How To Insure The Pre Existings?...

south_oc_sales · 09-30-2008, 01:46 PM

I got a lead yesterday for girl with "dormant" endometriosis. She's in her early twenties and already paying $600 a month for coverage through COBRA. Says she can't afford to pay for COBRA anymore, but will likely not qualify for Medi-Cal. Any ideas on how to insure her for less? Only been on COBRA since July, BTW.

aufan · 09-30-2008, 02:25 PM

My answer is somewhat simple, depending on her current ability to work.

As she is only twenty years old, is she able to work full time? If so, simple answer is to get a job with group health.

Other than that, most all "reputable" carriers I know will not touch her as my experience has proved out.

BrokersAllianceAnnuities · 09-30-2008, 05:13 PM

Ask her if you can find a policy that will take her, excluding the pre-existing condition. If it is dormant, it may not be costing her that much.

The risk is, of course, that if the pre-existing comes out of its dormancy.

Not sure if this is the best idea or if a carrier would accept her, but possibly worth trying to help her.

moonlightandmargaritas · 09-30-2008, 05:40 PM

Endometriosis (even "dormant") is an automatic decline for the majority of health insurers.

Dave020 · 09-30-2008, 05:41 PM

It's a California case and in CA there are no riders or exclusions on IFP major medical. It's all or nothing.

You can eliminate the carriers who have lousy underwriting right up front (I am looking at you Health Net and Blue Shield), Anthem BC says it's possible rated up as does Aetna (according to the UW guideline).

The key is that there is nothing else going on with the applicant. This condition with a GOOD carrier (I am not looking at you Health Net and Blue Shield) who knows how to underwrite is not a decline by itself. Most likely rated up 50% something like that. But, if she takes any meds for it or has any other condition or problem (smoking, weight, BP, Chol, you name it) then it becomes a different issue.