Health Insurance in FIRE

[maddythebeagle]

If a problem, please explain what state and why.

 

[REWahoo]

None of the above.

Not hard to get but a) expensive b) excludes pre existing conditions [and the definition of pre existing is up to the underwriter and is VERY broad] and 3) no prescription coverage.

REW

 

[Martha]

A great resource for determining your individual health insurance optionsif you don't have employer retiree coverage is www.healthinsuranceinfo.net. Has a guide for every state.


Under HIPAA one can usually move from a group plan after exercising COBRA coverage to an individual plan. However, HIPAA does not put any limits on cost. So people in their search for affordable health coverage look for plans with high deductibles, and may end up with plans that in one way or another limit coverage. Or they find insurance simply not affordable and go bare. Sometimes they are picked up by state risk pools if coverage isn't available or affordable in the individual market. Also, HIPAA doesn't provide protection once you have an individual plan and want to move to another individual plan. Therefore, you might not be able to qualify for any plan or the plan might have exclusions or lengthy waiting periods for pre-existing conditions.




Here are the HIPAA rules for health insurance portabiliby to go from a group plan to an individual plan:

You must:

1. Have at least 18 months of continuous creditable coverage
2. Have been covered under a group health plan, a governmental plan, or church plan (or health insurance offered in connection with such plans, such as COBRA) during the most recent period of creditable coverage
3. Not be eligible for coverage under a group health plan, Medicare, or Medicaid
4. Not have other health insurance coverage
5. Have not had your most recent coverage canceled for nonpayment of premiums or fraud (unless it was your employer that failed to pay premiums)
6. Have elected and exhausted any option for continuation of coverage (under COBRA or a similar state law) that was available under your prior plan.

If you qualify as an eligible individual, any insurer that sells individual health plans in your service area must offer you a plan. But keep in mind that your premiums are not governed by HIPAA; rather, they are determined by state law and can generally be set higher if you have medical problems. Thus, while your application for coverage won't be rejected because of your health problems, the health plan can charge higher rates as long as it has state approval. These rates can be very, very high.

In addition, your benefits could be vastly different under an individual plan. That's why when you're moving from a group plan to an individual plan it's especially important to shop around for the best rates and benefits to suit your needs.

 

[preben]

For expats: www.goodhealthworldwide.com covers my need very well for $1200/year.
Cheers!

 

[Michael]

Americans like to do everything the expensive way Ben. If I lose my health insurance for any reason, I may join you in Thailand. Its still affordable, but going up by leaps and bounds.

 

[garrynky]

I have a company plan that I'm grandfathered in, it will cost me $150 a month for my wife and I. The company quit offering this benefit about ten years ago.

 

[REWahoo]

I have a company plan that I'm grandfathered in, it will cost me $150 a month for my wife and I. The company quit offering this benefit about ten years ago.

Consider yourself blessed by the Healthcare Gods and pray that "grandpa" doesn't die...

REW

 

[maddythebeagle]

I think what this taught me is if you have a serious pre-existing condition and have to get your own policy, it could be a necessity to stay working or at least just semi-retire. Another thing to consider is that the longer you stay in the workforce, the more likely a condition could come up.

 

[RockMiner]

I have a question:  We plan to move to another state after I retire.  If I elect to pay for COBRA coverage, does HIPPA guarantee us access to insurance even though it's in a different state than the original employer insurance? 

I'm trying to understand if the expensive COBRA coverage is worth it...I do have a good backup with group insurance offered through a professional organization, though it is also a bit expensive   

Thanks for any input!

 

[treypar]

What is the best state to live in order to get affordable health insurance with a prexisting condition.

 

[REWahoo]

I have a question: We plan to move to another state after I retire. If I elect to pay for COBRA coverage, does HIPPA guarantee us access to insurance even though it's in a different state than the original employer insurance?

I am currently using COBRA after retiring "early" a couple of months ago. It is simply a continuation, at your expense, of you current health coverage through your employer. I don't think it is a question of "access" to insurance even if in another state, it is the same insurance you have while employed, and the same coverage rules would apply.

You can find a summary of COBA here:
http://benefitslink.com/cobra/summary.html

REW

 

[REWahoo]

What is the best state to live in order to get affordable health insurance with a prexisting condition.

You might want to do some research here:

http://www.healthinsurance.org/riskpoolinfo.html

REW

 

[RockMiner]

I am currently using COBRA after retiring "early" a couple of months ago.  It is simply a continuation, at your expense, of you current health coverage through your employer.  I don't think it is a question of "access" to insurance even if in another state, it is the same insurance you have while employed, and the same coverage rules would apply. 

Thanks REWahoo, but I'm not sure you understood my question.

Martha stated: "Under HIPPA one can usually move from a group plan after exercising COBRA coverage to an individual plan".  My question is:  Does this hold true when trying to move from COBRA coverage purchased in one state, to an individual plan in another state...in other words, are insurance providers in the new state of residence bound by the HIPPA rules to sell me insurance?  I'm trying to determine if it's worth paying for COBRA coverage in this situation.   

 

[REWahoo]

Thanks REWahoo, but I'm not sure you understood my question.

Martha stated: "Under HIPPA one can usually move from a group plan after exercising COBRA coverage to an individual plan". My question is: Does this hold true when trying to move from COBRA coverage purchased in one state, to an individual plan in another state...in other words, are insurance providers in the new state of residence bound by the HIPPA rules to sell me insurance? I'm trying to determine if it's worth paying for COBRA coverage in this situation.

You might try looking here:

http://www.cms.hhs.gov/hipaa/hipaa1/content/protect.pdf

REW

 

[kz]

Not hard to get since we are able to stay with ex-employer for up to 25 yrs. (gov't agency) But it's darn expensive. We pay the full premium of $1027 a month for DH and me.

Very good coverage, though. $10 co-pay for appointments and $5 co-pay for generic drugs. (the only script we take is a sleeping pill for me)

Plus physicals are totally covered once a yr for each of us and we get two eye exams per yr each.

 

[Mr._johngalt]

Not hard to get since we are able to stay with ex-employer for up to 25 yrs. (gov't agency) But it's darn expensive. We pay the full premium of $1027 a month for DH and me.

Very good coverage, though. $10 co-pay for appointments and $5 co-pay for generic drugs.  (the only script we take is a sleeping pill for me)

Plus physicals are totally covered once a yr for each of us and we get two eye exams per yr each.

For that premium they should make house calls and bring wine.

JG

 

[MJ]

I will continue to receive my health benefits from my former company and then will get it through cobra. One of the reasons I am thinking of moving from NY is to get cheaper insurance unless high deductable insurance is introduced here. Compared to the current cobra rate, I would save about $300+ a month if I moved to NM and get better coverage.

 

[Mr._johngalt]

I will continue to receive my health benefits from my former company and then will get it through cobra. One of the reasons I am thinking of moving from NY is to get cheaper insurance unless high deductable insurance is introduced here. Compared to  the current cobra rate, I would save about $300+ a month if I moved to NM and get better coverage.

I fell into this thinking for a while, i.e. looking to move based on the availability of cheap
health insurance. Spent a lot of time researching. IMHO, unless you are
really hard pressed, it's a poor reason to move although certainly can be
one of many considerations.

JG

 

[KB]

I just got an approval email that all of us are approved for an individual policy.

The premiums will be 471.00 a month vs 713.00 on Cobra. I'm thrilled. I only had to pay Cobra for 1 month after all.

My older son is planning on joining the military next year, so he should have his health care coverage through them....
That will lower it even more.

 

[REWahoo]

I just got an approval email that all of us are approved for an individual policy.

The premiums will be 471.00 a month vs 713.00 on Cobra. I'm thrilled. I only had to pay Cobra for 1 month after all.

My older son is planning on joining the military next year, so he should have his health care coverage through them....
That will lower it even more.

Congrats. I understand how nice that is. We're currently paying $741/mo for COBRA...

REW

 

[KB]

Ouch.

Does your carrier have a conversion plan? My HMO offers one that is priced between Cobra and individual. All medical requirements are waived. If we had been turned down for Individual, I would have taken that instead of Cobra.

 

[MJ]

I fell into this thinking for a while, i.e. looking to move based on the availability of cheap health insurance. Spent a lot of time researching. IMHO, unless you are
really hard pressed, it's a poor reason to move although certainly can be
one of many considerations.

JG, I agree that's why I said it was "one of the reasons". Change of climate and taking advantage of the high home equity were other possible reasons. Time will tell.

 

[Dawg52]

For that premium they should make house calls and bring wine. 

JG

Speaking of wine, I knew there was a benefit to drinking a glass of red wine a day for your heart but I didn't realize it was beneficial for cancer prevention in men. I'm headed to the local liquor store. 
 
Red Wine Stems Prostate Cancer
Daily glass cuts risk in half, study finds

TUESDAY, Sept. 28 (HealthDayNews) -- A glass of red wine a day may reduce the risk of prostate cancer by 50 percent, claims a study by researchers at the Fred Hutchinson Cancer Research Center.

Red wine's protective effect seems to be strongest against the most aggressive forms of prostate cancer, the study concluded.

The researchers interviewed 753 prostate cancer patients and 703 healthy men in the Seattle area.

"We found that men who consumed four or more glasses of red wine per week reduced their risk of prostate cancer by 50 percent," senior author Janet L. Stanford said in a prepared statement.

"Among men who consumed four or more 4-ounce glasses of red wine per week, we saw about a 60 percent lower incidence of the more aggressive types of prostate cancer. The more clinically aggressive prostate cancer is where the strongest reduction in risk was observed," Stanford said.

The study found that beer, hard liquor, and white wine had no impact on prostate cancer risk. The findings appear online in the current issue of the International Journal of Cancer.

Red wine contains an antioxidant called resveratrol, which is abundant in the skin of red grapes. Previous research suggested that resveratrol, which is also found in raspberries and peanuts and is available as a dietary supplement, may protect against cardiovascular disease.

More information

The U.S. National Cancer Institute has more about prostate cancer.

-- Robert Preidt 
SOURCE: Fred Hutchinson Cancer Research Center, news release, Sept. 22, 2004 

 

 

[JB]

I heard this story today on npr. Some republicans in the house are proposing that people be allowed to buy health insurance in other states. Makes sense to me! I recently moved to HI and the state were i moved from offered more/better high deductable plans. I couldn't get a high deductable plan here w/o a waiting period. Ended up with Kaiser, but other choices would be great... Especially if I can go to CA or NY if something really bad happens.

http://www.npr.org/templates/story/story.php?storyId=4769291

 

[tozz]

I'm all for increased consumption of wine, but I wonder to what degree the decreased incidence of cancer is due to the wine, as opposed to the health habits of the male demographic (higher income, higher education, less weight, etc.) that would more more inclined to opt for wine over beer or liquor.

"Among men who consumed four or more 4-ounce glasses of red wine per week, we saw about a 60 percent lower incidence of the more aggressive types of prostate cancer. The more clinically aggressive prostate cancer is where the strongest reduction in risk was observed," Stanford said.

The study found that beer, hard liquor, and white wine had no impact on prostate cancer risk.