POZ Community Forums
Main Forums => Living With HIV => Topic started by: ChristopherSF on November 26, 2007, 07:38:16 pm
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I've been on Cobra coverage since a layoff last year and my benefits are about to come to an end. I would love to hear from anyone who converted their group plan to an individual HIPPA policy. Is one insurance carrier any better then another? I currently have Blue Cross in California. To get a HIPPA policy with them it would run about $457 a month. The coverages are ok... $30 for my HIV drugs after a $250 deductible and a 30% co-pay everytime I go to the doctor. Lab work and any major surgery would be paid at 70% after I meet a $1500 deductible. Does anyone have any better coverage then this or do you think this is a good plan? Any advice/help would be appreciated.
Thanks,
Chris
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Educate me on what a "HIPAA Policy" is. I'm in the dark on the insurance part of that law. My take is that HIPAA means portability so that you can get COBRA coverage between jobs and instant coverage when you get the new job. After 18 months I think if you don't have a job then you have to pay for private insurance, and you will be subject to preexisting clauses when you do get a job. Are you just not finding a job you want?
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Sorry, I don't have any advice on which individual policy to choose...try to get as much information regarding your state regulations surrounding individual policies. From what I heard, because this is not as much regulated as a group policy, you can be subjected to big jumps in premiums that the law allows when it's time to re-enroll. This is because you do not carry the benefit of a risk pool that group coverages can afford its members.
If you are just doing this until you find another job, then remaining in an affordable individual policy would be the right step until you find your new employment. And in response to Creighton's post, individual policies do count as creditable coverage which would allow you to transition to a group plan by your next employer without being subjected to pre-existing condition as long as there is no lapse in coverage of over 63 days.
http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html (http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html)
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ok I am confused. If you don't have health insurance for 18 months consistantly a new employers insurance company can exclude any pre-existing conditions? I am insurance stupid so please help me out.
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He has COBRA which is essentially a continuation health insurance coverage from his former employer that he is entitled to; only difference is he (or in some cases, ADAP) pays the premium to avail of the insurance coverage. There is also a time limit in which someone can avail of this (12 to 18 months, depending on ones circumstances) after which he has to convert to an individual policy if he wants to continue getting insurance coverage, unless the person gets another employment with health insurance or finds another source of coverage.
http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html (http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html)