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Question for Americans



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Piper




 
 
    
 

Post Mon, Oct 08 2007, 7:38 pm
If both you and/or your spouse work, but employment does NOT come with health insurance, what do you do?
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chocolate moose




 
 
    
 

Post Mon, Oct 08 2007, 8:11 pm
I always carried the health insurance for us all, that's why I alway had to work full time.
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MMEC123




 
 
    
 

Post Mon, Oct 08 2007, 8:12 pm
You buy it independently...call all the companies and compare prices or use a broker.
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NotInNJMommy




 
 
    
 

Post Mon, Oct 08 2007, 8:26 pm
but be careful...if there's any gap in coverage, private insurance will not cover pregnancy which occurs in the first 1-2 years AT ALL! (they will consider it a pre-existing condition....)
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mommyX2




 
 
    
 

Post Mon, Oct 08 2007, 11:49 pm
we had to do this...we researched plans and got one on our own. its expensive but needed. and yes do not have a lapse in coverage!
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chavamom




 
 
    
 

Post Mon, Oct 08 2007, 11:51 pm
NJMommy wrote:
but be careful...if there's any gap in coverage, private insurance will not cover pregnancy which occurs in the first 1-2 years AT ALL! (they will consider it a pre-existing condition....)


I think most policies it's 9 mos. It can't be "pre-existing" for 2 years!
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boruchhashem




 
 
    
 

Post Tue, Oct 09 2007, 12:13 am
In NY they have what is called HEALTHY NEW YORK, where you get to choose which plan you want, or fits your needs the most, and as long as you have some income, and pay your premiums on time, you are covered. I pay 777.76 a month for a family plan. They have some more expensive, and some cheaper.
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chaimsmom




 
 
    
 

Post Tue, Oct 09 2007, 12:41 pm
Even though I have insurance through my job I still buy my own supplemental policy. I think it's a mistake to have your health insurance linked to your job.
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shoshb




 
 
    
 

Post Tue, Oct 09 2007, 1:21 pm
Are you self employed, or employed by someone else who doesn't provide coverage?
Either way, you could look into forming a group of individuals/small businesses to try to negotiate better rates from the insurance companies.
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gold21




 
 
    
 

Post Fri, Nov 09 2007, 10:08 am
what do you mean? an insurance wont cover pregnancy if it occurs within 9 months after signing on to the plan? why? how could it be a preexisting condition? youre not pregnant until youre pregnant... please explain.
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Starhavah




 
 
    
 

Post Wed, Nov 14 2007, 11:37 pm
gold21 wrote:
what do you mean? an insurance wont cover pregnancy if it occurs within 9 months after signing on to the plan? why? how could it be a preexisting condition? youre not pregnant until youre pregnant... please explain.


Insurance has to say that if you deliver within the first X months or years they will not cover you. They do not want to have to argue in court whether or not your child is premature and what date you actually got pregnant on. This way is easier and more politacally correct for them. And yes they give a buffer of way more than 9 months mostly because they do not want you to get insurance when you are planning on getting pregnant. They want you to have the insurance first so you pay a bunch of premiums and they make some money off of you first. Remember this is a business in America.

Star Havah

PS As some other posters pointed out it is only a problem if you have a gap in coverage.

Havah
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NotInNJMommy




 
 
    
 

Post Thu, Nov 15 2007, 6:35 am
chavamom wrote:
NJMommy wrote:
but be careful...if there's any gap in coverage, private insurance will not cover pregnancy which occurs in the first 1-2 years AT ALL! (they will consider it a pre-existing condition....)


I think most policies it's 9 mos. It can't be "pre-existing" for 2 years!


I shopped around in NJ and all the regular private policies would not cover pregnancy for the first 12-18 mos of enrollment, and yes, even though it in theory can't have "pre-existed" they do consider it as such...
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technic




 
 
    
 

Post Thu, Nov 15 2007, 6:40 am
NJMommy wrote:
regular private policies would not cover pregnancy for the first 12-18 mos of enrollment, and yes, even though it in theory can't have "pre-existed" they do consider it as such...


it could if ur an elephant...
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mumoo




 
 
    
 

Post Thu, Nov 15 2007, 11:30 pm
mommyX2 wrote:
we had to do this...we researched plans and got one on our own. its expensive but needed. and yes do not have a lapse in coverage!


this scares me. after our cobra ran out, I tried to get individual coverage. the forms I needed to fill out to qualify were staggering. in order to be underwritten I needed to list every doctor/hospital/psychologist visit for every checkup, ear infection, counseling session, er visit for everyone in my family-including drugs prescribed, dates, phone numbers (I went to a chiropractor in NJ once...)

I was worried I would forget something and then a co-worker told me this story:

after her mother died, her father was at a doctor who was also a personal friend. the doctor prescribed a tranquilizer in case his grieving became overwhelming. The father never needed it or had the prescription filled. TEN YEARS LATER, this self-employed man is dropped from his policy because they said he lied when asked if he ever took any psychotropic drugs. They researched his medical records. Having preexisting conditions, he and his wife were never able to acquire insurance and are now on insufficient government programs.

the broker I was using said they could have dropped him retroactively (all insurance payments made to date would have to be paid back)

I asked at my work to be put on their group plan and just pay the whole premium. Insurance in not normally provided to the office staff and I only work 12-15 hours a week, but the premium is my entire salary!
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