Some BCBS plans will let you move anywhere and keep the policy

[september]

I just discovered this forum, read most of the recent threads related to portability of individual hlth. insur....I found it very interesting because I just spent the past few weeks researching this issue (prior to reading this forum). The main point I want make, first, is: there is at least one (and I believe there's a few) BCBS individual PPO plans that will allow you to move anywhere in the US (permanently) without having to cancel the original policy (and get a "conversion"). But I would like to get your comments on this, and whether you actually believe what the plan is saying. (I'm still slightly skeptical, because it seems too good to be true). I don't remember the names of the expert posters off hand, but the agent/broker on the board says, I think, the none of the BCBS plans will let you do this...A woman (name) on the board said this also (but used the word "typically will not let you....". But one person on the board talked about moving from a particular state (i don't remember which) to Texas and not having to cancel over a very long period of time. Here's what I learned from my own BCBS plan on the east coast of USA, and i did ALOT of research on this (and I will tell you which plan it is, later on).. Here is a list of points of evidence, some of which I consider strong, and some weak....but they all point to the "good news".

(1) strong evidence: The contract states, in an amendment dated 10/02:
"Contract is amended to add the following: A members coverage will not be terminated based solely on the fact that the member no longer meets any residence requirements stated in the evidence of coverage. This amendment is issued to be attached to the evidence of coverage". (signed by the president of the bcbs plan/co.). (My comments: the earlier EOC says you must maintain a legal residence for at least 6 months in the service area".

(2) The website (available to the public), in the FAQ section of the plan says: "What to do if you move away from the service area: You can continue to use the blue card program anywhere.......".

(3) When you call customer service (after being a member): they say you can move anywhere and keep the plan.

(4) when you call "sales", about 70% say you can move anywhere, and about 30% says you have to cancel. (But the people who sound the "most on the ball" at the sales number are the ones who say you don't have to cancel".

(5) I called the BCBS national association, who typically will NEVER answer questions from the public. It was hard to reach anyone there who would talk, but I did reach someone in an adequately high-level position who said she talked the "legal dept." and was told there are "a few" bcbs plans that will let you move anywhere. Apparently the national association tells the plans they have to cancel you if you move, but it's superceded by fed/state laws.

(6) And now for the AMBIGUITY: Is this "contract" (in #1) valid? I called the STATE (health ins. examiners). They really were not totally sure, but said they did NOT think you could move out of the service area and keep the plan (but to tell you the truth, i didn't tell them exactly which BCBS plan/co. i was referring to, because at that time, i didn't want to "get the plan in trouble" or have them investigated (or make them change the rules, which may be silly on my part). The mentioned a state law (number) which i looked up, and it basically just said plans CAN cancel you if you move, but not that they HAVE TO. Anyway, the 2 people at the state where very sceptical about whether the contract is valid and one said "maybe it's unapproved". (??).

Comments welcome, and also on whether you would feel comfortable moving away, knowing that if they cancel you YOU ARE SCREWED (i would be).

[september]

After posting, i re-read it and noticed about 5 typos....but none were "crucial" and i think the post is readable.

[REWahoo]

Originally Posted by taxmar1

After posting, i re-read it and noticed about 5 typos....but none were "crucial" and i think the post is readable.

Welcome to the forum.

You will note there is a "modify" button in the upper right hand corner of your post (but not others). Click on that and you can make changes/corrections, but it is good etiquette to include a note at the bottom of the modified post to describe what changes you made ("corrected typos", etc.).

[kramer]

Hi Taxmar,

Great post. I have done a lot of research in this area (see recent thread I started on this forum), but have not contacted BCBS since they just seemed inherently non-portable and poster MKLD confirmed this in her service area (Colorado).

Actually, based on your post, I still tend to think non-portability is basically an issue for BCBS except in limited cases. Since BCBS is really 50 different entities, it is possible that a few of them have reciprocal agreements that allow moving without underwriting. Many of the points that you write about could be referring to moving within a state, or they will continue to provide services as long as you return to the original area of coverage for those services if you have changed states. [perhaps I am too skeptical ;-]

Also, when asking representatives questions, it is important to add the word "underwriting". It is not enough to ask if you move can I continue with BCBS coverage. One needs to ask if you can maintain the same policy without undergoing underwriting again. Otherwise, many customer service representatives might just look to see if BCBS is available in your new state and say sure, no problem, you can get coverage in the new area . . . without realizing that for someone with a preexisting condition this could be a problem. (I suspect you realize this, but just making sure, and trying to help other posters)

I am applying for Aetna health insurance. They told me in writing (well, in an email, a very carefully written email) that it is portable without underwriting. They are only in around 15 states or so, though, but cover the areas that I care about. I would rather go with Assurant Health which is everywhere but their prices are not competitive near my new location (even though they are very competitive everywhere else that I have looked).

Kramer

[september]

Hello...yes, i had read some of your previous posts. I'm talking about "without underwriting" and also "moving ANYWHERE" when I refer to the issue of "moving and keeping the policy" (and that's also what the people i've been querying are talking about...dont' worry). MInor update: I talked to one more person in the state govt, and although she didn't know the moving rules as stated in my contract (which i posted earlier), she said it didn't violate any state regulations if that's what the contract says (I usually talk to people in the state govt. called "examiners", many of whom handle complaints)...none of them really seem to know that much.
She did stress that if the contract says you can move and keep the plan, then they're bound by it (obviously)....and the contract does say that, doesn't it? (then again, maybe it says....we will not cancel you if you move, but will cancel you if you move AND IF you file alot of claims from outside the area)....nah...i doubt that's what #1 (in my first post) means.

One other point: Nowhere in any contract/documentation or any verbal info. from my plan/company has there been any mention that you have to notify them if you have a change of address or move out of the area, which is another "bit" of evidence i would add to the other ones.. In fact, I use a mailbox company for the past 5 years, and i probably would keep that address for quite a while even if i move away, because i like to get my mail forwarded to me wherever i am (i travel alot internationally also).

[Goonie]

I just attended an insurance seminar the other night that was sponsored and put on by my pension fund people. Our pension fund endorses health, dental, medicare supplement, LTC, and that sort of thing, through 4 different insurance companies. One of the companies was BCBS, and the reps said that those policies are portable or whatever you want to call it.....as long as I (or whoever) signed up while living here in IL, then the policies were good ANYWHERE in the America. We couldn't move to another state, and THEN sign up.....we had to sign up here in IL, and THEN we could move out of state, and the policy would stay in effect as long as premiums were paid up.

I read all the paperwork, manuals, and notes that they passed out, and it does in fact state that in writing!

[Goonie]

Originally Posted by kramer

Also, when asking representatives questions, it is important to add the word "underwriting". It is not enough to ask if you move can I continue with BCBS coverage. One needs to ask if you can maintain the same policy without undergoing underwriting again. Otherwise, many customer service representatives might just look to see if BCBS is available in your new state and say sure, no problem, you can get coverage in the new area . . . without realizing that for someone with a preexisting condition this could be a problem.

I read this after my previous post, and the reps did say (and it was in the handouts) that you do NOT have to go through the underwriting again, that you just keep your current policy "as is", no changes necessary when/if you move out of state.

[kramer]

Wow, thanks guys. I have my Aetna application all filled out on-line and ready to push the button for submittal. But maybe I will research BCBS this weekend as an option, too. Maybe I have been in too much of a hurry.

Goonie, technically your research might not apply to individual policies -- it could be part of the group deal for the union or they could treat group deals differently because they are inherently less risky for the group of BCBS companies. But it is still convincing and useful information. Thanks.

Thanks, Taxmar. Yeah, I don't like the idea that I can't really see any contract language before applying and getting accepted. And it is dangerous to over-apply to too many insurance companies because any rejection must be explained in all subsequent insurance applications for the rest of your life.

If I find anything new beyond what you guys have already shared, I will be sure to post here.

Kramer

[kramer]

This is a direct email quote from a Wellpoint rep in California (I had to search through my email, quote is from the last two weeks, Wellpoint is a BC and BCBS licensee in California and 13 other states -- http://www.wellpoint.com/business/default.asp ). This email was in response to a portability without underwriting question:

If an Individual purchases a plan with BC of CA and they move to another state, the only type of plan they can apply for without underwriting is a conversion policy. They have to apply for this type of plan within 30 days of transferring to another state. These plans are generally expensive since there is no underwriting.

Now, BC of CA has just started allowing Tonik members to transfer their existing plan to an equivalent Tonik plan in CO and NV. Also, if they are on any other PPO they can transfer to an HSA high ded $5000 plan.

Eventually, we will offer this to other states WellPoint operates in but for know these are the only two states. Please let me know if you have questions.

BTW, I do not really understand the difference between BC and BCBS. Wellpoint is a licensee for both and I was asking for anything that they had that was portable -- I was not specifically asking about BC or BCBS, in particular. I don't know if dealing with Wellpoint is different than dealing direct somehow.

From this, it appears to me that there still might be quite a few limitations on portability -- they are technically allowing moving without underwriting (thus, technically fulfilling contractual obligations?), but you may need a much higher priced conversion policy. The floor is open for interpretations!!

Kramer

[teejayevans]

Originally Posted by kramer

This is a direct email quote from a Wellpoint rep in California (I had to search through my email, quote is from the last two weeks, Wellpoint is a BC and BCBS licensee in California and 13 other states -- http://www.wellpoint.com/business/default.asp ). This email was in response to a portability without underwriting question:

I really be surprised if it doesn't depend on whether you move to one of the other 13 states.
Isn't it the underwriter that matters, BCBS is just an agent?

I asked the question of NC BCBS and they told me to talk to the PA BCBS (which has multiple companies,
they've split the state up into regions). At that point I decided that I needed to find a different company.
TJ

[kramer]

Originally Posted by teejayevans

I really be surprised if it doesn't depend on whether you move to one of the other 13 states.
Isn't it the underwriter that matters, BCBS is just an agent?

I asked the question of NC BCBS and they told me to talk to the PA BCBS (which has multiple companies,
they've split the state up into regions). At that point I decided that I needed to find a different company.
TJ

TJ, I think from the quote (and other information that I have heard) that, at least here in California, the policy is not portable to other states if you declare a change of residency. I don't know how they could have been more clear about that.

Colorada and Nevada (mentioned in Wellpoint's reply) are part of the states that they cover. So the guy was talking about the region that they cover, and it still was not portable except in very limited situations.

It is possible that this varies by the state you started in. This wellpoint rep was specifically addressing my question about starting in California. As Goonie pointed out, there are apparently exceptions for group plans, too.

When I was working with a broker, at first he assumed that health insurance policies were mostly portable (I was surprised that he didn't know the answers off-hand). But research with his colleagues started to reveal these limitations.

I sent in my Aetna application last evening It will be $85/month, HSA-eligible with $5K deductible if I get it (big if, of course, I am not a shoo in). Also, to answer the other question on a different thread that you asked -- I read through the exclusions and I think it will cover me overseas after the $10K deductible (nowhere is it excluded -- of course, the final contract will really tell). Presumably, they would reimburse up to customary charges only. I'll be sure to report details when I know.

One disadvantage of Aetna is that their individual health plan network is not in all 50 states (or even half of them). So I could be out-of-network while traveling in the US, too, if something were to happen. But they are located in states where I will be the vast majority of the time. And Aetna is expanding in this market.

Kramer

[teejayevans]

Originally Posted by kramer

I sent in my Aetna application last evening It will be $85/month, HSA-eligible with $5K deductible if I get it (big if, of course, I am not a shoo in). Also, to answer the other question on a different thread that you asked -- I read through the exclusions and I think it will cover me overseas after the $10K deductible (nowhere is it excluded -- of course, the final contract will really tell). Presumably, they would reimburse up to customary charges only. I'll be sure to report details when I know.
Kramer

Kramer, since you said you are no longer using a broker, did you go through one of the
rate finder web sites to apply? It's still too early for me to apply, I'm just lining up my ducks,
thx
TJ

[kramer]

Originally Posted by teejayevans

Kramer, since you said you are no longer using a broker, did you go through one of the
rate finder web sites to apply? It's still too early for me to apply, I'm just lining up my ducks,
thx
TJ

Hey TJ, I just got approved! Details are here:
http://early-retirement.org/forums/i...3214#msg253214

You are correct that I ended up not going through my broker. He didn't handle Assurant Health or Aetna. He did cover Nationwide, which was my third choice. And I told him that I would go through him if I ended up going for that. But I did share everything that I learned with my broker, which he greatly appreciated -- I ended up giving him much more info than he provided to me. In fact, I was wondering if there was some way I could send him some money legally. I am not sure if a broker can receive a fee for services compensation legally.

I actually applied directly off Aetna's web site. But they do pop up in ehealthinsurance.com. But make sure you know all the carriers for your area. For instance, I noticed that Assurant Health stopped popping up in ehealthinsurance.com now in certain locations. But you can go directly to their web site and get coverage and quotes for these same areas. Also, Nationwide does not appear, either. So make sure you do your independent research, too.

Kramer

[Helena]

You will need to check with your home BCBS plan about
your specific policy.

Group policies have to be portable, since most large
groups [ie, Wal-Mart] have members in multiple states.

BCBS ID cards that have a small suitcase logo enable
the member to see providers contracting with other
BCBS plans in other states and take advantage of their
provider contract [which usually gives you discounts.]
This interplan BCBS system is called, Blue Card.

[pedorrero]

Approaching the question from a slightly different angle: I have BCBS (of FL) that I got as "Guaranteed Issue." FL is by no means a guaranteed issue State! I tried, and was turned down, in FL and another State, due to the old "pre-existing condition(s)" (although in my case, fortuantely, they appear to be quite minor or even have gone away.) No matter. Most Co.'s will drop you like a hippie dropped acid, if they don't have to offer you coverage. I qualified under the HIPAA (similar to COBRA?) laws that allow conversion to a BCBS plan if you were previously covered by a group plan yackety smackety blah blah blah ...

The point is, and I am quite sure about this: this HIPAA protection is imposed on ALL States. You must be offered at least one group plan usu. by BCBS in those States.

If this is true, then it would seem reasonable that an existing BCBS policy holder such as me, would qualify to go to another State's HIPAA-imposed plan.