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Author Topic: Health Care Coverage while in College  (Read 2191 times)

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Offline HARLEY_B

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Health Care Coverage while in College
« on: October 10, 2010, 06:41:12 PM »
 Hello all:
 I've been considering the possibility of going to school full time and leaving my place of employment. The probelm is finding health insurance coverage for this preexisting condition and finding coverage that won't leave me penniless while I get through school. The program I'm interested in taking is a 4 year program and the only opportunity to work would be part time on the weekends.  I have health insurance such as it is but I was already covered before I found out about my status. I live in SC and was wondering if anyone had any experience with this before? The thought of leaving my job of almost 20 years is an unpleasant thought but the possibility of doing something better that pays much better is at least something to consider. If anyone has any input, I would greatly appreciate it.   Thanks!

                                                                                      Tim
« Last Edit: October 10, 2010, 06:43:28 PM by HARLEY_B »

Offline JR Gabbard

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Re: Health Care Coverage while in College
« Reply #1 on: October 11, 2010, 02:20:17 PM »
Howdy Tim!

Most colleges and universities have a student health plan that you could sign up for (many 4-year schools require it).  They are usually bare-bones policies that cover visits to the campus clinic, maybe lab tests and maybe hospitalizations.  You would have to look at what each school offers and see if it meets your needs.  But if you're not sick and you can get your meds through ADAP it might be a workable solution.

Pre-existing condition exclusions are now a thing of the past (thanks to health care reform)  so you don't have to worry about that.   The exclusion wouldn't have applied to you anyway, since you are currently covered.  Pre-existing condition exclusions only applied (past-tense) when there was a break in coverage--meaning you were uninsured for 6 months or longer.  Again, insurance companies are no longer permitted to exclude you from coverage due to a pre-existing medical condition.  That is not likely to change.

If you leave your job, you could still keep your old policy under COBRA, but the premiums might be unmanageable without help.  Sometimes ADAP will pay the premiums for you, but I'm not sure about SC (my gut tells me they don't, but I don't know).  If you would be eligible for Medicaid if you weren't working, you might consider getting on it when you stop working.  Medicaid will usually pay for a private policy (that you already have) because it ends up being cheaper for them. 

Both Medicaid and ADAP are state-administered, so if you are going to stay in SC to go to school then you should apply there.  If you are going out of state, and you plan on establishing residency in the new state (to get the cheaper tuition rates) then you should apply for these programs in the state where you're going to school.

If you are not eligible for Medicaid (meaning you've never been sick or had a really low CD4 count) then you will be able to purchase an insurance policy on the exchange, in a few years when that portion of health reform kicks in.  And just maybe you'll be able to buy in to Medicare without being 65 or disabled one day.  Current premium:  about $97/month.

Let me know if you want anything more specific!
It goes like this
The fourth, the fifth,
The minor fall, the major lift,
The baffled king composing Hallelujah!

L. Cohen

Offline Hellraiser

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Re: Health Care Coverage while in College
« Reply #2 on: October 12, 2010, 01:44:44 AM »
Pre-existing condition exclusions are now a thing of the past (thanks to health care reform)  so you don't have to worry about that.   The exclusion wouldn't have applied to you anyway, since you are currently covered.  Pre-existing condition exclusions only applied (past-tense) when there was a break in coverage--meaning you were uninsured for 6 months or longer.  Again, insurance companies are no longer permitted to exclude you from coverage due to a pre-existing medical condition.  That is not likely to change.

JR, is this already in effect?  I was under the impression this would not be part of the law until 2014.  With that said I was covered by my new health insurance within thirty days with no mention of a pre-existing condition exclusion.

Offline HARLEY_B

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Re: Health Care Coverage while in College
« Reply #3 on: October 12, 2010, 04:55:16 AM »
 Many thanks JR for your input. It is greatly appreciated. My CD4 count was really low (53) when I was first diagonosed 3 years ago but since I got on meds, it has climbed considerable and my VL has gone to undetectable. Hopefully my numbers will hold steady. So far so good..Have not decided on anything about education yet although I have been considering more and more my options. I've been going to school part time off and on for quite a while but what I want to really do hinges on what I can work out with my health insurance coverage.
                                                                                             Tim

Offline Assurbanipal

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Re: Health Care Coverage while in College
« Reply #4 on: October 12, 2010, 12:40:31 PM »
...  I was under the impression this would not be part of the law until 2014.  With that said I was covered by my new health insurance within thirty days with no mention of a pre-existing condition exclusion.

I noticed that too, and you are right.  It went into effect for children this year and goes into effect for adults in 2014.

Here's a link to a summary of the law from my new faorite website:  http://www.healthcare.gov/law/about/order/byyear.html
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Rev. Moon

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Re: Health Care Coverage while in College
« Reply #5 on: October 12, 2010, 12:49:40 PM »
JR, is this already in effect?  I was under the impression this would not be part of the law until 2014.  With that said I was covered by my new health insurance within thirty days with no mention of a pre-existing condition exclusion.



I noticed that too, and you are right.  It went into effect for children this year and goes into effect for adults in 2014.

Here's a link to a summary of the law from my new faorite website:  http://www.healthcare.gov/law/about/order/byyear.html

I may be confused then; I thought that the "high-risk pools" provision was effective July 2010?  Wouldn't this include those living with HIV?

http://www.healthcare.gov/law/provisions/preexisting/about/index.html

Thanks JR for what you've been doing in this area of the forums; I believe it is and will be of great help to all of us.
"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Offline Assurbanipal

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Re: Health Care Coverage while in College
« Reply #6 on: October 12, 2010, 01:00:31 PM »

I may be confused then; I thought that the "high-risk pools" provision was effective July 2010?  Wouldn't this include those living with HIV?

http://www.healthcare.gov/law/provisions/preexisting/about/index.html

Thanks JR for what you've been doing in this area of the forums; I believe it is and will be of great help to all of us.

The high risk pools are currently effective.  But that is not the same as "preexisting conditions being a thing of the past" 

The high risk pools allow you an option to find insurance if you have been denied coverage for 6 months because of a preexisting condition.  But they are expensive and you need that 6 month coverage gap to get in (although some states are more generous). 

Starting in 2014, all insurance will have to be sold without preexisting coverage conditions on it.  (I think there may be an exception to allow some "grandfathered" employer plans to keep their preexisting coverage exclusions, but they often don't apply preexisting condition requirements anyway.)

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Rev. Moon

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Re: Health Care Coverage while in College
« Reply #7 on: October 12, 2010, 01:10:24 PM »
Thank you, Assurbanipal.  That makes it more clear to me. 

I am almost sure that you discussed this in a previous thread.  And you are right, the cost can be quite high when all things are considered, ranging between $350 and almost $800 depending on state and age group. 

I believe that the OP will benefit equally with whatever plan that is offered by his university; it would all depend on specific coverage, deductibles, etc.
"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Offline JR Gabbard

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Re: Health Care Coverage while in College
« Reply #8 on: October 12, 2010, 05:19:54 PM »
Hi everyone,

I admit that I hadn't really boned up on the new health care law before I made my broad proclamation.  I'm working on that!  I've read what Assurbanipal linked to, and what Kaiser Foundation has to say.  I still need to read the law itself.  But from what I've discovered I'd like to clarify my post on pre-existing conditions.

If you are currently insured, including Medicaid, Medicare, a local government insurance plan (ie. Healthy San Francisco), or a private plan you got through your job or that you purchased on your own, and you lose your coverage, then for 6 months afterward an insurance company cannot deny coverage for your pre-existing condition.

If you have a 6-month gap in coverage, then effective June 2010 you can buy a policy through a high-risk pool that is administered state by state (although the federal government maintains control of the program).  I have no idea how expensive this option is, and each state will have different rates.  There will be a premium credit available, but not until Jan. 2014.

In Jan. 2014, private policies will no longer be able to deny coverage due to a pre-existing medical condition.  Group policies (the kind you get through employment) already do not exclude people for pre-existing conditions, although there may be a waiting period before you can claim benefits.  In 2014, that waiting period will be limited to 90 days.

Thanks Assurbanipal for posting the link to healthcare.gov.  I agree.  A great resource.  There is a link at the bottom of the page, by the way, that can get you state-specific information on the pools.  Also to Hellraiser (do you play Starfleet?) for calling me out for my hyperbole.

Here's another helpful link for information on the healthcare reform act.

Best of luck, Tim.  I hope it works out for you that you can go to school.  Look at it as an investment in your future, the one you got back when the meds started working!
It goes like this
The fourth, the fifth,
The minor fall, the major lift,
The baffled king composing Hallelujah!

L. Cohen

Offline Rev. Moon

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  • Smart ass faggot ©
Re: Health Care Coverage while in College
« Reply #9 on: October 12, 2010, 05:52:30 PM »

If you have a 6-month gap in coverage, then effective June 2010 you can buy a policy through a high-risk pool that is administered state by state (although the federal government maintains control of the program).  I have no idea how expensive this option is, and each state will have different rates.  There will be a premium credit available, but not until Jan. 2014.


Since Tim mentioned that he is in SC here are the listed rates from the healthcare.gov website:


Below are the monthly PCIP premium rates for South Carolina by the age of an enrollee.

Ages 0 to 34: $301

Ages 35 to 44: $361

Ages 45 to 54: $462

In addition to your monthly premium, you will pay other costs. You will pay a $2,500 deductible for covered benefits (except for preventive services) before the plan starts to pay. After you pay the deductible, you will pay a $25 copayment for doctor visits, $4 to $30 for most prescription drugs, and 20% of the costs of any other covered benefits you get. Your out-of-pocket costs cannot be more than $5,950 per year. These costs may be higher, if you go outside the planís network.

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Offline HARLEY_B

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Re: Health Care Coverage while in College
« Reply #10 on: October 13, 2010, 08:08:58 PM »
 Thanks so much guys! I am humbled by you all taking the time to answer my question. It helps point me in the right direction.

Granny60

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Re: Health Care Coverage while in College
« Reply #11 on: October 13, 2010, 10:49:52 PM »
What just went into effect was the end to caps on coverage... no more lifetime limit.

Offline danitheches

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Re: Health Care Coverage while in College
« Reply #12 on: November 04, 2010, 04:18:19 PM »
If you are going to school in SC then please contact Patti Sullivan at DHEC as the SC ADAP program offers insurance continuation and they do not have a waitlist.  They pay premiums and meds through this program based on income guidelines and the type of insurance you have.  You may have to send her your whole policy for review.  Her number is 1-877-606-8498

SC also participates in the high risk pool for those denied coverage should you lose your coverate for some reason.  See this link for state specific information.

http://www.healthcare.gov/law/provisions/preexisting

Hope this helps,
Dani

Granny60

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Re: Health Care Coverage while in College
« Reply #13 on: November 04, 2010, 07:46:10 PM »
If you are going to school in SC then please contact Patti Sullivan at DHEC as the SC ADAP program offers insurance continuation and they do not have a waitlist.  They pay premiums and meds through this program based on income guidelines and the type of insurance you have.  You may have to send her your whole policy for review.  Her number is 1-877-606-8498

SC also participates in the high risk pool for those denied coverage should you lose your coverate for some reason.  See this link for state specific information.

http://www.healthcare.gov/law/provisions/preexisting

Hope this helps,
Dani

Great post Dani, and it nice to read that South Carolina has their act together. :)

 


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