Health Insurance options?

[cristeen]

So, 18 mos ago, DH took a new job, which does not offer family coverage. I was 6 mos pg and had to opt for COBRA coverage because of the pg. When DS was born we got him an individual policy w a high deductible. Now COBRA is running out. And so far almost all the plans i've been quoted cost even more than COBRA. It was a stretch to manage the COBRA pymt, i cant manage double or triple that. I can get coverage from DHs company for $500, but even that was more than COBRA. And i think i have to wait for open enrollment.

So today the insurance agent called to talk to me about options and quoted me a plan for under $200, which sounds great. It doesnt have any maternity coverage, which doesnt really bother us, since we were out of pocket on DS' midwife fees. But the question at this point is whether i'll be approved for it. I was rejected last time because of BMI, and it hasnt gone down any.

So the question becomes, what do i do if i'm rejected? What other options do i have? Going without is absolutely not an option, DH is already coming unglued because my coverage expires at the end of the month and i dont have a new policy yet. And getting a job just for the bennies isnt an option, since this area has some of the highest unemployment rates in the country (not to even mention the cost of childcare).

So whats left? The kicker to all of this being that the last time i even saw a doctor was at 20 wks. And before that was the fertility specialist 2 mos before DS was conceived.

[Sharon, RN]

I think you are going to have to pay the $$ and get insurance through your husband's employer.

Private insurance can (at least right now) still refuse to cover you for pre-existing conditions or just for things like high BMI, etc.  As the health care bill provisions go into action, there is going to be a high-risk insurance pool where no one will be refused- but I have no idea how much this is going to cost, and it may be WAY more expensive.  I believe some states have them now, and I've heard the prices are crazy.  If you obtain insurance through an employer, they cannot refuse you for pre-existing conditions, although some employers are choosing to charge higher premiums if you smoke, are overweight, etc.  I don't believe you have to wait until open enrollment; since your COBRA is expiring, it's considered a change in circumstance (like losing your job, or your husband getting a new one) and they can enroll you within 30 days of that change.  (I'm not 100% sure about that, so check with your DH's HR department.) 

Good luck- dealing with health insurance is the pits!

[Vaske]

My state has a program to help people who can get insurance, but who can't really afford it, pay their premiums.  The income/asset limits are fairly high, though I don't know how much the benefits are.  Maybe your state has something similar.

[texmati]

Originally Posted by Vaske 

My state has a program to help people who can get insurance, but who can't really afford it, pay their premiums.  The income/asset limits are fairly high, though I don't know how much the benefits are.  Maybe your state has something similar.

My county office offers a similar program. I'd check with them as well.

[AnnaNova]

i would look into state covered insurances too, if they refuse to insure you, they will insure your child. dont stress out about being without insurance while you make a coherent decision. we've been without insurance for months and we ok... thats unless you have medical reasons to get one STAT :-)))) when we were without coverage one time when i did have to go to the dr, i just paid out of pocket and they charged me 60.00 which wasnt too bad, they normally charge around 100 but because its our family doc they gave us a discount after i explained the situation.

should something bad happen (god forbid), there are programs to help you pay for expenses when you dont have the coverage. most counties have indigent funds, most hospitals have charity programs, and social workers to help you find a source of help. the hospital wants to get paid and it doesnt matter to them if that money is coming from you or someone else.

the bottom line, i would take time to select something that would be good for your family, i wouldnt freak out if i didnt have coverage for a little bit after cobra expired.

also, always read the fine print!!! that quote you got may have been a good one, but is the ins accepted by your doc? are there any limitations? (like some will pay if its an emergency, but won't if its 'selective' or routine or "standard care").

good luck

[zebra15]

Im amazed that your COBRA was under $500.  When I had a COBRA option it was close to $800 for just myself.   Anyways back to your dilemma.  Individual plans vary greatly and may not cover what you think they will cover.  Individual plans can be highly exclusive meaning they wont pay for xyz, abc etc.  If you have the option to get on your DH's group plan I would probably do that.  IDk how much your DH pays for his coverage, what the deductables are etc but if you have BMI issues (and i do as well so i know ins is difficult to get) a group plan is probably your best option.

*I currently have a version of medicaid and it stinks,  services are cut all the time, referrals are needed for every little thing.  One month an rx is covered, the next its not...

[mnnice]

Originally Posted by AnnaNova 

i would look into state covered insurances too, if they refuse to insure you, they will insure your child. dont stress out about being without insurance while you make a coherent decision. we've been without insurance for months and we ok... thats unless you have medical reasons to get one STAT :-)))) when we were without coverage one time when i did have to go to the dr, i just paid out of pocket and they charged me 60.00 which wasnt too bad, they normally charge around 100 but because its our family doc they gave us a discount after i explained the situation.

should something bad happen (god forbid), there are programs to help you pay for expenses when you dont have the coverage. most counties have indigent funds, most hospitals have charity programs, and social workers to help you find a source of help. the hospital wants to get paid and it doesnt matter to them if that money is coming from you or someone else.

the bottom line, i would take time to select something that would be good for your family, i wouldnt freak out if i didnt have coverage for a little bit after cobra expired.

also, always read the fine print!!! that quote you got may have been a good one, but is the ins accepted by your doc? are there any limitations? (like some will pay if its an emergency, but won't if its 'selective' or routine or "standard care").

good luck

I am going to respectfully disagree.  I opted out of the insurance coverage my employeer offers for a long time and we used coverage from DH's employer.  Then he was laid off and before my family went on my coverage I had to show that we had had coverage the past several months with either no or very little lapse in coverage before my employer's provider would cover my family. Maybe it's not a big deal if you have almost no assets, but I would be sick if a serious health concern bankrupted me (realizing that a truly catostrophic situation would bankrupt me and most other people in this county).

I too am amazed that your COBRA was under $500.  I think it worthwhile to look for some cheaper coverage, but would be suprised if you found it even if you go with big deductible limits.
 

[camprunner]

http://www.samaritanministries.org/

Might something like this work for you?