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Old 08-12-2011, 11:50 AM
 
Location: Phoenix, AZ > Raleigh, NC
15,021 posts, read 18,874,120 times
Reputation: 24009

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We are considering moving to FL from Arizona. I am an early retiree, soon to be 55, so a long ways off from Medicare. (husband is on Medicare, so no problems there, except for my jealousy of his coverage and premium costs.)

Due to pre-existing conditions and medications, I am not eligible for any underwritten policy. In AZ, I obtain my health insurance through a group plan with the AZ Small Business Association (it's expensive, but. . .) I keep a couple of online businesses, largely to keep my membership in the Association valid. If/when I leave the state, I will lose that membership.

Is there something similar in Florida? Or are there other alternatives that I haven't discovered. From what I have found, the high-risk group through the state closed for new enrollees over a decade ago.

(let's not get into a discussion about if the Health Care Reform Act is going to solve this problem. It doesn't take effect until 2014, and who knows if it's ever going to happen. And yes, I"m aware of the PCIP program, but again, who knows if it's going to exist in a year?)
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Old 08-12-2011, 01:26 PM
 
11,314 posts, read 7,316,395 times
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Quote:
Originally Posted by Jkgourmet View Post
We are considering moving to FL from Arizona. I am an early retiree, soon to be 55, so a long ways off from Medicare. (husband is on Medicare, so no problems there, except for my jealousy of his coverage and premium costs.)

Due to pre-existing conditions and medications, I am not eligible for any underwritten policy. In AZ, I obtain my health insurance through a group plan with the AZ Small Business Association (it's expensive, but. . .) I keep a couple of online businesses, largely to keep my membership in the Association valid. If/when I leave the state, I will lose that membership.

Is there something similar in Florida? Or are there other alternatives that I haven't discovered. From what I have found, the high-risk group through the state closed for new enrollees over a decade ago.

(let's not get into a discussion about if the Health Care Reform Act is going to solve this problem. It doesn't take effect until 2014, and who knows if it's ever going to happen. And yes, I"m aware of the PCIP program, but again, who knows if it's going to exist in a year?)
How can you not bring up the health care reform act? Many other states have or are setting up their insurance exchanges that would help you out. I think Florida is one of the few states who are not setting up an exchange. It's unfortunate, but Florida is ran by a bunch a clowns currently.
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Old 08-12-2011, 01:48 PM
 
15,311 posts, read 17,507,733 times
Reputation: 13405
This is available, but you must have a preexisting condition and you must have gone with NO health insurance for the past 6 months. I don't like the part that forces you to go without insurance for 6 months. Anyway....
Pre-Existing Condition Insurance Plan: Florida




Eligible residents of Florida can apply for coverage through the Pre-Existing Condition Insurance Plan program run by the U.S. Department of Health and Human Services.

To qualify for coverage:
  • You must be a citizen or national of the United States or lawfully present in the United States.
  • You must have been uninsured for at least the last six months before you apply.
  • You must have a pre-existing condition or have been denied coverage because of your health condition.
PCIP covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, even if it’s to treat a preexisting condition.
Please note rates have changed as of July 1, 2011. The monthly premiums for your state are:
Age Standard Option Extended Option HSA Option
0 to 18 $118 $158 $122
19 to 34 $176 $237 $183
35 to 44 $211 $284 $220
45 to 54 $270 $363 $280
55+ $376 $505 $390

In addition to your monthly premium, you will pay other costs. In 2011, you will pay a $1,000 to $3,000 deductible, which varies by your plan option, for covered medical benefits (except for preventive services) before the plan starts to pay. A plan option may have a separate drug deductible. After you pay the deductible, you will pay a $25 copayment for doctor visits, $4 to $40 for most prescription drugs, and 20% of the costs of any other covered benefits you get. Your out-of-pocket costs cannot be more than $5,950 per year. These costs may be higher, if you go outside the plan’s network.
http://www.healthcare.gov/law/provis...states/fl.html

Last edited by sware2cod; 08-12-2011 at 01:58 PM..
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Old 08-12-2011, 04:20 PM
 
Location: Phoenix, AZ > Raleigh, NC
15,021 posts, read 18,874,120 times
Reputation: 24009
Quote:
Originally Posted by Winter_Sucks View Post
How can you not bring up the health care reform act? Many other states have or are setting up their insurance exchanges that would help you out. I think Florida is one of the few states who are not setting up an exchange. It's unfortunate, but Florida is ran by a bunch a clowns currently.
In fact, I believe that 26 states plus DC set up their own exchanges. 24 are doing it through the federal exchange.

More to the point, I don't think ANYONE can say with a reasonable level of assurance that the Health Care Reform Act will not be repealed. See this, just from today. Appeals Court Strikes Health Insurance Requirement. Next stop - Supreme Court.

Plus, the requirement to go bare (without ANY insurance) for 6 months in order to be eligible for PCIP is incredibly ridiculous. I've yet to get an answer from any congressman or senator explaining this requirement.

So, I think looking for other alternatives is just the smart, responsible thing to do.
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Old 08-12-2011, 04:25 PM
 
Location: Phoenix, AZ > Raleigh, NC
15,021 posts, read 18,874,120 times
Reputation: 24009
Quote:
Originally Posted by sware2cod View Post
This is available, but you must have a preexisting condition and you must have gone with NO health insurance for the past 6 months. I don't like the part that forces you to go without insurance for 6 months. Anyway....
Pre-Existing Condition Insurance Plan: Florida




Eligible residents of Florida can apply for coverage through the Pre-Existing Condition Insurance Plan program run by the U.S. Department of Health and Human Services.

To qualify for coverage:
  • You must be a citizen or national of the United States or lawfully present in the United States.
  • You must have been uninsured for at least the last six months before you apply.
  • You must have a pre-existing condition or have been denied coverage because of your health condition.
PCIP covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, even if itís to treat a preexisting condition.
Please note rates have changed as of July 1, 2011. The monthly premiums for your state are:
Age Standard Option Extended Option HSA Option
0 to 18 $118 $158 $122
19 to 34 $176 $237 $183
35 to 44 $211 $284 $220
45 to 54 $270 $363 $280
55+ $376 $505 $390

In addition to your monthly premium, you will pay other costs. In 2011, you will pay a $1,000 to $3,000 deductible, which varies by your plan option, for covered medical benefits (except for preventive services) before the plan starts to pay. A plan option may have a separate drug deductible. After you pay the deductible, you will pay a $25 copayment for doctor visits, $4 to $40 for most prescription drugs, and 20% of the costs of any other covered benefits you get. Your out-of-pocket costs cannot be more than $5,950 per year. These costs may be higher, if you go outside the planís network.
Pre-Existing Condition Insurance Plan: Florida | HealthCare.gov
Yes, this is the PCIP plan - the bridge that HCR set up to cover those with pre-existing conditions until the HCR plan becomes effective in 2014. IF IT DOESN'T get repealed - which may very well be what happens.

And the requirement to go without insurance for 6 months - just plain ridiculous, IMO.

I've been trying to get an answer from congressman and senators about what will happen to those who enroll in PCIP if HCR never takes effect. "We are unable to determine that" has been the most frequent answer. One honest congressional aide told me (verbally, not in writing) "umm, I think they will be uninsured again."

So - back to my question. Are there alternatives in FL for the self employed - like a small business association that offers health insurance to its members? Or another alternative?
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Old 08-13-2011, 12:13 AM
 
Location: Miami
1,821 posts, read 2,316,530 times
Reputation: 914
August is open enrollment month in FL for health insurance for small businesses.
Here are a couple of websites with info:
Small Group Carrier List

https://apps.fldfs.com/sercs/

It's expensive, but these companies have to accept you. You can deduct it on your Schedule C so that helps a little.
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Old 08-13-2011, 06:47 AM
 
11,314 posts, read 7,316,395 times
Reputation: 4479
Quote:
Originally Posted by Jkgourmet View Post
In fact, I believe that 26 states plus DC set up their own exchanges. 24 are doing it through the federal exchange.

More to the point, I don't think ANYONE can say with a reasonable level of assurance that the Health Care Reform Act will not be repealed. See this, just from today. Appeals Court Strikes Health Insurance Requirement. Next stop - Supreme Court.

Plus, the requirement to go bare (without ANY insurance) for 6 months in order to be eligible for PCIP is incredibly ridiculous. I've yet to get an answer from any congressman or senator explaining this requirement.

So, I think looking for other alternatives is just the smart, responsible thing to do.
That part should be repealed. I don't think mandating health insurance is the right thing to do, but the rest of the bill seems reasonable to me. The Supreme Court is controlled by pro-corporate forces and the individual mandate is a creation of corporate America, so I'm thinking the Supreme Court will uphold the individual mandate.
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Old 08-13-2011, 09:09 AM
 
15,311 posts, read 17,507,733 times
Reputation: 13405
I hope it doesn't get repealed. I can't wait until 2014 so I can purchase a policy. I am willing to pay good money for the premium. Just need to be able to buy health insurance. I'm semi retired and don't want to have to work in a job just because I need health insurance and for no other reason. This takes a lot of jobs away from other people that really need the job.

There are lots of folks in FL that moved here to retire early and are 50s-64. Many currently work in FL just to get the health insurance..at retail jobs/big box stores and such that are totally outside their prior careers. They often have pensions/income from prior jobs and moved to FL to retire. They are too young for medicare. But they work in FL just enough hours to qualify for health insurance. I think once 2014 rolls around, a lot of these folks will leave those jobs because they will be able to purchase a policy elsewhere. This will have a trickle down effect...as those jobs will then become available.
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Old 08-13-2011, 09:26 AM
 
11,314 posts, read 7,316,395 times
Reputation: 4479
Quote:
Originally Posted by sware2cod View Post
I hope it doesn't get repealed. I can't wait until 2014 so I can purchase a policy. I am willing to pay good money for the premium. Just need to be able to buy health insurance. I'm semi retired and don't want to have to work in a job just because I need health insurance and for no other reason. This takes a lot of jobs away from other people that really need the job.

There are lots of folks in FL that moved here to retire early and are 50s-64. Many currently work in FL just to get the health insurance..at retail jobs/big box stores and such that are totally outside their prior careers. They often have pensions/income from prior jobs and moved to FL to retire. They are too young for medicare. But they work in FL just enough hours to qualify for health insurance. I think once 2014 rolls around, a lot of these folks will leave those jobs because they will be able to purchase a policy elsewhere. This will have a trickle down effect...as those jobs will then become available.
I agree. I hope the whole bill doesn't get repealed. I hope that in the future there will be a plan that is like Medicare that people can buy into. I'm all for capitalism, but when it comes to health care I don't think that profit should be the ultimate motive.
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Old 08-13-2011, 09:38 AM
 
Location: Phoenix, AZ > Raleigh, NC
15,021 posts, read 18,874,120 times
Reputation: 24009
I didn't want to turn this into a political debate on HCR. Which is why I suggested leaving it out of the discussion entirely in my OP.

Valicky, thanks for those links - hopefully, they will point me in a direction that will resolve my problem. I simply don't feel ANY high level of assurance that HCR will actually ever take affect. And I'm not thrilled with taking the personal risk of going without insurance for 6 months just to be allowed to buy insurance, either (especially since I have insurance, and I'm paying for it - dearly).

ADDITION: From my initial research, The above referenced Florida policies for small businesses require a minimum of 2 employees. That eliminates this as an option for me.

Last edited by Jkgourmet; 08-13-2011 at 09:59 AM..
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