Straight to High Risk Pool

[astroboy]

Have come to the sobering conclusion, two years out from ER, that we probably won't be able to get any private health insurance then. Heard too many stories about out-right refusal to insure due to seemingly trivial conditions. Whether fair or not, that's the way it seems to be, so need to adjust.

While we will try to get insurance, realistically we know we'll probably be declined, so our plan now is to simply go straight from Cobra to state's high risk pool (we will probably retire to AL). Have read their plan's wesbite information and seems to be an acceptable alternative and while may be considered expensive by some, we are in fortunate position to be able to pay. At least it's guaranteed coverage and that's the important thing.

Just wondering though if any others have been in their hish risk pool plan (or other states) and what experience has been and whether others have this kind of scenario in mind when ER. Any down side? Have heard that some states only allow limited number of people in plan at a time, but AL's doesn't seem to. Is there some information somewhere that compares state high risk pools, so can determine which is best?
Thanks.

 

[Dawg52]

I wouldn't give up on private health insurance yet. Do you have a serious problem of some kind? If you have some health problems you might try for a high deductible plan if you can afford the out of pocket deductibles. I had some minor issues and went with a $10,000 plan with dr and drug copays. I have been told by some agents that insurance companies are more willing to take you on if you assume more of the risk through the higher deductible.

So think about a 5k and up deductible. It works for some.

 

[mykidslovedogs]

I wouldn't give up on private health insurance yet. Do you have a serious problem of some kind? If you have some health problems you might try for a high deductible plan if you can afford the out of pocket deductibles. I had some minor issues and went with a $10,000 plan with dr and drug copays. I have been told by some agents that insurance companies are more willing to take you on if you assume more of the risk through the higher deductible.

So think about a 5k and up deductible. It works for some.

Especially with Humana One. They have really lightened up their underwriting guidelines on the higher deductible plans....

 

[Martha]

This guide has state by state information on risk pools: http://www.tnhis.com/statebystateguide.htm

Careful though, the cost information is based on a 35 year old male, not the typical purchaser. Costs are usually a LOT higher the older you are. Also be careful as the author's political positions color what he says.

Other good info on your state rights is in the Georgetown guide at www.healthinsuranceinfo.net.

My experience is that risk pools differ widely on cost and coverage. A number have very low lifetime limits of $500,000. Too low! Also watch for yearly limits and limits for treatment for a particular condition.

Minnesota is know for having the best pool. The costs are based on no more that 125% of private market insurance. The lifetime limit is three million and there are many choices on deductibles, even an HSA choice.

I suggest working with a good agent in your state to see what you might be eligible for before resorting to the risk pool. That said, my husband and I when COBRA expires will be in the Minnesota risk pool.

 

[AlmostDone]

Is there a difference between a broker and an agent? I thought a broker did not represent a particular insurance company, but could shop multiple companies for you. I haven't been able to find an insurance broker - the only one that came up on an internet search referred me to BC/BS when I contacted him.

 

[mykidslovedogs]

Is there a difference between a broker and an agent? I thought a broker did not represent a particular insurance company, but could shop multiple companies for you. I haven't been able to find an insurance broker - the only one that came up on an internet search referred me to BC/BS when I contacted him.

The terms can be used interchangeably, but broker is more often used to describe a person who does not represent any one company. To find a reputable independent broker/agent in your state, go to:
http://www.nahu.org/consumer/findagent.cfm

 

[astroboy]

We had always planned on a HDHP/HSA, but thought even then we would be denied. Glad to know that may not always be the case. Plan to be pre-screened before we take the ER plunge so we know for sure if will be accepted and at what cost. Guess I'm just trying to be pyschologically and financially prepared for needing a high-risk pool as a last resort.

 

[Zoocat]

Martha, you make a very good point. I looked into Colorado's high risk insurance as a last resort option and the lifetime maximum was $1,000,000 versus most policy's $3,000,000. How is $1,000,000 max a safety net for people with high risk conditions?