Health Insurance Navigator
with Lisa Zamosky
The Affordable Care Act is bringing sweeping changes to American health care. Lisa Zamosky is here to help you navigate the health care maze and understand how these changes affect you.
Thursday, May 12, 2011
Reader's Question: Losing Work Health Insurance
Today's blog is devoted to the following reader's question:
My company is no longer going to offer health insurance to its employees and we are going to lose our health insurance coverage and will have to find our own individual policies. What are the pre-existing conditions insurance companies would deny you coverage for, and if denied, what are the other options?
A: There are certain illnesses that almost always result in an application for health insurance on the private market being declined. These would include cancer, heart disease, diabetes, rheumatoid arthritis and drug and alcohol dependency. Other minor conditions, such as allergies, asthma, mild depression, or well-controlled high blood pressure or migraines may result in a denial from some insurance companies but not others. There is no one industry standard.
Insurance Options
When the health reform law takes full effect in 2014, insurance companies will no longer be able to deny people with pre-existing medical conditions insurance coverage. Until then, there are a number of options to explore.
COBRA
Because you've had coverage through your employer, you would likely qualify forCOBRA Continuation Coverage, which will extend your current health plan for 18 months. Once you've exhausted your COBRA benefits, you're guaranteed by federal law to get a policy on the private insurance market.
Just make sure you obtain a certificate of "credible coverage" from your current insurance company once your COBRA benefits end. This document proves to a new insurer that you had prior coverage; you can be denied a plan without it. Although under these circumstances a policy is guaranteed, you should be aware that in some states insurers can take your health condition into consideration when setting premium rates.
You can find out about local rules at your state's department of insurance. It's also important to note that the price of COBRA often places it out of reach for many people. You'll pay the full cost of your plan (your part and your employer's), plus a 2% administrative fee.
PCIP
Pre-Existing Condition Insurance Plans (PCIP) were set up under health reform to extend coverage for the medically uninsurable. The plans are intended to function as a bridge until 2014, when insurers can no longer deny coverage even to those who are sick.
My company is no longer going to offer health insurance to its employees and we are going to lose our health insurance coverage and will have to find our own individual policies. What are the pre-existing conditions insurance companies would deny you coverage for, and if denied, what are the other options?
A: There are certain illnesses that almost always result in an application for health insurance on the private market being declined. These would include cancer, heart disease, diabetes, rheumatoid arthritis and drug and alcohol dependency. Other minor conditions, such as allergies, asthma, mild depression, or well-controlled high blood pressure or migraines may result in a denial from some insurance companies but not others. There is no one industry standard.
Insurance Options
When the health reform law takes full effect in 2014, insurance companies will no longer be able to deny people with pre-existing medical conditions insurance coverage. Until then, there are a number of options to explore.
COBRA
Because you've had coverage through your employer, you would likely qualify forCOBRA Continuation Coverage, which will extend your current health plan for 18 months. Once you've exhausted your COBRA benefits, you're guaranteed by federal law to get a policy on the private insurance market.
Just make sure you obtain a certificate of "credible coverage" from your current insurance company once your COBRA benefits end. This document proves to a new insurer that you had prior coverage; you can be denied a plan without it. Although under these circumstances a policy is guaranteed, you should be aware that in some states insurers can take your health condition into consideration when setting premium rates.
You can find out about local rules at your state's department of insurance. It's also important to note that the price of COBRA often places it out of reach for many people. You'll pay the full cost of your plan (your part and your employer's), plus a 2% administrative fee.
PCIP
Pre-Existing Condition Insurance Plans (PCIP) were set up under health reform to extend coverage for the medically uninsurable. The plans are intended to function as a bridge until 2014, when insurers can no longer deny coverage even to those who are sick.
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Disclaimer: 'MS Views and News' (MSVN), does not endorse any products or services found on this blog. It is up to you to seek advice from your healthcare provider. The intent of this blog is to provide information on various medical conditions, medications, treatments, and procedures for your personal knowledge and to keep you informed of current health-related issues. It is not intended to be complete or exhaustive, nor is it a substitute for the advice of your physician. Should you or your family members have any specific medical problem, seek medical care promptly.
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