Help? Someone who knows about group and individual health insurance...

[lewmonst 0]

Situation: As some of you know, I broke my femur last year and got a titanium rod put in. The Doc says I should have it taken out this fall. I'm considering leaving the school I teach at now to move. I am concerned that if I lose my health insurance for leaving my job, I may not be able to get coverage for the follow-up surgery to remove the rod. Can I get individual health insurance that will cover a pre-existing condition like this? Would group coverage do it? Will individual insurance policy ask me about all this?
fyi, I had the accident and surgery before I came to this school, so the group insurance just assumed me and my condition. The only coverage I've needed since then is doctors visits...

So, if you're familiar with all this, please let me know how it works and what I can expect.

Thanks!
lew

http://www.exitshot.com

[lawrocket 3]

lew:

First off, COBRA should be offered. THis insurance will cover you for a period of time, though it comes out of your pocket.

Also, if you get new insurance, some of it may cover your pre-existing conditions if you had insurance within a certain period of time. If you leave, make sure you have a "certificate of credible coverage." This way, you can give it to your new insurer and it demonstartes that you didn't just get insurance to cover the pending surgery.

Above all, ask questions and get the representations from the agent in writing.

My wife is hotter than your wife.

[Gawain 0]

Quote

I'm considering leaving the school I teach at now to move.

Not to hi-jack the thread, but where are you thinking of moving?

As to your primary question: It depends on several factors, one of the most important being whether your "new" employer's policy covers pre-existing conditions if you had a policy within 6 or 12 months (just an example). I would ask this question to your new perspective employer during an interview.

So I try and I scream and I beg and I sigh
Just to prove I'm alive, and it's alright
'Cause tonight there's a way I'll make light of my treacherous life
Make light!

[kpjumps 0]

I am not sure about where you teach but here in Texas all teachers are covered through TRS
(Teacher retirement system) It is one big blue cross and I think coverage is continuous since the change over to a state wide program a few years ago.

_________

Your character will ultimately determine your destiny.

[Nightingale 0]

in California, health insurance options are up to the school district, or school or diocese, in the case of private and parochial schools.

Lew, you teach at a private school now, yes?

[lewmonst 0]

yes. private. I'm just considering moving closer to Elsinore. ok, to Elsinore. I haven't decided yet. I am also not sure if I will look for another full-time teaching position right away.. I might consider part-time or substituting... in which case, I'd probably have to get my own health coverage. I will be covered for sure through August, so there shouldn't be a gap in coverage. Removal of the rod will likely be in October or November. Thanks for everyone tips,
peace
lew

http://www.exitshot.com

[Michele 1]

O.K., you're allowed to move closer to Elsinore. But NO further away. Hear me??

But before you do move, we need to have dinner at Boca De Beppo's....

I don't know anything about insurance. Just wanted to voice my opinion about your moving.

Ciels-
Michele

~Do Angels keep the dreams we seek
While our hearts lie bleeding?~

[kelpdiver 2]

Quote

lew:

First off, COBRA should be offered. THis insurance will cover you for a period of time, though it comes out of your pocket.

I didn't think voluntary termination counted, but that was wrong. I think you would do best to take that, despite the costs, until you are eligible for another group policy. No matter what, don't allow for an uncovered period. The preexisting conditions clauses usually don't apply when you maintain continuous coverage. But they may not want to give you a policy when you tell them about the event.

You have a couple months time before the cobra deadline, so you have time to investigage other offerings. COBRA is just the simplest route. It may not be the best or cheapest.

[ltdiver 3]

FAQ about COBRA

Not sure about a school district, but when I left a job a few years ago, I signed up under COBRA insurance for a short time. My concern as well was pre-existing condition coverage.

I found that the insurance my former employer had was -also- available in individual form as well...and it continued with coverage of pre-exisiting needs. It was Blue Cross.

Perhaps you could research into this as well, lewmonst.

ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[ltdiver 3]

A quote from that COBRA site above (page 2 on the site):

"What happens when my COBRA insurance runs out?


If you qualify, you're protected by the Health Insurance Portability and Accountability Act (HIPAA). In a nutshell, HIPAA mandates that insurance companies normally offering individual health care plans can't deny you coverage or impose waiting periods for preexisting conditions, if you've been covered by COBRA (or other) insurance within the required timeframe."

ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[lewmonst 0]

Cool, thanks Lori!

Michelle, we won't Bucca without you.

peace
lew

http://www.exitshot.com

[Michele 1]

Quote

Michelle, we won't Bucca without you.

HAH. You'd best not...LOL.

Hugs to you and Ed! (And did his mom ever get to tandem??)

Ciels-
Michele

~Do Angels keep the dreams we seek
While our hearts lie bleeding?~

[lewmonst 0]

Quote

Quote

Michelle, we won't Bucca without you.

HAH. You'd best not...LOL.

Hugs to you and Ed! (And did his mom ever get to tandem??)

Ciels-
Michele

Hey, yes! Ed's mom did do a tandem on Wednesday. I drove down after work on Tuesday and it was very gusty, so we opted to try again Wednesday. It was awesome. She rocked. On the ground she said she wasn't nervous and was happy she did it because she doesn't want to be afraid of what her son does. She also said she wanted to "make memories" with Ed, as that hasn't been possible until now. It was very, very cool. I'm glad I was there for it. I flew main camera, and Tigger flew 2nd camera. We gave the film to her to take home and develop. She said the photos turned out great and will send us copies. I'll scan them when we get them.

I hijacked my own thread, sorry.

peace
lew

http://www.exitshot.com

[AntiPinkChrissy 0]

Legally, if your company employes more than 20 people they are required to offer you COBRA no matter how you leave your job. It is usually very expensive, depending on how good your insurance is...$300-$500 a month. COBRA lasts 18 months. The pre-existing condition clause is waived (under HIPAA) as long as you have 18 months of continuous coverage with a break of no more than 63 days. They should provide you with a HIPAA certificate to prove your coverage dates. Individual policies are usually more strict, many health insurances do not cover hazardous activities. So if you have more than 18 months of continuous coverage they won't be able to deny you for a pre-existing, but they could deny you because skydiving is not covered under their policy. You can request their Summary Plan Description which spells out EXACTLY what is and is not covered.
I use to administer health insurance, so let me know if you have anymore questions
The one thing about COBRA though is companies do not want people on it. Adminstratively it is a pain in the a**. So if you do elect it, they will not send you bills or payment reminders, and once you don't pay your monthly premium, you are terminated and will not be able to get back on it.

edited to add: my disclaimer: it has been a few years since I have worked in the health care industry, but I doubt anything has changed that much.

~La La Gang Member #2~