NT - Shopping for health insurance

[Kea]

My husband retires next month and that will end our employer provided health insurance.

Does anyone have any recommendations for independent agents to help me find insurance? Any companies that are good or ones to avoid? Is anyone familiar with the Marsh Insurance discounted through NATP?

I am paranoid about going in for a broken finger and being denied coverage because I didn't disclose a hangnail I had 20 years ago - obviously I have pre-existing finger problems. I want coverage I can count on.

I like the idea of going through an agent since they will know all the requirements of the various companies. I also worry about applying somewhere and then getting denied coverage. That could make other companies automatically deny me.

Thanks

[Janitor Bob]

My husband retires next month and that will end our employer provided health insurance.

Does anyone have any recommendations for independent agents to help me find insurance? Any companies that are good or ones to avoid? Is anyone familiar with the Marsh Insurance discounted through NATP?

I am paranoid about going in for a broken finger and being denied coverage because I didn't disclose a hangnail I had 20 years ago - obviously I have pre-existing finger problems. I want coverage I can count on.

I like the idea of going through an agent since they will know all the requirements of the various companies. I also worry about applying somewhere and then getting denied coverage. That could make other companies automatically deny me.

Thanks

As long as you have had prior coverage through ANY health insurance, there is not a "Pre-existing" conditions concern. If you have had continuous coverage through any health plan(s), a new health plan is required to cover them.

[Kea]

JB - I would like to believe that, but I've heard that's not true in Texas. It may only apply to whether or not a company can deny your application - not real sure about that part. This is what it said on a TX insurance web page:

I have previous group health insurance coverage. Does this mean the health insurance company must accept my application and apply no pre-existing condition limitations?

No. In Texas it does not matter that you have previous group health insurance coverage. A health insurance company can still deny your application for individual or family coverage. However, if your application is declined, you may be eligible to participate in the Texas Health Risk Pool (www.txhealthpool.org ) established for persons who are unable to obtain health insurance coverage on the open market.

[AnnieR]

See, JB, there is a reward for living in OH. The company I retired from allowed us to continue our health insurance until I was 65 with no premium. It was a real blessing. Now it is a "new" company, new rules.

[JohnH]

Kea:

I don't have a specific agent or company recommendation, but I want to make a general suggestion. I've been concerned for the past couple of years that my wife's insurance carrier might drop spousal coverage altogether (she's a retired NC employee), so this subject has been on my radar screen for quite a while.

If I ever have to make the leap, I'm leaning in the direction of a Health Savings Account rather than traditional insurance. There's still the matter of selecting a good carrier for the Major Medical portion, but as fo0r the overall concept the HSA seems to be a good alternative to traditional coverage since an individual or small group really doesn't have any leverage with the insurance companies.

[Jake]

I will echo John H's reccomendation to at least explore the HSA option. If you are an infrequent user of medical and pharmaceutical services an HSA coupled with a high deductible insurance plan may be the way to go. I personally have an HSA and I have recommended them to several clients and though they are not a perfect solution for everyone they can work very well for some people if they are managed properly.

Good Luck

Jake

[Cathy]

If either of you go to work for a company that has a group health insurance plan, then yes, you will have portability of pre-existing conditions provided that you can prove evidence of being covered with a break not to exceed 90 days, I believe.

However, you seem to be where I was several years ago when I gave up employment in a parish (county) job and we had to buy an individual plan as we both were self employed. Our state (Louisiana) also guarantees everyone insurance but the premium was ridiculously high with horrible coverage.

I applied and was accepted with Blue Cross Blue Shield in my state...you may have one in your state also. On my application I went with the highest deductible of $5,000 at that time which made us eligible for an HSA. We did have pre-existing conditions, but all of them were under control......at least until 3 months after our policy became effective....then all hell broke loose! Deductible is now $5,600 but 100% of prescriptions and medical bills paid in full after the deductible. The policy has been a God send!

Take care,

Cathy

[Bart]

I have previous group health insurance coverage. Does this mean the health insurance company must accept my application and apply no pre-existing condition limitations?

No. In Texas it does not matter that you have previous group health insurance coverage. A health insurance company can still deny your application for individual or family coverage. However, if your application is declined, you may be eligible to participate in the Texas Health Risk Pool (www.txhealthpool.org ) established for persons who are unable to obtain health insurance coverage on the open market.

As I read that, it says that the insurance company can deny you coverage but if they do accept you they might cover pre-existing conditions. I think you need to ask.

[Kea]

I have found an independent agent and we should be able to get coverage cheaper than Cobra and will probably be an HSA. We are generally healthy but both have weight issues (me more than my husband), but he has borderline high blood pressure and cholesterol. But we will probably end up being covered by 2 different companies (BC/BS for him, Aetna for me). And a few days ago I found out I might have a possible pre-existing condition. I go for a biopsy on 5/30. It should be nothing but the timing is just too close to my husband's last day of 6/1.

The agent said we had 60 days to decide on the Cobra. So if the test is positive we sign up for Cobra and if it's negative, we apply for a regular policy.

I really debated about saying anything about the previous bad test result. Since I don't have a pre-existing condition YET, I didn't know how it would affect the application. I might be able to get a policy, but then they would turn around and cancel it immediately.

Thanks for your recommendations.

[JohnH]

Since time is an important issue for you, it might be a good idea to try and accelerate the date for the biopsy. If you explain the situation, they may be able to accommodate you by squeezing you in earlier. You might also try to get on a "wait list" in case they have a cancellation. I've had a couple of medical situations in which I'd work out arrangements with the appointments secretary to call them every morning just to ask if they had a cancellation for that day. (In one case I would just delay eating until I had made the call). The last thing you need is a tight schedule for making an important decision like this, so getting an earlier answer might take some pressure off. And hope all goes well with your biopsy.

[Kea]

I'll double check with them but I think the doctor was out or there was some other reason they couldn't do it this week. We've been planning to be out of town the next couple of weeks, but all that can be worked around. I'll call Monday.

[kcjenkins]

I'll be praying for you, Kea.

[Kea]

Thanks - I appreciate it. I'm pretty sure it's nothing.... at least I hope so.

[Catherine]

Thanks - I appreciate it. I'm pretty sure it's nothing.... at least I hope so.

More prayers coming your way, Kea. And good wishes for getting the insurance conundrum straightened out to your satisfaction.

Catherine

[Kea]

Thanks so much.

[bstaxes]

My prayers go with you. Hope it is nothing.

[Gail in Virginia]

If you are sure it is nothing, I am sure you right. But we can, and will, pray for you all the same.

[Kea]

Thanks for everyone's prayers and concerns. The biopsy came out fine - just an infection that can be treated with antibiotics.

But the bad test result is still on my medical history forever. Even though I am generally healthy, I am overweight (and I'm working on that). When they combine that with the test result, my odds of getting insurance go down significantly.

So now I am back to the other part of my question. If I can't get a private policy, can I still get one through an association (like NATP)? Or, can those policies deny you, too? Is anyone familiar with their policy through Marsh & McClennen?

Anyone familiar with any of those companies that advertise on TV that they cover anybody regardless of pre-conditions? I think most of them are just discount programs rather than real insurance and they all sound pretty fishy in their ads. Just wondering if any of them were real policies?

We have my husband's coverage through the end of June and we can go on Cobra for $1540 per month after that. (So much for his pension!)

Thanks so much.

[Lion EA]

Our state has a pool for hard-to-insure conditions. Of course, it's expensive; but it's coverage. And, there's more than one company to negotiate with. I have a client with Lupus who uses the pool carriers; she's changing carriers this year to save $300/month. Maybe a combination of a high deductible insurance policy and a health savings account is right for you at this time. Anyway, glad to hear all is well for now. Good luck tracking down a policy you're comfortable with.

[Kea]

We are looking at the HSAs with $5000 deductible (each). The 2 companies that MIGHT accept me won't accept my husband and 1 company that might accept him won't accept me. Even if the insurance companies think I might be high risk, I don't really consider myself in that category. I don't have diabetes, high cholesterol, high blood pressure, cancer, lupus or any other chronic condition. OK, I'm hypothyroid - and that's under control. (I could probably go off the medication since I was only slightly out of range when they 1st put me on the meds. The doctor sees the good range now and won't take a chance.)

TX does have a high risk pool and I'm sure it's expensive. But if I can't get the private insurance or through an association, I may have to consider that.

[Lion EA]

Did you run the numbers for you each to have your own policy?

Does it make a difference in the premiums if you're buying as individuals or if you as a company buy for your employee husband? Can your company hire your husband and provide health coverage to him and his family (you)? It could still be a high deductible plan and company provided HSA.

I have a client who formed an LLC from her sole proprietorship, because her insurance agent was able to get her lower premiums that way. Don't know why that helped since she's single and the LLC is a disregarded entity, but the agent has a copy of her Schedule C.

[Kea]

Right now we can't get a combined policy. Perhaps if we both lose enough weight, we might be able to get a joint policy - but that would probably take a few months.

I have not yet looked into policies as a business. I might be able to find something I can hire my husband to do. But my practice is so small that having an employee and insurance would probably mean I would never be profitable again. But it is an option to consider.

Thanks.

[Lion EA]

My husband does pick-ups and deliveries for me and goes to the bank and stops at Staples, that type of thing. My daughter sorts/organizes paperwork for two of my clients and creates large, green ledger sheets (can't get her to work in Excel yet) adding up their business income and expenses and itemized deductions and office-in-home items and anything else she uncovers with a tax consequence. She also files. If your clients overlap, perhaps he could schmooze with the waiting clients. He could answer the telephone, screen your e-mails, serve coffee, file, etc.

[Kea]

My husband would probably mostly file and go to the post office and other errands. He's not much of a schmoozer so that one's out. One big task that he'll help with this year is scanning all my old paper files into the computer. We want to save a lot of space. We are hoping to spend a lot more time traveling in our RV. I still need to come up with a plan to have a nice efficient mobile office. As long as I have internet, I can get e-mail, faxes (they come to my e-mail) and send e-files. But it's going to be impossible to move my big fire-proof safe into the RV. So I think I can keep him pretty busy scanning in 10 years of files.

Hummm. If I do all my work in my RV, but it moves from place to place, do I have a primary place of business anymore?

[Catherine]

Meant to post this earlier -- I was _very_ glad to hear that your biopsy came back fine. Congratulations on that, at least!

And, for your amusement, a paraphrased quote from a book I read: "As long as one is breathing and the bowels move regularly, all other problems are but temporary and transient."

Catherine