insurance questions...

[nanramone]

hi all - uhoh - I found out what I didn't want to find out...

I have been unemployed since last September, and continued my insurance through work via COBRA. The 18 months will  be up in March of 2011. At that point, because of pre-exisiting condition, the only way I can insure this thing is through the state run high risk pool, unless I've been misinformed - and comparing prices of all available plans, I'll be paying about $12,000 per year for medical insurance.

That's not good. I'm enrolled in school this fall, and barely making ends meet now, while collecting unemployment benefits, which won't last forever...


6 month MRI in November will be covered, but if I don't have insurance at the one year mark in May....I wonder what I'll do? Other state run health care plans seem inadequate and also require a person to go uninsured for 6 months in order to be eligible.

Does anyone have any ideas? I'm considering dropping insurance altogether, as crazy as that sounds..I really have no idea what to do....

[Jim Scott]

Nancy ~

I'm sorry to learn of your vexing situation with your medical insurance coverage.  I 'm sure that many people are in similar circumstances, today. 

I suggest you go to this website and call the Indiana '211' service. http://www.in211.org/  It's run by United Way .  They'll take your information and tell you what, if any, options may be available to you via government assistance with your insurance and how to access that help.  It's certainly worth a phone call and if you do call, I hope they can steer you to assistance with this problem. 

Jim

[leapyrtwins]

I could be totally wrong here, but I didn't think pre-existing conditions were an issue anymore.  Didn't HIPPA or the portability laws (passed under the Bush administration, I believe) eliminate all of that?

I'd check around, Nancy.

My insurance broker told me a few months ago that if I were to change my health insurance that my pre-existing conditions (basically the AN) would mean I'd have a waiting period of a few months before a new policy would cover it, but he said it WOULD be covered with another provider.

I'd investigate this a bit more.

Good luck,

Jan

[nanramone]

Hi - the person I talked to was a representative from the Indiana Comprehensive Health Insurance Association. This is the high risk pool program in Indiana, and is what is available to people with pre-exisiting conditions who are also HIPAA eligible.  This is the state and (soon to be) federal government subsidized program that protects people with pre-exisiting conditions in Indiana. Each state has different laws, which might be why it's different for you Jan.

My current insurance company told me they will not sell me a policy after COBRA continuation expires in March. Apparently, they have the legal right to do this. I will still investigate. If I could find a job with a large company, they might have a plan that would overlook the condition, but I have been unable to find work.

Well, Jim, you're certainly correct - there are a lot of people in trouble these days!

Nancy

[dalern]

I think I will pipe in here.  Not only am I a nurse, but also have an insurance license and keep pretty up to date with the regulations.  I will say the one thing that stands out is YOU ARE CORRECT that every state is different.  The new legislation about pre-existing conditions is  not yet in effect.  A HIPAA policy is good, but could cost a lot.  I think in most cases, a pre-existing condition will not affect your ability to go from COBRA to a HIPAA policy.  It will not be like your other insurance and tends to cover mostly catastrophic events.  However, private insurance companies still do have the right to turn down anyone for any reason.  Hoping that will all change soon, but it has not as of this time.  I don't know what the HMO situation is like in Indiana, or how prevalent it may be.  If you can get an HMO that will cover you in a good health care system, that could work.  Problem is, though pre-existing won't be a major issue, cost is often more for an HMO than a PPO.  It's because so many services are included and bundled together. 

Not sure if this helps.
~Dale

[nanramone]

yes Dale, it does help. What you wrote confirms what I've discovered so far. Indiana is not a good state for public health care. I've been cautioned not to try to go without insurance for a while in order to qualify for state aid, because quality of care is poor and I would need to travel to Indianapolis for care.

However, I did talk to a financial services rep at the local hospital who told me if I have a large deductible and low income, they will definitely work with me so that I can continue to get my MRIs in a timely fashion. Again, all available HIPAA plans here (and they are PPOs, not HMOs like I have now) will cost about $12,000 per year.

The federal laws that would help me do not go into effect until 2014. At that point, I'll be able to find much less expensive insurance, with a cap on out of the pocket expenses. So I plan to struggle and probably lean on family for the next 3 and a half years, unless I can find work...which will be complicated, because I'm going to be in school full time in spring in order to retrain to do something....ahhhhhh! Bad timing for everything!

Still, I'll keep my head up - there's no point to think negatively.

thanks to all for ideas...

Nancy