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Location: Mableton, GA USA (NW Atlanta suburb, 4 miles OTP)
11,334 posts, read 26,089,277 times
Reputation: 3995
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Please forgive me if this is an obvious question, but I have a friend in a difficult situation, and I have no idea what his options might be. I've always had health coverage through work.
In any case, I would appreciate some advice. Thanks in advance...
We have a male friend in his mid-thirties who had been living with his girlfriend of a few years, and he was on her health insurance (her policy apparently allowed coverage for unmarried but cohabiting couples). She was and is working full-time, and he was going to school full-time (online) and was working toward getting a degree.
To make a long story short, he had a heart attack about two weeks ago. Concerned, she brought him to the emergency room, they treated him for a heart attack and operated (four stints), and he spent the better part of six days in the hospital.
While he was still in the ICU, they apparently had a falling out, and she ended up kicking him out of her townhouse. He has an alternative place to live for now, and his room and food is taken care of, but she's going to be dropping him from her insurance policy immediately. He is still covered, but the change to his coverage (from her policy) is taking place relatively quickly.
He lives in Cobb County, Georgia.
In my home state, I would probably direct him to MinnesotaCare, but that isn't where the situation is taking place, and I strongly suspect Georgia does not have an equivalent program in place.
What are his options? Because of his recent heart issues, he has (and will have) a number of upcoming medical expenses including prescriptions and regular visits to at least one specialist.
Any advice would be appreciated. I suspect the fact that he still has temporary coverage is important for his future insurability, so it's probably important to find something quickly. Is that a correct assessment?
He will have the option for COBRA at least until he gets on his feet and finds something else. Private plans are an option but depending on the laws in GA, the recent heart attack might be an instant decline.
Cobra followed by insurance through his university...
assuming its a state university with an online program (they will have health insurance for students) as opposed to something like Univ. of Phoenix, which probably doesn't offer health insurance plans for students..
Or, get a job - (with benefits!) quickly - and don't let the COBRA run out before that!!!! (fyi: Cobra can be very expensive)
He also needs to check into the pre-existing coverage offered under the new healthcare law which is already in effect.Cheackig with his local health srevice or even right dept of the hospital he is i should get him on that track if he can't get needed coverage thru college.I know that to aplly that one requirement is that he be reject for coverage by a insurer with his condition.
Please forgive me if this is an obvious question, but I have a friend in a difficult situation, and I have no idea what his options might be. I've always had health coverage through work.
In any case, I would appreciate some advice. Thanks in advance...
We have a male friend in his mid-thirties who had been living with his girlfriend of a few years, and he was on her health insurance (her policy apparently allowed coverage for unmarried but cohabiting couples). She was and is working full-time, and he was going to school full-time (online) and was working toward getting a degree.
To make a long story short, he had a heart attack about two weeks ago. Concerned, she brought him to the emergency room, they treated him for a heart attack and operated (four stints), and he spent the better part of six days in the hospital.
While he was still in the ICU, they apparently had a falling out, and she ended up kicking him out of her townhouse. He has an alternative place to live for now, and his room and food is taken care of, but she's going to be dropping him from her insurance policy immediately. He is still covered, but the change to his coverage (from her policy) is taking place relatively quickly.
He lives in Cobb County, Georgia.
In my home state, I would probably direct him to MinnesotaCare, but that isn't where the situation is taking place, and I strongly suspect Georgia does not have an equivalent program in place.
What are his options? Because of his recent heart issues, he has (and will have) a number of upcoming medical expenses including prescriptions and regular visits to at least one specialist.
Any advice would be appreciated. I suspect the fact that he still has temporary coverage is important for his future insurability, so it's probably important to find something quickly. Is that a correct assessment?
Wow, that certainly is "kicking a man while he is down!"
Location: Mableton, GA USA (NW Atlanta suburb, 4 miles OTP)
11,334 posts, read 26,089,277 times
Reputation: 3995
Quote:
Originally Posted by PastTense01
Did he talk to the insurance company his former girlfriend is insured with about getting an individual policy there?
He has done that, and also talked with a number of other people. My wife is actually coordinating things with him more than I am, so I'm not aware of details at this point. Just looking for options.
Quote:
Originally Posted by golfgal
He will have the option for COBRA at least until he gets on his feet and finds something else. Private plans are an option but depending on the laws in GA, the recent heart attack might be an instant decline.
Yup. It's too bad this state doesn't have better programs. Fulton County seems superior to Cobb in this regard, but both tend to heavily favor females with kids. I guess male citizens don't matter as much here.
There's a fed program for people who can't get insurance, but he won't be eligible for six months.
Quote:
Originally Posted by Briolat21
Cobra followed by insurance through his university...
That was my initial idea, but he is in fact taking classes through the University of Phoenix, so that after COBRA isn't an option.
Quote:
Originally Posted by texdav
He also needs to check into the pre-existing coverage offered under the new healthcare law which is already in effect.Cheackig with his local health srevice or even right dept of the hospital he is i should get him on that track if he can't get needed coverage thru college.I know that to aplly that one requirement is that he be reject for coverage by a insurer with his condition.
Yes, I know he's been talking to the folks in a couple of hospital systems. I'm sure some arrangement can be made. At least things will be (hopefully) limited to follow-up care at this point, and the major stuff is done with. He may be able to use the services at one of the free clinics in the area. Time will tell.
Quote:
Originally Posted by germaine2626
Wow, that certainly is "kicking a man while he is down!"
Have him discuss this with the hospital social worker, they might have some ideas.
OP is quite right about not letting coverage lapse between policies. If there's a gap of more than 63 days between GROUP policies, then, they can deny previous existing conditions. Note I said GROUP policies. Many people make the mistake of buying an individual policy to fill in between group policies, only to find they are then excluded from group policy coverage.
Sorry, the part of Obamacare that prohibits exclusion from insurance coverage based on pre-existing conditions doesn't kick in until 2014.
Location: Mableton, GA USA (NW Atlanta suburb, 4 miles OTP)
11,334 posts, read 26,089,277 times
Reputation: 3995
Quote:
Originally Posted by MaryleeII
Have him discuss this with the hospital social worker, they might have some ideas.
It sounds like he's working something out. Thankfully, many of the meds he will be needing are $4/month at Walmart, and he can get one for free. Not sure how he did that, but... One is more expensive, but he can cope.
Anyway ... COBRA appears to not be possible. They need information from his ex's employer that he can't provide and that she is not willing to give him, so it sounds like he can't get it due because of paperwork technicalities. Frustrating. He doesn't know the name of the contracting firm she was working through, only the place she was actually working, and they won't release that info either.
My wife used to work in workers comp and has been talking to all sorts of people ... at least it sounds like they've made some headway. The healthcare system in this country (or more precisely, the delivery mechanism) really makes me wonder sometimes...
Anyway ... COBRA appears to not be possible. My wife used to work in workers comp and has been talking to all sorts of people ... at least it sounds like they've made some headway.
PCIP was set up to cover the interval between enactment of the ACA and full implementation in 2014. Several on this board are using it and feel the PCIP has been a godsend.
Quote:
Originally Posted by rcsteiner
The healthcare system in this country (or more precisely, the delivery mechanism) really makes me wonder sometimes...
No kidding. It's all about self-reliance and free-enterprise, don'cha know. In other words, don't get sick if you can't afford health insurance.
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Thanks in advance...
