Cobra to PCIP...Denial Letter

[AzDubster]

Please help. I have a pre-existing condition (quad bypass) and Iam 50 yrs old...other than that, great health don't smoke, drink very little.

• Wife lost insurance through job August 30, 2010.
• We went on Cobra. (for one year)
• My job ended at the same time...so Cobra comes into play about $900 per month for us total.
• 12 months into COBRA, we opt to cancel we were going bk and so we cancelled everything that we didn't need before finally cancelling COBRA...
• Last two years of tax records we were insolvent. ie we didn't make enough to pay for cobra.
• My wife found good insurance (privately) and I am still screwed.
• 6 months later (start of March) I apply for PCIP through a broker (I can't get on the phone right now). I have an average job, but can now afford PCIP.
• They denied me two ago.

I am about to call them and find out why, then I found you guys. The letter said I was denied because I had insurance the last six months so I didn't qualify. I am long past the six months so is this an error by the government...OR...it is being held against us because we cancelled our COBRA? Is this possible? In their eyes we still had 6-months of cobra available to us so we had to take it even though we couldn't afford it?

So the question please...is it more likely they made a mistake or dropping cobra was a mistake on our part?

Thank you!

 

[STIBROKER]

the Risk Pools will require you to exhaust cobra but do not think the PCIP plan does......call them to see if it is a mistake......

 

[AzDubster]

Yeah I was going to do that but wanted to understand my options before I made the call. I didn't want to be blindsided by a question that I didn't answer properly when I could have. I mean I'll do the truth, but is there a pproper way to present it? Going bk at the time was very possible...so does not being able to afford COBRA enter into it at all?
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STI...mkay...just called California PCIP (I'm in Arizona don't ask lol) and three different times I asked her three different ways if I could cancel COBRA at 12 months because of cost vs it being mandatory for us to use it for 18 months and she said...yes, it was okay to cancel. So you may be right. Thank you.

I will update this after I talk to my state to help others down the road with the same type of question.

 

[CABenefits]

Please help. I have a pre-existing condition (quad bypass) and Iam 50 yrs old...other than that, great health don't smoke, drink very little.

• Wife lost insurance through job August 30, 2010.
• We went on Cobra. (for one year)
• My job ended at the same time...so Cobra comes into play about $900 per month for us total.
• 12 months into COBRA, we opt to cancel we were going bk and so we cancelled everything that we didn't need before finally cancelling COBRA...
• Last two years of tax records we were insolvent. ie we didn't make enough to pay for cobra.
• My wife found good insurance (privately) and I am still screwed.
• 6 months later (start of March) I apply for PCIP through a broker (I can't get on the phone right now). I have an average job, but can now afford PCIP.
• They denied me two ago.

I am about to call them and find out why, then I found you guys. The letter said I was denied because I had insurance the last six months so I didn't qualify. I am long past the six months so is this an error by the government...OR...it is being held against us because we cancelled our COBRA? Is this possible? In their eyes we still had 6-months of cobra available to us so we had to take it even though we couldn't afford it?

So the question please...is it more likely they made a mistake or dropping cobra was a mistake on our part?

Thank you!

Even if you had COBRA, if you have been without for 6 months and can provide a doctors letter stating your conditions and that you cannot get private insurance or a denial letter during the last 12 months of applying for private insurance, you qualify. If they denied you, you can reapply or ask them to review your application with you. If you need a quick denial letter Dave Fluker has one on his website: www.davefluker.com/MRMIP-Request_Anthem.pdf

Mike

 

[AzDubster]

Mike thank you...apparently you are right. Called today and found it out that it is an error on the govt part. (duh) Since my insurance went out a little over 6 months in advance it was to close and that warranted additional proof that they don't tell you they need. They just opt to deny you vs tell you that you need proof your insurance went away when you said it did.

So if you are applying, include proof you had insurance 6 months+ out.

Thanks guys!