health insurance

[fishyak]

So buy an individual policy while you are "young" and healthy from a big carrier and be prepared to see rates rise over time. If you are leaving the corporate world, you can keep your group plan for 18 months under COBRA and most people do not know there is another continuation option (the coverage is not as good, but you cannot be declined) under HIPAA (Health Insurance Portability Act).

Association plans have mostly failed over the last 20 years; it would take too long to explain why. And since there is no employer-employee relationship between poker players, group insurance is not available.

[phish]

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Well I currently live in md, soon to move to LV. I have no prior conditions but i sprained my leg. I'm gonna get a settlement and everything should be fine. I imagine showin a current leg sprain would be horrific. Any other suggestions?

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Showing a leg sprain will not make any difference.

Also, don't be such a wimp. You don't even need to see a doctor for a leg spain. It's people like you who go to the emergency room for the most trivial concerns (and who get drugs for everything) that helps to drive up the cost of medical insurance. And then you complain about how expensive it all is.

[Rick Nebiolo]

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In CA, Rick this is dead wrong. All insurance products are labeled and are filed with the Dept. of Insurance. Carriers cannot create sub-pools of experience within a single product.

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So what you seem to be saying is when I look up policies on let's say ehealthinsurance.com and I see policies from Blue Cross or Healthnet and I get one my rates will only rise as the general rates for that sort of policy rises.

Of course my guess is they can play the game of making a slightly new product and doing the "death spiral" that way. You do seem to imply that Blue Cross is more reputable in this regard.



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Self-employed individuals are sold individual health insurance plans. With a total of 2 or more employees, even if the owner is "self-employed" (i.e. not incorporated) group insurance w/o evidence of insurability is available. You do have to be able to document a valid employer-employee relationship to be eligible for group insurance.

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I don't think I'll be employed by a big company for the next year or too. Good info though, thanks.



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The Blues have lots of old plans around, but keep in mind they have been writing coverage for 50+ years. In CA, death spirals occured when you bought "cheap" insurance with relatively unknown carriers or with trusts. But the cost spiral of reliable companies is bad enough. When you cross an age break, every 5 or 10 years, your rates jump again without the annual cost increases.

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Actually, we didn't encounter a "death sprial", I just read about it over time since health insurance has become a big worry. What happened to us was that I made the mistake of buying a policy from a life insurance company from a well known poker player who did insurance on the side. The company was Universal Olympic Life and it went out of the health insurance business in 1993 or so. I stupidly let the situation lapse for a while. Then my wife got hit by a big one (unrelated to her current leg problems) and my full-time poker career was over.

Are the good Blue Cross plans generally available on ehealhinsurance.com? They list policies but I'm not sure if they are good. Also, I'm not clear if you do health insurance in the LA area so I'll send you a PM (but you can answer here if you think it's OK). I'd like to go through you if possible; I've gotten a lot out of your replies here.



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Also, individual plans in CA by law CANNOT rider pre-existing conditions if you had prior coverage. They can only accept, rate up, or decline. This makes it hard to get approved if you have any kind of significant history.

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My understanding is you have a two month window when existing coverage (under COBRA) runs out. Is this correct?



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In fairness, medical CPI is higher than even education CPI and when you add the normal morbidity increase as you age people need to plan for and expect their annual contribution to health costs including their insurance to do nothing but go up under current conditions.

Remember medical care represents overe 14% of our nation's Gross Domestic Product. That expense represents someone's premium. Who is ready to stop going to the doctor?

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Good point. People complain but our medical system is probably the best in the world.

~ Rick

[fishyak]

There are no "subsets" of experience on current individual policies. Depts. of Insurance will heavily "frown" on any new product issued solely to create a new pool. The only business for both Blue Cross and Blue Shield is health insurance, so absent going broke, they cannot abandon you the way small companies can when costs turn against them.

The product each agent sells is the same and is sold at the same price as ehealthinsurance.com. Everyone pays the same price for the quart of milk. The only difference is service.

Yes, you have a window after expiration of COBRA to apply w/o pre-existing condition limitations, but I do not remember what it is off the top of my head.

I do not write individual health insurance any more, but can refer to you to someone who would do the job right, particularly in EXPLAINING things up front.

It would be best to inquire about options BEFORE COBRA expires. If there are going to be problems, then HIPAA and "Level 3" (guaranteed issue) health insurance options can be reviewed and discussed to keep your best options open under the circumstances.

I am sorry for your bad prior experience. This is why, as a general rule, it is a good idea to stay away from people who sell insurance "on the side." Bad poker advice may cost you a couple of pots. Bad insurance advice can cost...

People need to work with experienced, knowledgable reps., not their school buddie or their brother-in-law. It's a good career for people who do it right. But at times, it makes poker look easy.

[Rick Nebiolo]

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There are no "subsets" of experience on current individual policies. Depts. of Insurance will heavily "frown" on any new product issued solely to create a new pool. The only business for both Blue Cross and Blue Shield is health insurance, so absent going broke, they cannot abandon you the way small companies can when costs turn against them.

The product each agent sells is the same and is sold at the same price as ehealthinsurance.com. Everyone pays the same price for the quart of milk. The only difference is service.

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I think the best bet for me is to get the general idea looking at ehealthinsurance but go to an agent. I do want to stick with the big companies, Blue Cross or even continue with Healthnet, although I really didn't use them much (of course my wife did).



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"I do not write individual health insurance any more, but can refer to you to someone who would do the job right, particularly in EXPLAINING things up front."

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I've PMed you so reply there when you get a chance. Thanks again for the help.



[ QUOTE ]
It would be best to inquire about options BEFORE COBRA expires. If there are going to be problems, then HIPAA and "Level 3" (guaranteed issue) health insurance options can be reviewed and discussed to keep your best options open under the circumstances.

I am sorry for your bad prior experience. This is why, as a general rule, it is a good idea to stay away from people who sell insurance "on the side." Bad poker advice may cost you a couple of pots. Bad insurance advice can cost...

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Actually he was an insurance agent who played poker on the side. He passed away a few years ago but I'm really unhappy he hooked me up with a private insurer back in 1990.



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People need to work with experienced, knowledgable reps., not their school buddie or their brother-in-law. It's a good career for people who do it right. But at times, it makes poker look easy.

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No argument with that [img]/images/graemlins/grin.gif[/img]

~ Rick

[Jimbo]

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My understanding is you have a two month window when existing coverage (under COBRA) runs out. Is this correct?


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63 days Rick, per HIPPA act of 1996.

Jimbo