Health insurance | Imamother

TwinsMommy

Sun, Jan 16 2011, 1:03 am

it's been 3 long years since either of us has had group coverage.... for 3 years we paid between $1000 and $1700 per month out of pocket privately. We're now going without health insurance--- we just can't afford $1000 a month right now when our other expenses are so high. After 3 years of trying to find a private health insurance plan that will take a family with pre-existing conditions for under $1000 a month....... I'm turning to all avenues to try and find specific solutions...... has anyone else been in this boat--- pre-existing conditions and private insurance? how much did you pay and with which company?

My husband has been trying for 3 years to find a position with group coverage. And if I take a different position I'll definitely make less money per hour--- right now I'm self employed, working from home, and for the hours I'm able to put in while being primary caregiver to 2 special needs kids, I'm making good money (but no health insurance). So group coverage just doesn't seem to be in the cards for us at this point and we're at a loss.

I need specific examples of "we have pre-existing conditions and paid ___ with ___ company". Try this company and try that company won't help much--- we've already tried lots of companies and it takes a LOT of time to apply to these companies. Thanks!

cookielady

Sun, Jan 16 2011, 1:22 am

Is there anyway you can avoid a lapse in coverage. If you have a lapse it's almost impossible to get INS to cover pre existing conditions without a waiting period. If you go from policy to another, I think many will cover pre existing stuff right away.

Tova

Sun, Jan 16 2011, 2:27 am

Currently I am almost 100% positive that insurance is totally state regulated. Meaning, you being from OH cannot shop nationally and get a NJ policy, for example. I used NJ because they are a "socialist" state (our family term) - by law insurance companies cannot deny coverage for most pre-existing conditions but ultimately that means much higher cost.

It could be you will be in a better situation with the complete phase-in of the health care bill by 2014...in fact, I believe you will be REQUIRED to hold a certain level of coverage (or else be subject to a fine).

I wish I had better answers...maybe you can speak to an insurance professonal or advocate?

TwinsMommy

Sun, Jan 16 2011, 4:41 pm

lapse in coverage--- we were told we could come back with no issues if we come back within 6 months. we're done as of January 15th. But to come back, our financial situation would seriously have to change by then.

I got ONE Pm telling me that a certain company was well OVER $1000 a month for a family with pre-existing conditions. Any other answers?

We're screwed till 2014 and it sucks.

NotInNJMommy

Sun, Jan 16 2011, 4:44 pm

well, be careful of "lapse" in coverage and find out what it really means, because PREGNANCY can become a pre-existing condition if there's a lapse in coverage and pregnancy occurs soon enough in the time period when insurance has been started again (for private insurance, not group generally).\

I had a lapse, and found that if I got pregnant within 2 years of being enrolled privately again, that the pregnancy would NOT be covered.

PS I lived in NJ then.

Peanut2

Sun, Jan 16 2011, 7:09 pm

For the most non-helpful comment around: I have health insurance through my work. To add a spouse to this group plan is about $580 a month. To add a child or children is, again, about $580 a month. Thus, for a person employed where I work to rely on the employer's plan and put a family on it would cost over $1000 (plus, I pay part of my coverage.) Health insurance in the US is terrible.

After sharing that... really look into medicaid. I recently read an article about how it's possible to apply for kids with more expensive health needs even with higher incomes. And have you called an insurance broker? It may me worthwhile to let someone else do the legwork.

Isher

Sun, Jan 16 2011, 8:06 pm

I came across this link that might be helpful

http://jfs.ohio.gov/ocomm_root.....#HCQ1

The following is a small portion of the article:

Q. I think I may make too much money to qualify for Medicaid. Should I still apply?

A. Yes. You may be eligible for certain deductions that could reduce your income to help you qualify. For more information, call or visit your county department of job and family services (CDJFS) or go to http://jfs.ohio.gov/OHP/consum......stm.

Q. My family doesn’t qualify for Medicaid, but we still can’t afford health care coverage for our children. What should we do?

A. Ohio offers a state-funded Children’s Buy-In (CBI) program for certain uninsured children in families with income over 300 percent of the federal poverty level. The program is open to children younger than 19 who are U.S. citizens and Ohio residents and who have been uninsured for the previous six months. Families with children enrolled in the program are required to pay monthly insurance premiums, which are determined based on the size of the family and annual household income. For more information, call the toll-free number (800) 324-8680 or visit http://jfs.ohio.gov/ohp/cbi/.

Hope it helps,
Good Luck!

TwinsMommy

Sun, Jan 16 2011, 8:51 pm

Yeah they don't seem to be willing to budge on the medicaid income limits here (I did ask, out of desperation), but I don't want us on medicaid anyway. For what it's worth, we went through something similar when buying special formula for the kids--- we were paying $90 a week for formula and someone told us to apply to WIC--- so I called and was told it's only for people under a certain income--- it doesn't matter how much you pay out, it only matters how much you're taking in. I didn't WANT to be on WIC, but I really couldn't afford $90 a week just on formula. Anyway, the formula went on credit cards. And now I suppose health insurance could go on credit cards but I'm really trying not to go that route.

Tell me more about SSI---- all I know is that certain kids with special needs can get it but I don't know why or how or what the qualifications are, etc etc. My kids do have multiple special needs. Where does SSI money come from exactly?

thanks.

Mkay

Sun, Jan 16 2011, 8:57 pm

Since group coverage is much cheaper (at least in NY it is) than private, what you can do is incorporate yourself (since your self employed). Then take out a paycheck for at least minimum wage x 20 hours a week (again, in NY that's the amount of hours you need to work to qualify for insurance, but maybe it's universal). Then you can apply for group coverage - most insurance companies need a minimum of 1 employee for a group (though I did hear of 1 co. that needed 2).

Last I was doing this, Empire Blue Cross accepted pre-conditions on most of their policies, I'm assuming it didn't change.

One of the cheapest rates Blue Cross offered (a bit over a year ago) was about $300 for a single a month, and close to $600 for a couple. Family was about $900. (Though I know someone that took the highest deductible and got a dirt cheap rate).

TwinsMommy

Sun, Jan 16 2011, 9:12 pm

I thought about that..... but though I'm self employed I'm not REALLY my own boss and can't do anything against what others in the company do. I'm a sales director for one of the big direct sales conglomerates. The other sales directors are all sch C sole props and so am I. Not sure it's kosher for a few reasons to incorporate but that's something else to check into with the powers that be.... thanks!

Mkay

Sun, Jan 16 2011, 9:22 pm

You can incorporate your own company which will receive the checks instead of you - in fact you can incorporate under your "own name Corp" and take the checks as you receive them and deposit in your account. (The only issue, at year's end you have to nominee the income reported on the 1099 into the corporation - speak to an accountant)(and of course to an insurance agent for the health insurance coverage)!

TwinsMommy

Sun, Jan 16 2011, 9:31 pm

and I'm already 1099'ed from the ds company...... so I'd be accepting that income into my biz account and then writing a check to the corporation if it were kosher to do so..... definitely something to consider if it will save me a bundle on HI. thanks.

JAWSCIENCE

Sun, Jan 16 2011, 11:56 pm

You should look at the local freelancers union in your state. It is usually free to join the union, there are no dues, and they negotiate group rates for health insurance. It is cheaper to negotiate as a group rather than go private and most freelancers therefore faced your dilemma so the union started doing group negotiating. The rates are set by state so you need to ask how much it will cost you.

amother

Mon, Jan 17 2011, 12:09 am

I second the motion to look into incorporating! We just discussed it with an insurance agent, and from that end it was pretty simple. Definitely speak to your accountant as well. I live in a different state, and know of several ppl who do this. As long as you comply with all legal aspects, it is 100% kosher. And for many of us, its the only way to get affordable coverage.