Group to Private Health Insurance Advice

[jkaiyee]

What is the name of your state? California

Hi, I'm looking for advice as to whether I should stay with my company's group health plan or to move to private insurance. I quit my job last April due to having Parkinson's but was allowed by my company to stay with the group health insurance plan which is with Kaiser. The plan is up for renewal and I'm debating whether or not to stay with the company health plan, or to try to apply for one of Kaiser's individual plans. The reasons I would want to change to an individual plan are because I don't want to trouble the company and because I'm not sure I can legally be a part of the group health plan if I'm not actually working for the company. The reasons I am hesitant to change are because I don't know if Kaiser will deny my application or make me pay a higher rate due to a preexisting chronic condition (parkinson's). I would like to stay with Kaiser. Please advise as to whether I should stay with the company or change to individual insurance, thanks!

[ecmst12]

Yes, it's likely you will have trouble getting an individual plan because of your condition, but you haven't even asked.

Are you on Cobra? If so, that's perfectly legal (required, actually) but time-limited. Other then that, the only way to know whether it's legal for you to stay on the group policy would be to read the policy. Did you quit, or are you on disability, or did you retire?

[cbg]

You can legally remain on the company's health plan for up to 18 months, longer if they permit it. There isn't any law that makes it illegal to continue on their plan for any length of time; they can let you stay on it forever if they want. But they are REQUIRED by law to allow you to stay on it for up to 18 months.

California is not a guaranteed issue state; you can be denied coverage for pre-existing conditions on an individual plan. I'd stay on the company plan for as long as possible; as I said, you are guaranteed by law to be allowed to remain on it for up to 18 months. But start looking for new coverage at least four months before you need it; it may take a while to find it.

[Betty]

I can't predict what all companies/any individual co. would do. However, speaking as a former ins. underwriter the co. I worked for, the cos. we reinsured with (all major cos.) & I believe most (if not all) of the cos. writing individual health ins. policies would decline you for parkinson's disease. You'll need to shop around - get a broker's help/talk to a broker who writes for more than one co. & see if they can do anything for you. At this time stay with the gr. ins.

[jkaiyee]

I left because of disability (parkinson's). Thanks, everyone, for your replies! Very helpful advice.

[TIMMAAYY]

If COBRA is exahausted, you should be federally eligible for any of the carrier's HIPAA plans, and according to the following: from this link [url]http://stateinsprograms.com/#CaliforniaRef[/url]

California Department of Insurance
Consumer Communications Bureau
(213) 897-8921
[url]www.insurance.ca.gov[/url]

Eligibility: (1) California resident, (2) ineligible for COBRA/CalCOBRA, and (3) denied coverage within the past 12 months with rejection letter from insurance carrier, involuntarily terminated from coverage for reasons other than fraud, or offered coverage with premium higher than MRMIP, or (4) federally eligible.

HIPAA-eligible individuals: State requires mandatory acceptance by all individual insurance carriers without exclusions for preexisting conditions. Each company independently determines the monthly premium.

You should be federally eligible once COBRA is exhausted, and they can't pre x you if you meet the requirements. Granted, the HIPAA plans are usually costly, but if you have a high cost condition, it may be worth it.

Also, if you are disabled and not able to work for 24 months, you are eligible for Medicare AFTER the 24 months, for a short period of time ( not permanent until you hit age 65 ).