Insurance co= Lucy and the Football?

[lemming]

I just called Aetna in Virginia about continuing my insurance coverage after Cobra. The first rep gave me a flat out No when I said I have a preexisting condition (tiny little cancer issue).

Remarkably I did not scream and curse at poor CSR but asked about my other options. Usually I just hang up without continuing. She gave me another phone# which she said was high risk pool. But 2nd call agreed that VA has a HIPPA continuation which I will qualify for after Cobra ends. All is golden-maybe. They won't accept an application until end of Cobra coverage. I want to lock in now. Hence my vision of Lucy holding the football then jerking it away. Quick quotes on phone ranged from 614 to$ 1745.

Any thoughts ?

Mass was looking pretty good for a while. I actually web searched and found a couple of places I could be happy in. Except for the snow thing and one apartment was a high rise at the beach in Revere. I would like that for the 3 years I need insurance except it would be moving away from family.

 

[dgoldenz]

I'm a health insurance agent in Virginia and I can tell you that Aetna's rates are incredibly high compared to other companies, especially for HIPAA cases. There are limitations on some policies for HIPAA that definitely need to be considered before you buy. Aetna's policies limit prescription benefits to only $5,000/year. Most people who have ever had any type of cancer know that prescriptions for cancer can easily be $5,000/month. What do you do when you burn through the annual benefit limit in a month and have to pay the rest out of pocket?

What part of Virginia are you in and when does your COBRA end? Rates may be going up 9/23/10 due to some of the mandates in the healthcare law. You can't apply for HIPAA coverage if you are still 6 months away from COBRA ending. If you are within two months of COBRA ending, you may be able to apply with some carriers at this point. Every company is different on how far out they will accept an application for.

 

[lemming]

It was the HIPAA rule that I was sharing info on. Not every state is doing the same thing but it is something no one considers when they talk about availability of insurance.

I have seen so many posts from others , and fairly current that say they were refused insurance because of health conditions that I am awed by the fact that they are required now to offer coverage. After all my pre existing history is cancer not just high blood pressure or something.

 

[dgoldenz]

HIPAA conversions are available in every state. Some states have different rules about what plans the insurance companies have to offer for HIPAA-eligible people. States that already have high risk pools may put HIPAA-eligible people into the risk pool instead of having their choice of insurance companies. In Virginia, you can get a guaranteed-issue plan from any company with any of the plans they otherwise sell to a healthy person. They all have different rating systems though.

You have to exhaust COBRA or have your group plan cancelled altogether to be HIPAA-eligible, so most people dont qualify for it.

 

[Martha]

You can move to another state and carry your HIPAA eligibility there. So, if it turns out that Virginia options are too costly you could check other states where you may be interested in living. Unfortunately, timing is tight and you cannot have much of a gap between your COBRA expiration and going on to a HIPAA qualified plan. And I trust that you don't want any gap at all!

Texas has a pretty decent risk pool you can get on if you are HIPAA eligible. California stinks. Some of the guaranteed issue states out east where you live have options that are very costly. (The guaranteed issue states are NJ NY VT ME and MA). Minnesota, Wisconsin, Iowa are excellent but you probably don't want to live there.

Unfortunately most of these options for the unisurable are pricey, whether it is a state offered risk pool or special HIPAA qualified plans from private insurers. But there are huge state differences in price and coverage. Our FAQ section has a lot of information on buying private health insurance. http://www.early-retirement.org/forums/f47/faq-archive-buying-private-health-insurance-30756.html

Under current law (not health reform which is not yet in effect) depending on the state people can get turned down for insurance and have NO options. This can happen if they are not HIPAA eligible. HIPAA gives options to people coming off of employer group health insurance. (The FAQ section gives the complete rules for HIPAA eligibility). Those same options may not be there if you are uninsured or coming off of a private plan.

 

[dgoldenz]

The HIPAA eligibility window is 63 days from the time your COBRA ends, just to clarify. After that, you're on your own.