Pre-existing conditions and insurance

[Archman]

Is it possible for some one with high cholesterol and high blood pressure, which are under control with medication, and is currently insured through his employer, will be able to get individual health insurance if he becomes FIRE?

 

[KB]

you might be able to covert your group coverage to an individual plan with the same insurer. Some offer conversion plans with no underwriting.

 

[donheff]

You should find out whether your state has provisions for mandatory coverage for people coming off group plans. When my daughter got too old for my Federal Plan BCBS (her insurer since birth) denied coverage on an individual plan. Turns out DC negotiated a mandatory plan for such situations. She ended up under that plan with BCBS at a better rate than the standard individual plan. Go figure.

Would another option be to apply for an individual plan with the insurer in question and find out?

 

[Martha]

You might want to read our FAQ on buying private health insurance: http://www.early-retirement.org/forums/f47/faq-archive-buying-private-health-insurance-30756.html

There is one agent who posts somewhat regularly here, dGoldenz. If he stops by he might have some idea as to whether there are any companies that will accept you, or accept you with exclusions/riders, which only some states allow.

I suggest talking to an independent insurance agent in your state. He will have the best feel for what insurers in your state accept.

 

[dgoldenz]

Is it possible for some one with high cholesterol and high blood pressure, which are under control with medication, and is currently insured through his employer, will be able to get individual health insurance if he becomes FIRE?

Will probably depend on your height/weight and what state you're in. Most companies have a "three strikes" rule where three co-morbid conditions (overweight, HBP, high cholesterol, smoker) will cause an automatic decline. If the numbers are under control and you don't have a "rateable build" you could qualify with most, if not all, companies here in VA, not sure about what companies offer in your state.

If you request a quote online, you will probably get called by 4-10 agents. Do your research, know what questions to ask, and "qualify" the agent, then listen to their advice. Some may be dumber than a box of rocks, others may know the market like the back of their hand. If you can hear people talking in the background like a call center, move along. Commissions have been drastically cut for most companies starting in 2011 though, so a lot of agents are packing up their bags and moving on to other types of insurance.

you might be able to covert your group coverage to an individual plan with the same insurer. Some offer conversion plans with no underwriting.

Conversion plans are usually very expensive compared to fully underwritten plans. Keyword is usually.

 

[CyclingInvestor]

At least in California, after COBRA is exhausted 18 months after retiring, HIPAA allows you to get insurance no matter what conditions you have as long as you follow the rules carefully. However, the price can be high.


Frequently Asked Questions about Portability of Health Coverage and HIPAA

 

[nwsteve]

I just went through a very similar conversation with my broker. We get our insurance through my C Corp consulting practice but it is a high deductible policy with company picking up the deductible amounts. I needed to be sure when the company stops (SER) and no longer provides coverage, that my wife (an employee) can convert to an individual plan without pre-existing.
What surprised me is that UNLESS you are coming from a group plan, insurers (in WA State) can apply a pre-existing condition limitation for anyone coming from a high deduct plan. In WA, you must have been with a group plan for 18 continuous months and go directly to your individual plan not to get hit with the pre-existing. Pre-existing applied to anything being treated in the previous 6 months. Reinforces to get clarity on definitions and timing.
Turns out I can keep the company plan going longer than I thought so should still be able to insure even if I am medicare eligible.
Nwsteve