've always thought of HIPAA as an Act to protect medical privacy etc. Does HIPAA have anything to do w/ offering health insurance? I've researched online on HIPAA and its website seems to indicate that it is about medical data privacy protection, etc. Found nothing on rates or coverage for those with pre-existing condition, etc. Please clarify. Thank you so much.
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Old 09-04-2012, 01:55 PM   #44
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HIPAA guarantees the right to purchase individual health insurance, if the rules are followed.
All states have some type of HIPAA plan, it may be the state high risk pool or a private company.

The details are here...

http://www.cms.gov/Regulations-and-G...y_Criteria.pdf
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Old 09-04-2012, 02:05 PM   #45
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HIPAA is primarily regulations of health care insurance for employers and insurance providers. COBRA is a different set of regulations that give employees with current health care coverage certain rights. They are different health care regulations that overlap. One reason health care and insurance is so difficult to understand.
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Old 09-09-2012, 08:35 AM   #46
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and thats just downright wrong ! I hate to hear that people cannot get health insurance.

I'm going to show my stuipidity right now ... if my position gets eliminated that qualifies me for unsubsidized HI. Does that mean I get the same rate as someone who does not have pre-existing conditions ? I'm sure the costs will be awful but at least I'd be covered.
Live and Learn,

In my state, you can quit voluntarily and still get COBRA for 18 months. You do not have to be laid off to get COBRA. And the COBRA rate would be the same rate they are paying for you now, which would be the same rate as people in your company with no pre existing conditions ( 99 percent sure, someone correct me if necessary).

In my state, the only way you would not be eligible for COBRA would be if you were fired for "gross misconduct".

It seems to me you could just plain quit and get COBRA at the group premium rate.

I called my HR person, and she said yes, I could quit and get COBRA for 18 months, at the low group rate premium I now have. I would be paying $385 a month for decent HI, since $385 a month is what they are paying in premiums for me now.

I don't think your pre existing conditions would affect your COBRA premium.


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Old 09-09-2012, 08:43 AM   #47
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HIPAA is primarily regulations of health care insurance for employers and insurance providers. COBRA is a different set of regulations that give employees with current health care coverage certain rights. They are different health care regulations that overlap. One reason health care and insurance is so difficult to understand.
Not to mention that every state implements the COBRA & HIPAA differently, you need to check the guidelines for your state.
TJ
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Old 09-09-2012, 11:18 AM   #48
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The OPs question is difficult to answer because so much of healthcare insurance is dictated by where you live. ACA might bring in some uniformity, but with the possibility of opt outs and the resistance coming from many states there will still be enormous geographical differences.

So if you ER you cam get insurance through COBRA and after 18 months you will have to buy it on the private market. In both cases you will have to cover the entire cost and as health insurance and care is expensive in the US you will have to carefully consider your budget. In many states a preexisting condition will make your search for insurance difficult, while in some there are laws that protect you from being denied coverage.

If you want to investigate the system in Massachusetts that Mitt Romney did a lot to develop and was the model for ACA there is a state website where you can to compare policies and buy insurance. The ACA wants every state to provide a similar website for people to buy insurance.......but how or if that gets implemented is still pretty unsure, but the link below will show you how it works in MA.

https://www.mahealthconnector.org/portal/site/connector
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Old 09-09-2012, 11:22 AM   #49
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It seems to me you could just plain quit and get COBRA at the group premium rate.
Well you need to check. I remember when DH retired he went from the rate employees pay for family coverage to the subsidized retiree rate which was a lot less than the COBRA rate. For an individual and spouse for example the rates were something like this for individual coverage monthly:

Employee rate - $95
Subsidized retiree - $359
COBRA or unsubsidized retiree - $893

So, COBRA coverage was a lot, lot, lot more expensive than the employee rate or the subsidized retiree rate.
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Old 09-09-2012, 02:17 PM   #50
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<snip> . For an individual and spouse for example the rates were something like this for individual coverage monthly:

Employee rate - $95
Subsidized retiree - $359
COBRA or unsubsidized retiree - $893

So, COBRA coverage was a lot, lot, lot more expensive than the employee rate or the subsidized retiree rate.
I have 20k per year budgeted for medical costs (HI, copays, other out of pocket) for DH and I combined. As crazy as it sounds, I'd take the $893 per month in a heartbeat and be extremely happy !
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Old 09-09-2012, 02:24 PM   #51
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I have 20k per year budgeted for medical costs (HI, copays, other out of pocket) for DH and I combined. As crazy as it sounds, I'd take the $893 per month in a heartbeat and be extremely happy !
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Old 09-09-2012, 02:36 PM   #52
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I have 20k per year budgeted for medical costs (HI, copays, other out of pocket) for DH and I combined. As crazy as it sounds, I'd take the $893 per month in a heartbeat and be extremely happy !
My GF just got a new job and her health insurance coverage is from 1980s. $100 max hospitalization deductible, $10 office co-pays and $10 script. Can put spouse on for around $200 a month. I think she needs to propose to me and not quit her job until I die!
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Old 09-09-2012, 02:43 PM   #53
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My GF just got a new job and her health insurance coverage is from 1980s. $100 max hospitalization deductible, $10 office co-pays and $10 script. Can put spouse on for around $200 a month. I think she needs to propose to me and not quit her job until I die!
For those benefits I wouldn't wait for her to propose to you, I'd be the one making the moves
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Old 09-09-2012, 02:46 PM   #54
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For those benefits I wouldn't wait for her to propose to you, I'd be the one making the moves
What is funny, Alan, was I always had to listen to her anti union "rants". Now that she is suddenly benefitting from their benefits her memory has gone bad all the sudden.
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Old 09-09-2012, 02:47 PM   #55
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What is funny, Alan, was I always had to listen to her anti union "rants". Now that she is suddenly benefitting from their benefits her memory has gone bad all the sudden.
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Old 09-09-2012, 03:00 PM   #56
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Well you need to check. I remember when DH retired he went from the rate employees pay for family coverage to the subsidized retiree rate which was a lot less than the COBRA rate. For an individual and spouse for example the rates were something like this for individual coverage monthly:

Employee rate - $95
Subsidized retiree - $359
COBRA or unsubsidized retiree - $893

So, COBRA coverage was a lot, lot, lot more expensive than the employee rate or the subsidized retiree rate.
+1
Cobra entitles the policyholder to continue with the same coverage for 18 months but paying the full, unsubsidized rate plus and additional 2%. Some businesses may offer better terms but that is entirely voluntary on their part.
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Old 09-09-2012, 03:28 PM   #57
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My GF just got a new job and her health insurance coverage is from 1980s. $100 max hospitalization deductible, $10 office co-pays and $10 script. Can put spouse on for around $200 a month. I think she needs to propose to me and not quit her job until I die!
Oh come on - where's the justice ! ? Your HI costs are low, hers are low and mine is going to be more than most peoples mortgages !

(PS: I agree with Alan ! get moving )
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Old 09-09-2012, 08:02 PM   #58
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I suppose you have already considered this, but I didn't see it mentioned. If you have pre-existing condistions the chances of purchasing individual health insurance is slim to none. You can't purchase it at any price because they will not sell it to you, or if they do it come with riders and exclusions for the very thing you need the insurance for.

This is where COBRA comes in. If you take COBRA, use it up, you then become HIPAA eligible which you are guaranteed the right to purcahse a HI policy. What that is varies between states. It can be the state risk pool or a conversion policy etc.

If you don't use COBRA then you loose the HIPAA protection. For a family coming off a highly subsidized, low dectuctible "cadillac" plan then it is very expensive. But for single coming from high deductible plan to start with it's much better than fighting the insurance companies ( you can't win ).
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Old 09-10-2012, 01:05 PM   #59
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I suppose you have already considered this, but I didn't see it mentioned. If you have pre-existing condistions the chances of purchasing individual health insurance is slim to none. You can't purchase it at any price because they will not sell it to you, or if they do it come with riders and exclusions for the very thing you need the insurance for.

This is where COBRA comes in. If you take COBRA, use it up, you then become HIPAA eligible which you are guaranteed the right to purcahse a HI policy. What that is varies between states. It can be the state risk pool or a conversion policy etc.

If you don't use COBRA then you loose the HIPAA protection. For a family coming off a highly subsidized, low dectuctible "cadillac" plan then it is very expensive. But for single coming from high deductible plan to start with it's much better than fighting the insurance companies ( you can't win ).
Thank you for this. I did know this but it was somewhere in the back of my mind rather than right up front where it belongs.
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