Girl Friend and Son Need Health Insurance in Northern Virginia, Pre-existing Migranes

[mlg]

Any agents in Northern Virginia. My girl friend and son in Ashburn, Virginia needs med insurance. She has had migranes since she was 15. She is now 35. Got quoted by blue cross, product name was anthem I believe. Went from original quote of 238 to 339 after underwriting and migranes are her only issue. Blue Cross double billed her and gave her a run around so she did not get the policy. Our son is fine and in perfect health. Please let me know by replying or pm.

Thanks,
Mike

 

[Dave020]

I Need An Agent In Another State

 

[mlg]

Added note I can not pm yet. She is on a med called topomax for her migraines. In perfect health other than that and is not a smoker. Any pm's I will get back with after dinner. Thanks.

 

[dgoldenz]

I'm licensed in VA and used to live in Centreville/Haymarket. You won't find rates lower than Anthem in northern VA, and they do cover pre-existing conditions if she's had at least 12 months of prior continuous coverage without a 63+ day break. United Healthcare's rates will be similar, but I can almost guarantee they would exclude the migraines from coverage. Anthem also has fantastic customer service (by far the best of any insurance company I've ever dealt with) and I doubt they double-billed her. More likely, there was probably just a misunderstanding. If her effective date was mid-month, they probably billed her credit card for the first month, then gave a partial credit towards the following month while billing for two months at the same time.

Anthem's underwriting process has four risk levels (numbered Levels 1-4) that determine the rates. If she chooses a deductible less than $5k, they will assign a Level 3 risk class which is probably what they did. If she chooses a $5k or higher deductible, they will give her the Level 1 (best) risk class, which will have a much lower rate.

Judging by the rates you posted, I'm guessing she applied for the SmartSense plan with $750 deductible, which has an annual out of pocket maximum of $4,250. The Premier plan with $5k deductible would be $234/month and the annual out of pocket maximum is equal to the deductible since the coinsurance is 0%. She saves $105/month, gets unlimited office visits with a copay instead of 3 per year, gets a better prescription benefit, and only increases the annual maximum OOP by $750. I came up with those rates by guessing that her son is ~10 years old since the $339/mo number matched up.

Send me a PM or call me at 703 753 3376 if you want some help.

 

[moonlightandmargaritas]

She is on a med called topomax for her migraines. In perfect health other than that...

Migraines are usually a symptom of something else. Not always, but usually.

 

[dgoldenz]

...and Topamax is really expensive. There is a generic (Topiramate) for it available now that is 5% of the price.

 

[b61mack]

Mig, I think it is time for you, to step up to the plate, and marry the mother of your child. Just my opinion.

 

[alwaysinsured]

I think they need more than medical help. There are reasons for the migraines that may be stress related of dehydration related. The DR would just give pills that will depress the symptom.

 

[saieddie]

I'm in Virginia and its hard to beat Anthem without an exclusion. Have her reapply with Anthem with a future effective date and there shouldn't be a problem with double billing.