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Limited Benefit Plans and Hippa
Old 12-05-2007, 11:01 PM   #1
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Limited Benefit Plans and Hippa

I was reading the article in Jan 2008 Consumers Report which advised against limited benefit plans.

My knowledge regarding one such plan is that it is a group policy, no medical underwriting required and limits to 5 doctor visits, $200 annual in prescriptions and maybe $10,000 maximum payout for everything.

Not a very good plan but I was interested in finding out if one participated in a plan like this then was offered cobra for 18 months would he be hippa eligible for his states hippa plans at the end of cobra?

Or would a full hippa plan not be offered since it was a limited group plan to begin with?
Seems to me that a exhausting cobra benefits from any group plan would make one hippa eligible but I would not know where to go to confirm this.

This limited plan may make sense for someone who hopes to become hippa eligible 18 months from now.

Any comments?
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COBRA? or Portability of Coverage?
Old 12-06-2007, 11:22 AM   #2
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COBRA? or Portability of Coverage?

Quote:
Originally Posted by Florida View Post
I was reading the article in Jan 2008 Consumers Report which advised against limited benefit plans.

My knowledge regarding one such plan is that it is a group policy, no medical underwriting required and limits to 5 doctor visits, $200 annual in prescriptions and maybe $10,000 maximum payout for everything.

Not a very good plan but I was interested in finding out if one participated in a plan like this then was offered cobra for 18 months would he be hippa eligible for his states hippa plans at the end of cobra?

Or would a full hippa plan not be offered since it was a limited group plan to begin with?
Seems to me that a exhausting cobra benefits from any group plan would make one hippa eligible but I would not know where to go to confirm this.

This limited plan may make sense for someone who hopes to become hippa eligible 18 months from now.

Any comments?
Where is the COBRA coming from? That's an employer sponsored benefit when the employer provides group coverage. If you don't have a employer sponsored group plan, you won't be eligible for COBRA.

Now, if what you want to do is establish health care coverage because you want to avoid a pre-existing condition wait period, as provided by the portability provisions of HIPAA, then, buying a limited benefit plan (or catastrophic plan) would meet the need of being able to switch carriers at a later date.
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Old 12-06-2007, 11:47 AM   #3
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Hum. Don't know anything about individuals buying into a group limited benefit plan. Are you sure that it is a group plan? What is the group?

Gotadimple, HIPAA eligibility requires that your last plan be a group plan. HIPAA doesn't apply if you buy a private individual or family plan and then want to switch plans.

Florida, even if you are not HIPAA eligible, you still may be eligible for a risk pool or guaranteed issue plan. However, not all states have these. You may be able to avoid the preexisting condition waiting period if you have credible coverage before hand. You will have to look at the state the specific risk pool/guaranteed issue program to see how credible coverage is defined.

However, if you are moving from one state to another, that state very likely will have residency requirement of 6 months before you can be covered on their risk pool. Be sure to check that out as well. The waiting period does not apply if you are HIPAA eligible.

Now isn't this nice and complicated? I sure would like a national system. There. Political point made.
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