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Old 08-16-2011, 08:00 AM
 
1,468 posts, read 4,166,742 times
Reputation: 1071

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Quote:
Originally Posted by valicky View Post
In the second link I posted you can check the FAQS.
Here is one of them: "What does Guaranteed Issue for a Group Health Plan mean?
Guaranteed issue for a group policy means that a health plan must be offered and issued to an employer, employee, or dependent of the employee, regardless of claims history, pre-existing conditions or health status. Small groups (1-50 eligible employees) are guaranteed issue but large groups (51 or more eligible employees) are not.
At what cost? I moved from my group to an individual policy because it cost too much and when my wife tried to move they said she has a pre existing condition from some back problem she had years earlier. She was stuck on the group plan. In two years the rate went up from $875.00 a month to over $1500. month. She now has the

PCIP - Pre-existing Condition Insurance Plan - Home

and it is great. A few hoops to jump through at first but that has changed and it is easier now. This is no freebee or give away you pay a deductible and pretty good premiums but you can see any doctors with a small office copay. She now goes to the Cleveland Clinic and has some of the best doctors in the country. Thinking back to what it was like with our old HMO BS that we paid through the nose for it was more like being in an inner-city poverty clinic environment. Now we see doctors who actually practice medicine, not spend all day worrying about running their business.
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Old 08-16-2011, 12:25 PM
 
2,930 posts, read 6,199,150 times
Reputation: 1376
Quote:
Originally Posted by mango23 View Post
At what cost? I moved from my group to an individual policy because it cost too much and when my wife tried to move they said she has a pre existing condition from some back problem she had years earlier. She was stuck on the group plan. In two years the rate went up from $875.00 a month to over $1500. month. She now has the

PCIP - Pre-existing Condition Insurance Plan - Home

and it is great. A few hoops to jump through at first but that has changed and it is easier now. This is no freebee or give away you pay a deductible and pretty good premiums but you can see any doctors with a small office copay. She now goes to the Cleveland Clinic and has some of the best doctors in the country. Thinking back to what it was like with our old HMO BS that we paid through the nose for it was more like being in an inner-city poverty clinic environment. Now we see doctors who actually practice medicine, not spend all day worrying about running their business.
Mango, how did she managed with 6 months without insurance? Does she take medicine? I have to agree with the OP, it's a terrible requirement especially for those who need prescription drugs.
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Old 08-16-2011, 12:50 PM
 
1,468 posts, read 4,166,742 times
Reputation: 1071
Quote:
Originally Posted by ♥♥PRINC3Ss♥♥ View Post
Mango, how did she managed with 6 months without insurance? Does she take medicine? I have to agree with the OP, it's a terrible requirement especially for those who need prescription drugs.
At the time she was without ins for the 6 months so we fit right in. I know some changes have been made in just the last months and this may be something you can get around now. What they didn't want was someone dropping other insurance to get it. Rather then reading on here and listening to speculation call them they answer right away and are there to help you not give you a run around. I know it is easier now.

I don't care what political party one follows this is a good thing and is saving lives and as we speak. It is not a government give away, you are being given the opportunity to buy into the same pool that covers government employees, it is by no means a freebee. You have to pay your premium on time or you will be without insurance again like with any company.

Someone who is poor or broke probably could not afford this either, they would end up on some welfare deal. It is for everyday people caught in a system that won't let them get insurance even if they want to pay. This is not a debate, my wife has it now and it is a life saver. I can't say enough about the doctors she now has access to she didn't have on the old Group plan I had for years. The truth is, most people who think they have insurance have *****. The first time they go to use it they find out how worthless it may be and how much they will pay for lousy care.

This is not a topic I can be subjective about, I am sorry. That insurance card people have in their pockets from their employer in many cases is all but worthless and they just don't know it. Add to that if they did get sick or injured they will probably lose their job, lose their insurance, have a pre existing condition now and be unable to get more insurance, maybe go bankrupt. People live on thin ice every day as they go through their lives in a blind false sense security.

Last edited by mango23; 08-16-2011 at 01:04 PM..
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Old 08-16-2011, 05:01 PM
 
Location: Phoenix, AZ > Raleigh, NC
15,070 posts, read 19,013,423 times
Reputation: 24177
I'm not getting into a debate about Health Care Reform. I said that in my original post.

But a couple of thoughts/facts from what other posters have said:

I've personally confirmed that Florida does offer a one-person group for their small business insurance. However, it is ONLY available during the open enrollment period in August. They may or may not offer this next August. For that matter, they may not offer this insurance at all next year. (This is what THEY told me.)

At what cost is this insurance? Yes, it is guaranteed issue - they can't turn you down. But yes, they can charge you more if you have pre-existing conditions. Up to 200% of the regular base premium. Which is one helluva chunk of change to 99% of Americans.

Mango23, in your wife's situation, the PCIP is a blessing. It must be a great relief to you and she, and the rest of your family, to have this coverage for her. But for many of us, taking the chance of going without any insurance for 6 months is risky - some would even call it financially stupid.

As far as the government worrying that everyone would rush to drop their expensive employer sponsored plans in favor of the PCIP - well, the Feds estimated that over 200,000 would enroll in the first 6 months after the PCIP was established on Sept 23, 2010. To date, less than 20,000 have enrolled. I'm guessing the number of enrolled would increase if they dropped the foolish 6 month no coverage requirement.

Personally, my biggest concern with the PCIP is that no one knows what will happen to the people who are insured in those plans if the Health Care Reform Act is repealed. As of now, the documentation indicates that they will not have this insurance when their contract ends. Let's hope for Mango and his wife (and many others) that doesn't happen.

I've found no reasonable solution for someone like me, who managed to save enough and get lucky enough to retire long before I'm eligible for Medicare. It may be that staying in Arizona, where I can obtain insurance through the AZ SBA (at $680/month for a $5000 deductible) is the smartest thing to do. At least until the Supreme Court shakes out if HCR will or will not be repealed.
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Old 08-16-2011, 08:10 PM
 
Location: Miami
1,821 posts, read 2,325,869 times
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Jkgourment - no company gave you an affordable quote?

During the month of August - 1 employee companies can get insured.

The 6 month no insurance is a deal breaker for me too.
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Old 08-16-2011, 09:40 PM
 
Location: Phoenix, AZ > Raleigh, NC
15,070 posts, read 19,013,423 times
Reputation: 24177
Quote:
Originally Posted by valicky View Post
Jkgourment - no company gave you an affordable quote?

During the month of August - 1 employee companies can get insured.

The 6 month no insurance is a deal breaker for me too.
I am still a resident of AZ, so none of the companies will give me a quote. I was able to dig into the links you posted earlier in this thread and find estimated rates for healthy people. They are broken down by age range and gender. You select a plan then select your county then it gives you the estimated premiums. Increase that 150-200% and you have a VERY general guestimate of what these programs will cost if you have pre-existing conditions. At least, that's what the FL dept of insurance told me to do to get a VERY rough idea.

So, even with the $5000 deductible plans, in Lee & Charlotte Counties, as a female aged 55-59, the lowest premiums I calculated were roughly $1500/mo and up. Higher deductibles and altering the county did decrease that somewhat.

To add insult to that injury, it also appears that there are some pretty specific requirements to qualify as a "small business" under this plan. You must show a profit on your tax returns for two of the last three years (which made the nice guy at the dept of insurance wonder if having a business in the state of FL for two years was ALSO a requirement, but he wasn't sure.). Just having a dba is probably inadequate. He suggested checking with other government departments and the carriers themselves for more information on this.

But, more to the point, the cost IS very high if you are classified as having a pre-existing condition. And, there is no guarantee that the program will exist next year. There is ONE thing that I personally think can be guaranteed: premiums will be higher next year than they are this year.

Sorry to say, but this may put a very large kink in our future plans to relocate.
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Old 08-16-2011, 10:11 PM
 
Location: on the edge of Sanity
14,269 posts, read 15,908,825 times
Reputation: 7899
So far less than 800 people have enrolled in the PCIP program in Florida. Tells you how popular it is.
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Old 08-16-2011, 11:50 PM
 
Location: Miami
1,821 posts, read 2,325,869 times
Reputation: 914
Wow - $1500! That's horrible. The only thing we show is the Schedule C of our tax return. I've never heard that it had to show a profit. We had already been in business for a long time so I don't know about the 2 year pre-requisite. It will be nice when insurance companies won't have the pre-existing conditions exclusions, but I think they'll raise their rates even more to make up for it.
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Old 08-17-2011, 01:22 AM
 
Location: Miami
1,821 posts, read 2,325,869 times
Reputation: 914
I found this about HIPAA guaranteed issue policies. Maybe something like this would work?

http://disabilityrightslegalcenter.o...yState2011.pdf

I can pm you the name of the guy we used to get health insurance from before we did the self-employed open enrollment insurance. He's in Miami but he may be able to give advice on what someone who's trying to relocate with pre-existing conditions is eligible for. I'd post his website, but I'm not sure it's allowed.
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Old 08-17-2011, 06:09 AM
 
1,468 posts, read 4,166,742 times
Reputation: 1071
Quote:
Originally Posted by justNancy View Post
So far less than 800 people have enrolled in the PCIP program in Florida. Tells you how popular it is.
The low number is due to several things. 1, a lot of people who don't have insurance and are not currently sick will still not join because it is not free. Many people still have no idea what it is or that it exists. Regardless it is at about 20% of the estimated it would draw and the rest of the people are on welfare programs like Medicaid and will just stay there regardless of how bad the care is because it is free.

Lets face it, even $200.00 or $300.00 a month will keep a lot of people out. They want something for nothing and this is not a give a way. The 6 month thing is not really the barrier and for someone who lost their insurance the 6 months will pass regardless. Many have been without insurance for years, some may have never had any. Lets face it a certain segment of the population always want everything for nothing.

All I want is to be able to purchase insurance that is not employer based. I don't want something for nothing just a pool I can buy into that does not tie me to a job. This is a ridiculous system where you are prisoner to a job because you can't risk losing your insurance. How are people ever to move on with their lives, start business, relocate if they can't take their insurance along. I am sorry for those who can't afford anything there are programs for them, but for me a millions of others like me who just want to buy our own good health insurance we need a place to go.

I used to have insurance through a thing in Florida called CHIPA if I remember right, that was a small business combined group. We were only 2 persons but the group was over 50,000 members and the insurance was fine. This setting up a fake small business so you can buy a group plan has been idiotic from the start. What the heck is a 2 person group anyway?

I had to come back and add this. Some people are wondering how we took the risk of her going without insurance for 6 months. The decision was easy, she had to get off the over priced merrie-go-round we were on with the group at $1500.00 a month that in 2 years would have been over $2500.00. After dropping it the only risk was should she get sick in the coming 6 months we would be out of pocket. Barring her all of a sudden being diagnosed with cancer or having a heart attack in the six month we were saving $1500.00 a month. And every day that went by we were closer to the 6 months with plenty of savings from having canceled to pay for any general health issues. Long story short, She went to the doctor once and we self paid for like $200.00. Bottom line, we saved $9000.00, spent $200.00 and she now has insurance.

All this because they found an old supposed back injury (Maybe), just some thing that appeared on an x-ray that may have been a chipped bone, (or nothing), she had never had a problem with, to use as an excuse to deny her insurance. The truth is, even though she was healthy, I was told by a agent privately they look for any way to deny women of her age range, (54), because they may become a risk. This had nothing to do with the old back injury farce.

Last edited by mango23; 08-17-2011 at 07:27 AM..
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