dual coverage issues pertaining to desire to keep individual coverage

[scrappy]

What is the name of your state (only U.S. law)? North Carolina

My close friend has a health condition that requires medications that currently cost approx $1,300/mo and other medical services of approx $7,000 per year. These expenses - currently around $22,000/yr - are likely to continue and may increase over the years.

He currently has good coverage under an HSA plan through his employer of many years. In addition, he has maintained coverage with an individual policy that he held prior to diagnosis of his condition and prior to joining his current employer's plan. Coincidentally, both insurance plans are through the same company, but they're very different policies.

My friend has kept the individual policy for one reason: He wishes to maintain health insurance coverage at a reasonable expense should he at any point lose coverage through his employer. For this reason, for a number of years, he has paid premiums (currently over $2,800/yr) to keep his individual policy in effect. He sees no added advantage to holding this policy other than as 'insurance' against the loss of coverage through his employer's HSA plan.

My first question: Is my friend correct in thinking that, should he lose coverage through his employer, he would end up with either no coverage or very expensive coverage after COBRA, if he did not have this existing individual policy to fall back on due to this expensive pre-existing condition?

Until recently, there seemed to be no major problem keeping both policies (through the same insurance co), though they were not truly designed to be held simultaneously. Recently though, his attempt to fill a monthly subscription failed when the system denied it for reasons as yet unknown. This subscription should have been covered in full because at this point my friend had met his yearly deductible of $2,700 on the HSA plan. He is nervous about approaching the insurance company directly about this without first obtaining more information from a third party.

Can anybody advise as to how he should navigate this insurance maze? What is the best way to continue the ability to maintain good individual coverage at reasonable cost given these circumstances?

Help here is much needed and would be greatly appreciated.

Thanks!What is the name of your state (only U.S. law)?

[ecmst12]

I have no idea why he would be reluctant to contact his insurance company. His individual policy is secondary but there is no reason he can't keep both as long as he keeps current on the premium. However I don't know what the law says about when they can cancel or non-renew or raise the premiums on the individual policy. Individual policies I have no direct experience with. He should read the policy - this information should be in there somewhere.

Keeping the individual plan does in fact protect him if he were to lose the group coverage, he is right in believing that it would be very difficult for him to be approved for an individual policy NOW.