Health Insurance

[bookman51]

Just got word three months after applying and 8 days after the end of my health insurance coverage that my wife will not be covered under the health insurance I am trying to get from Blue Cross-Blue Shield.  She has some pre-existing conditions but nothing I (or her doctor) considers serious..some blood pressure, cholesterol issues.  BC-BS referred me to the state's CHIP (which BC-BS administers), and we are still eligible for the COBRA through my previous employer.  I think CHIP cost is 135% of usual costs of insurance (which is not cheap).  Anyone have any experience or recommendations regard COBRA, CHIP or altneratives?   My view is one more evidence that health insurance in this country is broken.  Three months to get an answer (and contrary to the one I got informally in the inquiry before retirement).  Thanks in advance.

 

[haha]

A reply that would be useful to you depends on your state of residence. In some states, coming off Cobra you are eligible for standard rate individual policies without being underwritten. In other states this may not be true.

So Cobra might or might not be useful to you. It only lasts 18 months. Is this enough to get you to Medicare?

Ha

 

[dumpster56]

Broken health care system usa? What? Really?

Hey we get what we deserve, big health insurance companies in business to MAKE MONEY!

Both parties stink dems and repubs, they all have health care and really do not give darn about the rest of the population.

Your wife SHOULD be covered PERIOD!

You should have medical insurance

We all should have medical coverage here in the greatest country on earth right?

 

[bookman51]

A reply that would be useful to you depends on your state of residence. In some states, coming off Cobra you are eligible for standard rate individual policies without being underwritten. In other states this may not be true.

So Cobra might or might not be useful to you. It only lasts 18 months. Is this enough to get you to Medicare?

Ha

Nope, It will not get to me to Medicare.  About five years short.

Thanks

 

[razztazz]

We all should have medical coverage here in the greatest country on earth right

Now wait a minute. Don't blame freemarket insurance companies.  If you cant afford insurance all it means is you're not striving hard enough and achieving enough to deserve it. At least that's the Business Model.

And where does it say in the Constitution that we all should have medical insurance, anyway? And by the same token where does it say in the Constitution that we all shouldn't be able to have it? (They never answer that question?)

Reliable, affordable medical insurance. It's the American DREAM! So, keep dreamin'

 

[bookman51]

Broken health care system usa? What? Really?

Hey we get what we deserve, big health insurance companies in business to MAKE MONEY!

Both parties stink dems and repubs, they all have health care and really do not give darn about the rest of the population.

Your wife SHOULD be covered PERIOD!



You should have medical insurance

We all should have medical coverage here in the greatest country on earth right?

I agree.  Hard to understand it all.  Thirty some years ago when I was in graduate school I did a paper on national health insurance.  At that time Ted Kennedy was pushing it and some observers thought something would happen in the next session of Congress.   Well, you know it did not.  Just read the book "Bait and Switch"  and recommend it.  Health insurance does a good job of chaining people to jobs and feeding a multibillion dollar industry.  Oh well, this thread soon could become a political tirade (billions for a war in Iraq but we cannot afford national health insurance!!!] and I just need some practical advice.  

 

[bookman51]

Now wait a minute. Don't blame freemarket insurance companies.  If you cant afford insurance all it means is you're not striving hard enough and achieving enough to deserve it. At least that's the Business Model.

And where does it say in the Constitution that we all should have medical insurance, anyway? And by the same token where does it say in the Constitution that we all shouldn't be able to have it? (They never answer that question?)

Reliable, affordable medical insurance. It's the American DREAM! So, keep dreamin'

Many years ago I worked in a county welfare office.  I learned as a young person that the safety net for the middle class is very thin.  The working class already know that, but the middle class is just learning it with corporate downsizing, exporting jobs, etc.   I doubt that it is going to get better.  I think we should demand the same quality of health insurance our congress people and senators have; or else they should have to give up theirs and purchase it privately.  That might get some action from them!!   As I wrote earlier, do not want to turn this thread into poltiical tirade but just need some practical advice.

 

[Martha]

What state do you live in? Answers are different for every state. Did you look at the Georgetown guide for your state at www.healthinsuranceinfo.net?

Most states that have risk pools require you to use up the COBRA first (though you need to apply while you are on COBRA).

HIPAA may also give you some rights to force insurers to sell you insurance. Again, your state of residence is important to know.

 

[Rich_by_the_Bay]

Nope, It will not get to me to Medicare. About five years short.

Hmm. Sounds like your wife (and thus you) is getting punished for taking care of herself, avoiding premature catastrophic illness by taking proper preventive measures. No one wants to pick up a few hundred bucks per year risk in order to avoid tens of thousands of risk decades hence.

If all Americans had at least catastrophic coverage from state or federal tax revenues, you would easily pick this up on your own. Let the carriers fight over coverage for the first $10K or whatever.

 

[bookman51]

What state do you live in?  Answers are different for every state.  Did you look at the Georgetown guide for your state at www.healthinsuranceinfo.net?

Most states that have risk pools require you to use up the COBRA first (though you need to apply while you are on COBRA). 

HIPAA may also give you some rights to force insurers to sell you insurance.  Again, your state of residence is important to know.

Nebraska

 

[scrinch]

My family and I are 7 months into a COBRA plan right now. It is exactly the same HMO coverage I had in my old job...same insurance co, same providers, same insureds. Because of the terms of a merger, I was able to get the COBRA coverage at company-subsidized rates rather than having to pay the full 102% premium. So far, so good. However, at month 5 the megacorp that I left decided to change the terms of the deal. They renegotiated the terms with the insurance company such that I now pay twice the premium and twice the copayments for otherwise identical coverage. We ex-employees) had a "special" open enrollment period in June where we could either re-opt into this HMO or get into the company's more traditional (less progressive) PPO plan.

Bookman, you asked for experience with COBRA. I guess I'm telling you this to say that under COBRA you get continuing insurance coverage, but you takes what you gets. I don't have such a bad deal, but in mid-year I got my premiums and copays doubled...and there was nothing I could do about it.

 

[bookman51]

My family and I are 7 months into a COBRA plan right now.  It is exactly the same HMO coverage I had in my old job...same insurance co, same providers, same insureds.   Because of the terms of a merger, I was able to get the COBRA coverage at company-subsidized rates rather than having to pay the full 102% premium.  So far, so good.  However, at month 5 the megacorp that I left decided to change the terms of the deal.  They renegotiated the terms with the insurance company such that I now pay twice the premium and twice the copayments for otherwise identical coverage.  We ex-employees) had a "special" open enrollment period in June where we could either re-opt into this HMO or get into the company's more traditional (less progressive) PPO plan.

Bookman, you asked for experience with COBRA.  I guess I'm telling you this to say that under COBRA you get continuing insurance coverage, but you takes what you gets.  I don't have such a bad deal, but in mid-year I got my premiums and copays doubled...and there was nothing I could do about it.

Thanks for the information. 

 

[Martha]

It looks like there are not a lot of options in Nebraska for those who are percieved as uninsurable.  Here is information on Nebraska's risk pool, CHIP:

http://www.doi.ne.gov/brochure/b_chip.htm

Your wife would want to qualify under option B, the option for HIPAA eligible people.  The would mean no pre-existing condition waiting period.  The HIPAA eligibility requirements are described in the brochure.  She likely will have to exhaust her COBRA benefits first.

Be sure to watch the time deadlines for applying. 

In Nebraska insurance carriers who offer individual insurance are free to turn people down based on health condition, are free to charge what they want, and are free to place elimination riders on their policies.  You could try working with an agent, but if BCBS won't cover her, the odd of getting coverage outside of CHIP are probably slim.

I echo Rich's comments.

 

[free4now]

Just to gripe about my situation:

Today I called BC to check on the status of my health insurance application (in California). I had sent them 63 pages of medical records that they requested on 6/23/06. I called them today 8/11/06 and the guy said basically "oops, we forgot to look at what you sent". Apparently they received the documents and imaged them on 6/26/06 and nothing happenned since then.

I'm five months into CORBA. I figure I might as well spend my 18 months applying for individual coverage, because it'll probably take that long to complete the application process This BC application started about three months ago.

 

[Andy]

That sorta happened to me too. I ended up with a waiver for cholesterol (but get this-they will pay if I have a heart attack or stroke :, a waiver on migraine headaches and a waiver on the oesteoarthritis in my back.

I debated about going to the high risk pool, but I figured the rates for that would rise much more rapidly than the regular pool and that pretty quickly I would be priced out of any insurance.

Even if you get into cheaper health insurance because you currently don't have any health concerns, that can change. As the well people in that group move because they can get something else less expensive, the pool you are in shrinks and your rates start rising rapidly. That has happen to me also.

I also think it is a disgrace that we are tied to our jobs because of health insurance.

 

[2B]

Well, you know it did not.  Just read the book "Bait and Switch"  and recommend it.  Health insurance does a good job of chaining people to jobs and feeding a multibillion dollar industry.  Oh well, this thread soon could become a political tirade (billions for a war in Iraq but we cannot afford national health insurance!!!] and I just need some practical advice.  

I have always advocated crucifixion for members of Congress. This is without regard to political party or position on the issue. If it isn't, they are.

There are many options that are never explored. I don't believe we are "entitled" to unlimited, tax payer funded health care but I do believe we are having the American taxpayer subsidize the uninsured and the rest of the world beyond what is reasonable.

 

[Gone4Good]

And where does it say in the Constitution that we all should have medical insurance, anyway? And by the same token where does it say in the Constitution that we all shouldn't be able to have it? (They never answer that question?)

Boo Hoo!

Where in the Constitution does it say you should be entitled to retire early and live off of the productive labor of your fellow citizens?

 

[REWahoo]

Where in the Constitution does it say you should be entitled to retire early and live off of the productive labor of your fellow citizens?

Ted? Is that you?

 

[razztazz]

[Where in the Constitution does it say you should be entitled to retire early and live off of the productive labor of your fellow citizens

Again, Where does it say we can't or shouldnt?

You areba communist. obscessed with rigging the game so that far far far too many people are chained in what is quite frankly almost aways UN-productive labor simply to acquire the bearets of encessituies. Then you use  sleight of hand buzz words like "rights" and "productive labor" and ask stupid questions  like "Where does it say we can...do this or that".

We dont need permission.  It's called freedom.  And we dont need to settle for somebody else who doesnt work (or their dupes and useful burn-out idiots like you) to rig the game to keep the rest of us working. I am for progress and moving forward. Less work. More lesiure. More stuff. Just like the suere rich who dont work and live of of government wealth redistibutionist programs 

A better and easier life for all. Otherwise just where have we mad any progress? The Wealth of Nations. Not the old fuedal model of slavery and all for One and the rest do all the work.

No, YOU can go back to boo-hoo'ing sonny. You wanna work... sonny?  Go right ahead but dont try to inflict it on other people. We can do better.

 

[REWahoo]

Let's try to keep it civil. The subject of the thread is Health Insurance, and name calling doesn't help persuade anyone of the wisdom of your point of view.

 

[alphabet soup]

We all should have medical coverage here in the greatest country on earth right?

"The greatest country on earth" doesn't measure up statistically in any quality of life category when compared with other industrialized countries.

Check it out.

 

[uncledrz]

Boo Hoo!

Where in the Constitution does it say you should be entitled to retire early and live off of the productive labor of your fellow citizens?

Not in those words. However, the Constitution does prohibit the government from depriving its citizens of their property without due process of law. So that if one is able to earn/save enough to generate an sufficient income to support oneself, that property cannot be taken away by the government without due process of law.

There is no "right" to retire early, or even to retire at all, in the Constitution. The best laid plans may fail miserably at some point. But the government cannot simply take away property, which is the basis, at least economically and fiancially, of retirement.

 

[Gone4Good]

And we dont need to settle for somebody else who doesnt work (or their dupes and useful burn-out idiots like you) to rig the game to keep the rest of us working. I am for progress and moving forward. Less work.

This is a joke, right?

Presumably you are in favor of national health care?  Did it ever occur to you that some one has to provide and pay for that service?  Did it ever occur to you that in a country with a national system the retiree is getting his health care paid for by the tax dollars of those still working? 

The joke is that you seem to want a system rigged in favor of the wealthy (like those who populate early retirement message boards) where "free" health care is provided to the non-working from the tax dollars of those who continue to work.  Furthermore, by raising taxes on labor to provide "free" services to "early retirees" it makes the goal of retirement that much harder for others to achieve.

Isn't a more equitable system one in which people pay for the services they consume - regardless of whether they are working or retired?



Edit / disclaimer: After re-reading razztazz comment I realized I have no idea what he is trying to say.

 

[Martha]

Even if you get into cheaper health insurance because you currently don't have any health concerns, that can change.  As the well people in that group move because they can get something else less expensive, the pool you are in shrinks and your rates start rising rapidly.  That has happen to me also.

This is an excellent point and a big problem with individual insurance.  

Keep in mind that you have more rights under HIPAA when moving from group coverage to individual coverage. Other than in guaranteed issue states, in most states  you have next to no rights when moving from an individual policy to another individual policy.  For example, if you buy an individual policy with exclusions and you develop a serious problem related to the excluded condition, most likely you would have a six month pre-existing condition exclusion if you moved to the risk pool for coverage of the condition.  Also, some risk pools don't allow you to join simply because your rates on the individual market are sky high and not affordable, but you could have joined  that pool when you were HIPAA eligible.  If you want to move from one individual plan to another which is not a risk pool plan, likely you can be turned down for any reason and charged any amount of money.

I suggest when shopping for individual insurance you be at least aware what protections you have under the law of your particular state.  The Georgetown guide is the best source at www.healthinsuranceinfo.net.

 

[Sheryl]

Martha has some excellent points.

In my state - Washington - we are able to move from our employeer's plan to an individual plan without underwriting (filling out "the questionaire" which would automatically kick me into the state risk pool). But once you get the individual plan, you are stuck with it. If you decide for any reason it's not working for you - tough luck! I'm going to have some serious research to do before I FIRE. Making this decision scares the crap out of me, when I think about how high the stakes are.