Apply for health insurance: Specific questions

[kramer]

Quote:

Originally Posted by Peter OK, but my late wife's final illness cost the insurance company well over $1MM over a 2 year period. That was 10 years ago ... so the point about caps is a good one. However, you may find that you need to change policies anyway. Elsewhere, Martha has pointed out how insurance companies increase rates for sick people .... basically the trick is to increase rates dramatically for the whole group. Healthy people then switch to a less expensive policy, leaving the sick guys with higher rates. Then the process repeats. And, by the way, you don't have to be all that sick. Slightly elevated BP will do it for sure. So will recreational Viagra Peter

Well, I can hope for the best. I am not sure what else I can do. Also, I will be accumulating a reserve in my HSA as a buffer against future health care costs. It is like everything in else in life, I guess -- there are just things that I can't predict now and I will try to be flexible in the future.

Kramer

[kramer]

Quote:

I wasn't even able to convert my $5K deductible, completely portable, "fee-for-service" policy to an HSA, because a switch to an HSA-qualifying policy required underwriting, which, unfortunately for me, I couldn't pass.

Yes, and for a high deductible policy like I have -- there is no way I could ever switch to a low deductible policy without underwriting or to a higher cap. I do feel very comfortable with this level of cap.

I see the higher risk areas as: insurance company going out of the business, the pool gets messed up or arbitraged like Peter mentioned, I get a chronic condition that requires payment of full deductible (plus a few uncovered costs) each year, and the highest risk factor of all that I see is California fundamentally changing their health insurance laws possibly causing companies to leave the state or significantly raise their premiums. I can only try to remain flexible as I can be for any of these situations.

As a super backup plan, I have familiarized myself with the private health markets in developed countries with efficient, inexpensive private health systems (Mexico, Thailand).

Kramer

[FIRE'd@51]

Quote:

Originally Posted by kramer Well, I can hope for the best. I am not sure what else I can do. Also, I will be accumulating a reserve in my HSA as a buffer against future health care costs. It is like everything in else in life, I guess -- there are just things that I can't predict now and I will try to be flexible in the future.

I agree that you have diligently done your homework and found what appears to be the best possible solution, so please don't think I am criticizing you, because I am not. This is just another one of those "quirks in the system" that MKLD likes to pretend doesn't exist. Also, I am not criticizing her. She is very knowledgeable and conscientious, so far as I can tell. If I lived in CO, I would want her for my agent.

It's just that this health insurance situation has been the biggest "bug-a-boo" for me in my life after FIRE. I described my experience with Mutual Of Omaha in a post above. I just haven't found a way to adequately hedge the many things that can go wrong.

[kramer]

This is also a reminder to always be aware of the state high risk pool regulations, fees, and limits in your particular state. You never know when you may need it. And to also make sure that you have saved enough to confront most situations to reduce risk, even if the risk can never be fully eliminated.

In fact, looking at the risks, I have found that my biggest risk reducer is simply a willingness to move. Not everyone is willing to do that.

I knew that I was taking some risk when I semi-FIREd recently. (Semi)Retiring early is a privilege, not a right. But it sure beats the alternative And it probably would not have been possible this quickly had I been born in any other country. Or if I had been unhealthy. I am very thankful.

Kramer

[teejayevans]

Quote:

Originally Posted by kramer The application is so detailed that there is no way you can fill it out without complete health records so prepare accordingly!

Kramer,
Congrats on the getting approved! Can you be more specific on health records??
Do they ask for your LDL, HDL levels?? Specific questions that required you to
contact your physician? You said they only go back 10 years? I ask because I was
hospitalized 30+ years ago and couldn't tell you anything about it.
BTW, if you are still in good health and the insurance company starts increasing your
rates, nothing stops you from switching, right?
TIA
TJ

[mykidslovedogs]

Quote:

Originally Posted by FIRE'd@51 It's just that this health insurance situation has been the biggest "bug-a-boo" for me in my life after FIRE. I described my experience with Mutual Of Omaha in a post above. I just haven't found a way to adequately hedge the many things that can go wrong.

The whole thing with Mutual of Omaha stinks, and I do realize that these things do happen. I just don't think nationalization is a good solution, as IMO, just as in your situation, nationalization will eventually hurt more people than it helps.

It's very unfortunate that poorly-thought-out legislation fails to take into consideration the consequenses to the masses of people. The short-sightedness of today's legislation scares me. It's always well-intentioned, put into place to help the small minority of people who, by no fault of their own, ended up in a bad financial situation with their health. But legislation like community rating is always put into place without regard for the vast majority of people who will be aliented after the legislation passes (as happened in the case with Mutual of Omaha).

No, Mutual of Omaha did not leave the market because of greed...they left the market because someone thought it would be a good idea to force community rating on them, which left the individual market unprofitable for the company. I'm sure community rating in Virginia and a few other states helped a quite a few people....meanwhile, it left a larger number of responsible people uninsured when their insurance company could no longer be profitable in the market because of the legislation.

BTW - State of Colorado Senate just passed community rating for small group insurance (HB1355). A sad testament for the market. First, they are going to take away carrier's ability to charge up to 10% more for the unhealthier groups. This will simply result in higher indexed rates for all groups. Next year, they are going to take away the ability for carriers to offer up to 25% off for the healthiest groups. This will result in huge rate increases for the 62% of groups that are now getting discounts. Many of these healthier groups will leave the market due to cost, so rates wil again rise at that time to compensate for the loss of healthy lives from the group markets.

I'll let all of you know the progress as we begin to lose competition. I am sure we will have lots of carriers leaving the market soon, and rates will rise in response to loss of competition. In this case, everyone will lose, including the people the bill is supposed to help!

[kramer]

Quote:

Originally Posted by teejayevans Kramer, Congrats on the getting approved! Can you be more specific on health records?? Do they ask for your LDL, HDL levels?? Specific questions that required you to contact your physician? You said they only go back 10 years? I ask because I was hospitalized 30+ years ago and couldn't tell you anything about it. BTW, if you are still in good health and the insurance company starts increasing your rates, nothing stops you from switching, right? TIA TJ

TJ, basically the form I filled out asks for anything that was abnormal during the last ten years by category of body function (circulatory disorders, skin disorders, etc.) So if anything happened in the last ten years, they would want to know about it, even if you are better now (the form asked you to estimate percentage recovered). If something happened more than ten years ago, it is only relevant if it was still a problem during the last ten years.

For instance, I was hospitalized for an infection from a bike fall about 12 years ago. But that did not go on the form because I was completely cured and it happened more than 10 years ago.

No, they didn't ask for BP or LDL/HDL. But they ask that if you have a condition that a doctor diagnosed or gave a recommendation about, or if you have a condition that a prudent person would seek medical treatment for, you should report it. So I wanted to look on the form to see if my doctor actually mentioned my BP (which was only 141) and he did mention it.

You need your medical records because they ask for doctor name, phone numbers and address for each issue that you reported. They wanted a list of medications, including non-prescription, for the last two years and how much medication and for what time period. For instance, I received a typhoid oral vaccine before an international trip, and technically this was a medication prescribed by a doctor, so I included it (along with medication name, amount, and duration) . I even included ibuprofen which I was directed to take by a doctor for my elbow problem.

You can go to insurance company web sites and download their application forms to get an idea.

It is like your taxes. A lot of the work is just getting all of your records together.

Kramer

[FIRE'd@51]

Quote:

Originally Posted by mykidslovedogs But legislation like community rating is always put into place without regard for the vast majority of people who will be aliented after the legislation passes (as happened in the case with Mutual of Omaha). No, Mutual of Omaha did not leave the market because of greed...they left the market because someone thought it would be a good idea to force community rating on them, which left the individual market unprofitable for the company. I'm sure community rating in Virginia and a few other states helped a quite a few people....meanwhile, it left a larger number of responsible people uninsured when their insurance company could no longer be profitable in the market because of the legislation.

If this is the case, why didn't MOH just leave NY and the other community rated states? That's what other insurance companies did. Why did MOH exit the entire individual insurance market nationwide, including all the non-community rated states as well? BTW, Virginia is NOT a community-rated state. Virginia is a very free market oriented "red" state with a number of insurance companies offering competitive policies there (e.g. Anthem, Assurant, Golden Rule just to name a few).

[mykidslovedogs]

Quote:

Originally Posted by FIRE'd@51 If this is the case, why didn't MOH just leave NY and the other community rated states? That's what other insurance companies did. Why did MOH exit the entire individual insurance market nationwide, including all the non-community rated states as well? BTW, Virginia is NOT a community-rated state. Virginia is a very free market oriented "red" state with a number of insurance companies offering competitive policies there (e.g. Anthem, Assurant, Golden Rule just to name a few).

This is as per an interview with Mutual of Omaha spokesperson, Nolan:

Health-care costs are increasing 20 percent faster than the general inflation rate, he said, and the cost of prescription drugs is rising more than 20 percent a year.

Nolan said state governments require more than 1,000 specific medical coverages on policies sold in their states, and many have agencies that control premium rates that companies can charge.

"Mutual of Omaha delayed this decision as long as possible," Nolan said, "staying in this market longer than most of our peers and working proactively on the legislative, regulatory and product fronts."

"It is extremely ironic to look to the government for an answer in the form of national health care when ill-advised legislation and policy played a significant role in creating the situation we face today."



...Based on what he is saying, it is the gov't mandates on specific things that must be covered in combination with legislation controlling premium rates that led to their demise in the industry. He doesn't name the specific states, but apparently, they didn't have enough business in the other states to make up for the bad legislation in states where they had higher levels of enrollment that caused them to leave the market altogether.