When Cobra Benefits end, and you have a pre-existing condition, Traditional carriers will not Insure, Hippa?

Question

Currently utilizing cobra, can't go back to work just yet, Cobra benefits will exhaust soon, also incredibly expensive, and Traditional Insurance Carriers, have turned me down, Anyone understand how Hippa can be of assistance in guaranteeing insurability? And if so, what is process? Must I wait until Cobra ends, would love to find a policy that is less expensive, with the assist of Hippa, and the guidelines that are applicable??? People are telling me that Hippa will assist when the Cobra benefits are exhausted, not quite sure I understand how Hippa works, and why I must wait until my Cobra benefits end, Can't I utilize whatever benefits Hippa can provide at this juncture, and if so, what is the process? Can someone please elaborate on how this all comes together?

Answer 1

Sure, it can guarantee insurability, but it doesn't guarantee what PRICE.  You do NOT want to wait until cobra ends, and you are NOT going to find anything as cheap as cobra, to cover the pre-existing conditions.  

Usually under HIPPA, the prices you get are intended to price you out of the market - it can be thousands a month.  There's no law to how much an insurance company has to charge, under HIPPA.  

You need a local, independent agent to help you out with this.  You should ALSO look and see if your state has a high risk health pool - it can be as low as $400 a month, or as high as $1600 a month, which is still likely cheaper than you'd get from a private policy with HIPPA, depending on your condition.

Answer 2

Here is the government website concerning HIPAA laws: http://www.dol.gov/dol/topic/health-plan...

As already mentioned, you must exhaust your COBRA benefits first, you must apply for the HIPAA plan within 63 days from the end of COBRA. You cannot have any short term medical plans during the time.

Almost all "traditional" companies have HIPAA plans but the selection is small, usually only one or two options. You are guaranteed the policy but not the premium so don't expect it to be cheaper than COBRA. The premium is based on your medical conditions. The least expensive plan any of my clients got was $1100 per month; the most expensive was $2900.

Answer 3

HIPAA is the Health Insurance Portability and Accountability Act. HIPAA enacted reforms in both the group and individual health insurance markets, in part to help many individuals maintain insurance coverage if they loose or leave their jobs.

If you meet all of the following requirements you may be HIPAA eligible.

A HIPAA eligible individual is defined as someone who: has had 18 months of prior creditable coverage (including group health plans, qualifying health insurance coverage, Medicare, Medicaid, CHAMPUS/TRICARE, or other publicly sponsored program)*;

was most recently covered under an employer group health plan, governmental plan or church plan*; has elected and exhausted COBRA or similar state continuation of benefits coverage, if it was available;

is not eligible for any other group coverage, Medicare, or Medicaid; does not have any other coverage; has had no more than a 63 day break in coverage, unless waiting for a period of time to expire before group coverage was effective; and has not had previous coverage terminated for fraud or non-payment of premium.

* If the most recent creditable coverage is individual health insurance , and the insurer offering it exits the individual

insurance market and cancels the policyholder's coverage, then only 12 months and not 18 months, of prior creditable coverage is required.

If you meet all seven HIPAA requirements listed above, you are a HIPAA Eligible Individual. Which means you are guaranteed coverage at the highest premium without having to answer health questions

From my experience Blue Cross has always had the best HIPAA rates. But there are other carriers that may also be worth trying depending on your condition.

You should use yellowpages.com to search for health insurance brokers in your area.

Don't call your auto and home agent they specialize in property and causality insurance. You need someone that specializes in Health insurance.

A Broker represents multiple carriers and can help you sort through all the different insurance companies and plan options in your State.

I would suggest you apply for coverage at least 30 days in advance of the COBRA expiration date. This will give you time to try a few different carriers.

Answer 4

In Illinois, there is the ICHIP program - Illinois Comprehensive Health Insurance Program. Try a web search to see if your state has a CHIP program.

My health insurance is through ICHIP. I'm 49 years old and pay about $6,400 per year (I live in the lowest rate zone). The insurance is PPO, with straight deductible - pay the deductible, then 20% copay on covered amounts over the deductible. It is administered by Blue Cross Blue Shield. The worst thing is, most years I don't reach the deductible, so I have to pay 100% of my doctor visits just to get prescriptions rewritten. Prescriptions are separate - copay from the first, amount depending on the price of the drug.