Health Insurance, pre-condition
 

My wife and I are considering moving to TV from New England. One of us is not yet 65 and currently enrolled in a Blue Cross HSA self pay plan but is being treated for a current health condition. If we move to TV we have to be certain we are covered for any & all existing conditions. Does anyone know how the pre-condition exclusion works in Florida and where we can get full coverage, i.e. no lapse in coverage between plans? We are hoping we can find a way to do this!
Thanks.

bump

LARYB: I am new to this what does "bump" mean?

Two ways come to mind. If you have BCBS through an employee group you can continue in that group for up to 18 months through COBRA, at your expense. If you hve single coverge (or group coverage for that matter) you will get a Certificate of Credible Coverage from BCBS and that will eliminate pre existing coverage issues through HIPAA. In either event contact BCBS and tell them of your situation. Good luck.

It's just a way of making a "null" post that forces the thread back to the top of the unread list. That way it helps keep the thread active and from being potentially overlooked. Usually done when someone's looking for a response and has not received one for a while.

Hope that helps!
Bill

Your very best bet is to call Blue Cross Blue Shield and talk with them directly. For something this important, get the information direct with the company instead of relying on a forum (which includes some very smart folks).

TBugs is right. Check with your current plan to learn your options. I know some folks just buy catastrophic insurance because so much is excluded - but each case is different.

go to the source (BCBS)....gn

Hi Rhodeislander! Sorry, been off line for a while, so I didn't see your question. BillnBrillo exlained it much better than I could. I'm in the same boat, so that's why I bumped. Good Luck :thumbup:

Thanks everyone. I will investigate HIPAA rules and speak to BCBS as suggested. We are retired and we both have coverage in private pans now so that should be helpful according to HIPAA Regs. I will post how we made out when it is resolved because it seems others have faced similar problems.

I read your original post, but now I'm confused by this statement. If you have coverage in a private plan now, why don't you simply contact your plan and ask if they have physicians and facilities in The Villages that are "in network"?

I am in a similar situation and in researching and looking for a new plan I came upon Landshealth.com They have reasonable rates, however, I live in CT and they do not offer their plan in Ct but they told me they do offer their plan in FL. My situation is that my Cobra is expiring in June, after being on it for 18 mo, and now I need to get my own insurance for 14 mo till I turn 65. It is a nightmare.....

I agree... shopping for healthcare coverage is a daunting task. We are also looking for coverage to take us from my retirement day to age 65. Thanks for the mention about landshealth.com

We saw a reference here on TOTV for Ross Lehman (352-425-4427) who is an insurance broker near TV. He provided much useful information. Ross has been successful at finding coverage that will provide me with decent coverage even with my history of prostate cancer.

Good luck. There IS a policy out there for YOU.

Good luck it is not going to be good in the state of Florida. I have all kinds of problems because of pre-existing health issues. Some of my pre-existing conditions aren't even right on my records. You will have to pay a lot more to get good coverage. Right now I have a five thousand dollar deductible at $289 a month with Aetna. I can't wait until I'm 65 to go on SS. As it is I am avoiding Drs, but with my unstable thyroid condition isn't easy. Good luck and I can't wait to hear what others have to say, maybe i can find something out I didn't know.

I work for a private company and have a PPO plan for my wife and me. Doctor's visit 30.00 co pay, specialists 50.00, ER 100.00, hospital 300.00 per day for 5 days. Prescription drug plan not too good. I pay over 500.00 per month and my company pays almost the same. I think your 289.00 per month is a great rate, I will take the risk of the first 5,000. I already pay 6,000 for the payments alone. Please note this rate is NJ which is high on everything.

I was researching Landshealth.com also. If I remember right, they state on the website that they are not a comprehensive health insurer, but rather they reimburse you set amounts for doctor visits, prescriptions, etc; I don't think they offer catastrophic illness coverage. Anyone else have more information on them?

Note: if you are getting insurance through an employer - whether, privately held, publicly traded, a governmental entity, etc. - it is NOT the same as getting insurance privately. COBRA and HIPAA only fixed part of the problem.

The only way to find out what is excluded as pre-existing is to do your own research - relative to YOU and your spouse. This could cost you a great deal if you go by "what you heard" here or at the squares etc.

Rhodeislander, I am very familiar with what you are going through. Had a job in Ohio with medical (BCBS) - quit my job to move to TV. Went on Cobra and it ran out in Feb. Have a pre-existing condition.

After several insurance companies denied me coverage, I did a conversion policy with Blue Cross/Blue Shield. They had to cover me. I went from no deductible to a $7500 deductible. Also used to pay $30 for 90 day supply of meds. Now I have a $1500 deductible on meds and pay $250 a month after that because one med is not generic. My BCBS is $580 a month but at least I have insurance!

It is not easy to get insurance and I took it for granted when I did have it. Not anymore! PM me is I can answer any questions.

Becky

My husband and I moved here from N Attleboro MA last Sept. He and I were covered under BC/BS of Mass HMO and it was explained to us by his HR person that we just switch to BC/BS of Mass PPO and we would be covered in FL. It has worked for us and I have a preexisting condition.

Florida coverage
 

I just went through this moving from OH to TV. My HSA Cobra for DW and I with 6K deductible (3+3) is over 800/mo. So I looked to go to something here. Insurance agent told me that even with continuous coverage that in the state of Florida the carriers do NOT have to insure you, and if you have any medical concerns that can inflate your cost to whatever number they choose. Try looking at ehealthinsurance.com That site allows you to enter your age and use whatever criteria you want to limit the policies you may want to consider. Be aware that the price given is for a person with no medical concerns or occupational risk. I was asked if I were a circus performer as they won't insure them at all! This will all change once the Affordable Health Care act is fully implemented in 3 more years.

The Affordable Health Care Act (ObamaCare to some) will take care of the problem of pre-existing conditions. Imagine all the Republicans who wanted to scuttle that. Well, they are the "party of NO".

The reason I am locked into this rate is because my pre-existing health problems showed up with Aetna. In Florida, you can get coverage at a high rate....Obama fixed it alright....you can get insurance but the rates are high, they sock it to you. I think I have phoned every insurance company there is. My agent said this is the best I can do, han in there until I'm 65...well that's **** years away! On top of that I had a home accident on sunday with a minor head injury....I prayed hard not to have o go to ER. I think I'm going to be ok in time.

Village Gal

I am going to be in the same boat you are in the 2 years, taking Cobra for 18 months and then pick up other insurance if no pre conditions or stay with what I have now. I have a couple of comments, Obama's health care plan is supposed to be capped at 4% of your salary. at 50 k per year the maximum you would pay would be $2,000. My understanding is that should start in 2013, lets hope that is true but I find that hard to believe. Have you considered starting a health savings account, these accounts allow you to put money in an account for healthcare costs and the growth in the accounts are tax free. I will try to invest a min. of $10 k to at least fund a few years for the higher deductibles. Good luck to you, hope you are recovering from your fall. I understand your concern about an ER visit, had a kidney stone a few months back and the bill was over $ 7,000, luckily I only had to pay $100.00.

The high rates have far less to do with the new health care law than you may think. HIPAA "fixed" the issue with GROUP insurers denying coverage for pre-existing conditions, but provided better sharing of data. For the most part, HIPAA does not address individual policies.

Did you try looking into group coverage? Some professional organizations allow you to join and have better rates.

katezbox, I'm not sure I know what group coverage is. I'm not employed, my husband is on SS. I have individual coverage.

ljones190, I'll check in to the health savings account, I've not heard anything about that either. As for my fall, I have a huge egg size bump on my forehead, bruises all over, and pretty sore still, but I am recovering just fine.

To lJones190: where did you hear of the 4% cap on insurance premiums? Do you have a website you can recommend. I did some research on Obamacare but wasn't able to find that information. We were afraid that with Obamacare all the insurance companies would start overcharging, so this is good news if it does go through.

Interesting reading, you need to read very carefully and the 4% cap is not stated directly, I can not find that but I am sure I read that somewhere, this covers pre-exsisting conditions, rates for retired people between the ages of 55 to 65 prior to Medicare. I was mistaken it is 2014 not 2013. I am hoping to Cobra in 2013 then hopefully convert to a plan in 2014 that is somewhat affordable. Hope this helps.


http://www.healthcare.gov/center/rep...s01282011a.pdf

Remember, when you go to the election booths next time, it is the Republicans and Tea Party who wanted to scuttle the Affordable Health Care with pre-existing conditions as an exclusion.

Foul!
 

Ok T-bugs I have to say I think your coments belong in Political !!!
Sorry, I know this is a hot bed issue tho!

The original poster asked this:

"Does anyone know how the pre-condition exclusion works in Florida and where we can get full coverage, i.e. no lapse in coverage between plans? We are hoping we can find a way to do this!"

Let's keep this on track and away from Political. Let's show a new member some hospitality, the way you would if you met in the square. Would you all of a sudden shove your political opinion in his face if you were asked this in the square?

Keep on topic, please.

Do not know if you were refering to my previous post but the website I mentioned earlier is the offical site for healthcare for the US Goverment, this covers the options for pre existing conditions before 2014 and after 2014. You can search the options available to all by state. This should help the orginl poster find answers to the question.

http://www.healthcare.gov/
__________________

Good morning, Ijones,

I do not think Mr. Tony was talking about your post. I think there might have been another post that has been removed.

I, too, had been looking for something that might help answer questions that had been asked in this thread.. I had looked at aarp.org and kiplinger.com but what I found there was more of an overall big picture presentation of the facts of timelines and changes. While that general info could be helpful, the link you provide here is far better.

With a little pointing and clicking around the site in your link to healthcare.gov, someone could begin to answer some questions they might have without wading through the taint of political interpretation that is out there in so many places.

Although I have never been without insurance, I have great concern for those who cannot access affordable, good coverage so I was trying to find a link that could help to sort out some things as applicable to individual situations -- without bogging down in politically motivated spin.

The link you provided supplies pure information in more detail than what I could find. It looks to me like healthcare.gov could really help someone who needs to get the facts as they apply personally. Thank you for providing that link.

Boomer

:BigApplause:

Your Welcome Boomer and Katezbox. Healthcare choices are difficult and it is costly, lets hope we stay healthy. It gives me some motivation to get in better shape, lose some weight and get more active. My wife always says to look for the positives in everything you do. Good advise.

My apologies to everyone. The administrator was right, and I got off topic from the original question from the first posting regarding Florida and pre-existing conditions. My bad.

I agree with others that first you need to call BC in your state. However, I will say having just gone through this process, BC doesn't want you and you may very well experience a sequence of incompetence and late notices etc. Basically the way I understand it works, once you move and notify BC in your home state that you have moved, they will then send you a notice of cancellation and advice of your rights to a Conversion policy. They send that to BC of Florida. Then BC of Florida sends you an application which you must complete and submit with a tight time frame. Your premiums have to be paid up in your home state for around two months first. Our experience was they delayed at every step of the way but they would not waive any filing date requirements if you missed the dates. So, lesson to learn, know the process, follow up at EVERY step and you may get the BC of Florida coverage. It is not an HSA and actually for us was slightly cheaper. Good Luck

Cobra is now 36 months
 

Just went to a retirement seminar in Fishkill, NY. Cobra is now 36 months.

Cobra
 

I think In NY only cobra is now 36 months


Here is a link that gives more info on Cobra.

http://www.insure.com/articles/healt...obra-tips.html

Cobra regulations
 

say that employers have the option of extending Cobra to 36 mos., but must get plans approved. Maybe NY is different.

Of course, if you are divorced, or the covered employee dies, you are covered for up to 36 mos., and I think there are a few other exceptions.