Health Insurance, pre-condition

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Old 04-18-2011, 05:42 PM
california dreamer california dreamer is offline
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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?
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Old 04-18-2011, 07:46 PM
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Originally Posted by ljones190 View Post
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.
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.
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Old 04-18-2011, 07:51 PM
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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
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Old 04-18-2011, 09:17 PM
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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.
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Old 04-19-2011, 08:29 AM
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Default 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.
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Old 04-19-2011, 08:51 AM
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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".
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Old 04-19-2011, 07:52 PM
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Quote:
Originally Posted by ljones190 View Post
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.
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.
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Old 04-19-2011, 08:43 PM
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Quote:
Originally Posted by village_gal View Post
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.
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Old 04-20-2011, 08:14 AM
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Quote:
Originally Posted by village_gal View Post
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.
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.
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Old 04-20-2011, 11:05 AM
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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.
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Old 04-20-2011, 05:14 PM
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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.
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Old 04-20-2011, 05:45 PM
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Quote:
Originally Posted by california dreamer View Post
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
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Old 04-20-2011, 06:41 PM
Tbugs Tbugs is offline
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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.
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Old 04-21-2011, 07:54 AM
ssmith ssmith is offline
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Ok T-bugs I have to say I think your coments belong in Political !!!
Sorry, I know this is a hot bed issue tho!
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Old 04-21-2011, 08:35 AM
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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.
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