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Health Insurance After PCa?

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Posted 5/21/2009 4:46 PM (GMT -8)
Has anyone had to get individual health insurance post-PCa.   I'm covered by group now (and was during treatment), but might be in a situation where I'm no longer in the group coverage (at least 18 months after COBRA runs out).   Anybody deal with this?  Tips?

 

Posted 5/21/2009 5:16 PM (GMT -8)
I did Sterd,
I had surgery, started HT and completed RT on COBRA. It was pretty costly. I had been with the previous employer for 16 years. So it was pretty scary to know my COBRA would eventually run out. Lucjily, I was hired by a new employer that had a 3 month grace period before benefits would kick in. This was just before I started my RT. So as a new employee, I missed an hour a day while I was in treatment, then just as I ended my new insurance kicked in and took over the pre-existing condition. Even though I was out of pocket 20g, I was covered moving forward with co-Pays and excellent coverage. I lucked out.

I am very thankful to the new guys that hired me...

Tony
Posted 5/21/2009 6:39 PM (GMT -8)
I believe the laws differ state to state, but you are better off maintaining some sort of coverage all the time, even if you buy something that does not cover a lot before COBRA runs out.
Posted 5/21/2009 6:58 PM (GMT -8)
Thanks guys....always such great responses here....

I'll clarify. I may quit my job where I am covered by group health, and become self employed. I can buy COBRA from my former employer for 18 months. I was wondering if anyone had ever shopped post-PCa coverage if self employed. I know it won't be cheap--- I'm just trying to build a cost into my business plan.
Posted 5/21/2009 8:20 PM (GMT -8)
I did.
I had to be covered by COBRA for a year for a pre-existing in anything I could buy before I could be covered by a private policy. We had lined up a new insurance carrier just as I was hired and never had to pay the second policy. We knew we would be paying double coverage to have uninterupted coverage I needed. That was a key to why I re-elected to join a group coverage, per se.

tony
Posted 5/22/2009 5:38 AM (GMT -8)
Hello Sterd,

I was in the process of getting a private policy when I was diagnosed. I was able to get a 10 month policy but it would not cover preexisting conditions. The rule is that if you get a policy whithin 60 days of expiration of the existing policy (assuming you are now insured) the new policy will cover preexisting.  I footed the bill for my treatment on my own and applied for a policy when my 10 month ran out. Only $8400 per year with a $5000 deductible and 40% copay and preexisting not picked up for one year. What a deal! Needless to say I am not covered right now. The policy that was available was an assigned risk policy. As I understand the rules you cannot be denied insurance but you can be charged heavily for it and it does not have to be all that good.

Good luck with the search. If you find something reasonable let the rest of us know.

Take care,

Don

Posted 5/22/2009 6:06 AM (GMT -8)
The other alternative is to set up an entity (corporation or LLC) and buy group insurance. Even if you have you and your SO on the policy it could be group. I believe there is no check for pre-existing conditions in this case, just ages of the covered members. I have done this in the past, but this was before I was diagnosed with PCa.
Posted 5/22/2009 9:45 AM (GMT -8)
nono  Sterd

States differ as far as pre-existing conditions.  New Jersey is a "guaranteed issue" state.  NO Questions asked, but you pay dearly.

Chamber of Commerce membership will usually have an open enrollment where you can pick up a policy with again; no medical questions.

Under the "Pork-u-less" package the mighty government will pick up 65% of your cobra premium for 9 months.  At the end of cobra you can stay with that insurance company, just pay the rate.

Good Luck!!! yeah

Posted 5/22/2009 10:47 AM (GMT -8)
Great stuff, guys.....

Geebra, the but my spouse in my LLC to get group was an idea I had found....does that work with just 2 people in the group?

Broker59.... Don't you have to be fired or laid off to get the "pork-u-lus" subsidy of 65%....plus, I think its phased at at 250k in income if you're filing jointly...sound right?
Posted 5/22/2009 10:58 AM (GMT -8)
I believe it works with just 2 ppl in the group - but call a health insurance broker and find out.
Posted 5/22/2009 11:10 AM (GMT -8)
I assume every state is different but the California policy is as follows

With Cancer you are totally uninsurable on an individual policy, but don't fel bad becausee just about everyone is too, doesn't take much, blood pressue, cholestrol, allergies etc, you basically have to a marathon runner to pass but then you would have skin cancer so you still wouldn't pass, maybe a nightime swimmer could do it.

so you can continue cobra for 18 months thru your old employer, than another 18 months directly from the provider with the same policy and cost. After that they switch you to a state manadated program where they have to accept you, in my case the insurance company is the same, the cost is slight less, but the deductable is higher ($1500) and the co pay is higher 30%. Its really not that bad.
Posted 5/26/2009 7:21 PM (GMT -8)
Most chambers of commerce offer group through the chamber, i.e. they take a bunch of small businesses ( 1 or more employees ) and combine them into a large group. In Ohio, the chamber plan is very competitive. Our plan doesn't even require a medical.
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