Insurance Q!! (pay, companies, benefits, account)

[sillygal]

Lets say u quit your job, and u have the option of taking cobra, and u do/ or don't........Is it wise to get on a different insurance plan while u still have another?

I guess what I am asking is this......??? If i didn't have any insurance at all and just went to an agency and I tell them my health, they will say well u can get so and so.....or maybe u can't. If I had insurance already and switched it to another would it be easier to switch? Without the lapse in insurance? I hope that makes sense........LOL!!!

[windflower]

I am pretty sure that having "duplicate coverage" is not allowed; at least it has not been allowed in any state in which I've ever been employed.

Nowadays with all insurance records being ultimately based on one's Social Security number, such things are easy to check. You might get away with it for a very short time if the "second" company doesn't check immediately; but if they do check, and find that you're already insured with someone else, I am fairly sure that they'd have grounds to cancel your policy because you made a false statement on the application form. All of the application forms I've ever seen ask whether you are covered by any other policy.

[Racelady88]

I would have a new insurance company lined up before I let my old insurance lapse. Insurance companies love to use the term "pre-existing condition" and exclude things from being covered.

It is very time consuming to shop for health insurance. I spent almost a month waiting on real answers, comparing plans, waiting to hear from the underwriter, etc.

[MoMark]

Originally Posted by sillygal

Lets say u quit your job, and u have the option of taking cobra, and u do/ or don't........Is it wise to get on a different insurance plan while u still have another?

I guess what I am asking is this......??? If i didn't have any insurance at all and just went to an agency and I tell them my health, they will say well u can get so and so.....or maybe u can't. If I had insurance already and switched it to another would it be easier to switch? Without the lapse in insurance? I hope that makes sense........LOL!!!

I'm not an expert, but I'll tell you what I think I know! At least with some of this information you can look it up yourself for more knowledge.
The U.S. government passed a law in 1996 called HIPAA (Health Insurance Portability and Accountability Act). This law means that even if you have a pre-existing condition, when you join a new employer group plan, you are instantly covered even for pre-existing conditions.
There are catches....
If you quit your job and choose not to keep COBRA coverage (which is basically that you maintain your current insurance but pay the full cost of the premium - you see the true cost under COBRA!) and lapse more than 63 days in continuous coverage before joining a new company and its group plan, they may exclude any coverage of pre-existing conditions up to 18 months.
It's best if you quit or leave a job to carry on the COBRA until you join a new company that offers the group plans. They must cover your pre-existing conditions immediately with no waiting period.
However...
If you go from a group plan by quitting a job and take COBRA and try to obtain private insurance, it's up to that insurer. They're under no legal obligation to cover you for pre-existing conditions and may deny you or cover you with limited benefits and extreme premiums.

The main point:
Let the HIPAA law protect you. Don't allow a lapse in coverage of more than 63 days before joining a new company's group plan. If you do, it may mean waiting 18 months for eligibility for pre-existing condition coverage.
Pay for COBRA if you have to.

[windflower]

I may have misinterpreted the original post; what I thought the OP's question was this:
1. She's now covered by her current employer's group insurance plan.
2. She's planning on quitting that job, in which case she'd have no health insurance at all, unless she signs up for COBRA.
3. She's concerned about the cost of COBRA? (which I don't understand because her premium under COBRA will probably be less than if she obtained private coverage for herself on her own)
4. She would like to apply for private coverage for herself directly with a health insurance company, while still working for her current employer, but not disclose to the new company that she has coverage right now under her employer's plan.
5. Then she would quit her job without opting for COBRA, because she will already be covered under her new, private policy.
6. When she finds a new job, she would drop her private policy and be covered under the new employer's group plan.

The thing I don't understand is why someone would want to pay more (for an individual policy) than less (for COBRA). Unless the employer's plan is a very very good (expensive) one and the individual policy is extremely bare-bones (cheap, or at least cheaper per month).

I once went out on COBRA and my premiums under that were $725/mo. To obtain the same coverage on an individual basis would have cost me $1100/mo. I could not have gotten any policy that I'd want to have, for less than $725/mo privately; and that was five years ago!

[Racelady88]

Originally Posted by windflower

I may have misinterpreted the original post; what I thought the OP's question was this:
1. She's now covered by her current employer's group insurance plan.
2. She's planning on quitting that job, in which case she'd have no health insurance at all, unless she signs up for COBRA.
3. She's concerned about the cost of COBRA? (which I don't understand because her premium under COBRA will probably be less than if she obtained private coverage for herself on her own)
4. She would like to apply for private coverage for herself directly with a health insurance company, while still working for her current employer, but not disclose to the new company that she has coverage right now under her employer's plan.
5. Then she would quit her job without opting for COBRA, because she will already be covered under her new, private policy.
6. When she finds a new job, she would drop her private policy and be covered under the new employer's group plan.

The thing I don't understand is why someone would want to pay more (for an individual policy) than less (for COBRA). Unless the employer's plan is a very very good (expensive) one and the individual policy is extremely bare-bones (cheap, or at least cheaper per month).

I once went out on COBRA and my premiums under that were $725/mo. To obtain the same coverage on an individual basis would have cost me $1100/mo. I could not have gotten any policy that I'd want to have, for less than $725/mo privately; and that was five years ago!

That was how I interpreted the OP.

For me, COBRA was several hundred dollars per month more than the private coverage I was able to get. And it was a pretty crappy plan that my employer had us on.

Something else to consider: when I left that job I moved out of state. My employer's plan did not cover anything but prescriptions out of state. Nobody provided me with that info, and I ended up having to pay several thousand dollars out of pocket.

Pros & cons to electing coverage under COBRA.

A new policy with a private carrier could be set up to begin the day after the employer's coverage ends.

[sillygal]

I know it was very unclear, I had trouble saying what I meant..........LOL Sorry for that........ Yes, I was worried about pre-existing conditions if lets say I quit, paid Cobra for a while and decided I couldn't afford it any longer to hang on to it until I get something else?.... So, I need NOT to let my cobra run out then.........I understand. I didn't know the law about the pre-existing conditions MoMark, thank you for telling me that. U are so smart!!!!!! I will double check on that........ I am thinking it was NOT good to let my insurance lap, ie quitting my job and letting insurance run out, and then later on try to get it. I have existing health conditions so this is critical for me.

Thanks Everyone and Sorry, I couldn't get it out the way I needed too!!!

[TriDad]

sillygal,

Variations of the law can vary from state to state, but HIPAA & COBRA are federal regulations so the info I'll provide will apply across the board. First off, you should seek out a licensed professional insurance agent who specializes in medical coverage.

COBRA is just a continuation of your existing plan that you pay 103% of the cost (3% admin fee is tacked on) The federal law states that as long as you did not have a gap of more than 63 days (2 months) without continuous coverage, and you transfer on to a new employer's group plan, you'll get what's called a "full takeover" of benefits and will be covered fully on the new group plan (provided you were fully covered under the previous plan whether it was COBRA, an individual plan, or another group plan through previous employer. btw....any waiting period imposed by your new employer (# of days you have to wait in order to become eligible for coverage) will not count towards the 63 days. That's a good thing because a number of companies have a 90 day waiting period for new hires.

If you exhaust your COBRA (keep it for the maximum 18 months) you'll have the option of converting it into a permanent individual plan with the insurance company covering you. You'd also have the option of going to another insurance company and applying for a "guaranteed-issue" individual plan. You'll need to provide the HIPAA Cerificate of Credible Coverage in order to apply for such a plan.

If someone has pre-existing conditions with no prior coverage, and gets on a group employer plan, they will get full coverage after a period of time depending on the size of the employer.

Yes, I am a licensed agent, and hope this helps. As always...seek out a good agent who's licensed in your state

[sillygal]

Ok.......What if I quit my job in NC, and move to TN will I be able to still get my cobra. I may be moved by the time my employers insurance runs out, or I may not be.....So, how would that work?

[TriDad]

Originally Posted by sillygal

Ok.......What if I quit my job in NC, and move to TN will I be able to still get my cobra. I may be moved by the time my employers insurance runs out, or I may not be.....So, how would that work?

COBRA is not a policy per se...it's just a way for you to continue your current employer-sponsored insurance. So if your employer offers Insurance Company ABC, and they have plans in TN then you'd be able to continue it there. If they don't have plans in TN, then you could obtain a HIPAA certificate and apply for a guaranteed-issue individual policy with an insurance company that offers then in that state.