Questions Concerning Post-COBRA Coverage with the ACA

[MisterMcDuck]

Hello,

I'm a 27 year old male with T1 diabetes that has been relying on COBRA (technically, Florida's COBRA equiv - State Continuation?) up to this point for my health care needs, but my coverage ends this month. I don't have any other major health ailments, but my medications alone would cost over 1000$/mo without prescription coverage.

I'm not sure what the best option would be at this point. I've planned on calling my current provider (United Health Care) and getting a quote on what an individual plan (conversion?) would be, but I'm worried that they'll deny me outright due to the pre-existing condition. I really want to avoid going 3 months without insurance. I'm also worried that if they provide me coverage, they'll only offer me a high deductible plan without coverage for prescriptions.

I could really use some advice from healthcare mavens such as yourselves on the best way to handle this issue, both before and after the 2014 transition.

Also, I work full time as an independent contractor and would most likely not qualify for any low income programs. I am not eligible for any group plans through my work.

 

[Yagents]

Hello,

I'm a 27 year old male with T1 diabetes that has been relying on COBRA (technically, Florida's COBRA equiv - State Continuation?) up to this point for my health care needs, but my coverage ends this month. I don't have any other major health ailments, but my medications alone would cost over 1000$/mo without prescription coverage.

I'm not sure what the best option would be at this point. I've planned on calling my current provider (United Health Care) and getting a quote on what an individual plan (conversion?) would be, but I'm worried that they'll deny me outright due to the pre-existing condition. I really want to avoid going 3 months without insurance. I'm also worried that if they provide me coverage, they'll only offer me a high deductible plan without coverage for prescriptions.

I could really use some advice from healthcare mavens such as yourselves on the best way to handle this issue, both before and after the 2014 transition.

Also, I work full time as an independent contractor and would most likely not qualify for any low income programs. I am not eligible for any group plans through my work.

You're only option for the next few months is to go forward with that guarantee issue conversion Hipaa policy from Goldenrule/UHC. Choice of two plans, both copay Select plans, with 2500 and 5000 deductible options, and you are required to add on the $200 RX deductible (vs. $500). Price is about 210% of the standard rating of that plan (at your age, my guess is the price will be in the $300-500/mo range). If you exhausted your Cobra, they cannot decline you for pre-ex conditions

With regards to the exchanges. You'll have choice of plans, all of them have a max out of pocket of $6350 including RX !! Other plans available with lower out of pocket. If you're income is higher, then you will be paying full price for a plan on or off the exchange. Prices for your age will run $200-300/mo. Use this calculator for an idea: Subsidy Calculator | The Henry J. Kaiser Family Foundation

 

[MisterMcDuck]

Bill,

Thank you for your reply! You've assuaged some of my fears about this process and made me feel like I wasn't making a total mistake. I'll make contact with UHC concerning the conversion.

Thanks again!

 

[Yagents]

Bill,

Thank you for your reply! You've assuaged some of my fears about this process and made me feel like I wasn't making a total mistake. I'll make contact with UHC concerning the conversion.

Thanks again!

I can assist you with both policies if you wish. Call me at 941 704 8148 if you would like my assistance (remember, you get an agent for free)

 

[riskybiz]

I can assist you with both policies if you wish. Call me at 941 704 8148 if you would like my assistance (remember, you get an agent for free)

Mister Duck you should really call YAGENTS there are some pitfalls trying to deal with theses companies on continuation. Why would you not usa a professional for free.

 

[MisterMcDuck]

Yagents, Will do. My work is extremely busy, but I plan to call early next week. Thanks again for the help and I look forward to speaking with you shortly.

 

[FLM2]

UHC would be your best choice for a conversion plan as they only increase rates by 220% (standard rate x 1.1 x 2) but you would be better off with the Copay Select option as it has a copay for prescriptions-the only choice is the $200 brand deductible.

I don't think UHC offers an HSA plan for this, every time I've called them it's always Copay Select and with your meds the copays will be very valuable, particularly since you probably have a 3 month window to have this coverage before the ACA options take over.

Although I represent UHC I don't normally get involved with HIPPA conversion plans unless it's a personal referral so I'm not trying to steal any business, just give you advice based on my experiences with UHC over the past 7 years.