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Temporary Health Insurance


Cetkat

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I'm getting kicked off my parent's insurance at the end of the month because I turned 22. When I looked into what I should do, a couple months ago, the office that handles their insurance said that I'd be able to be covered for up to 1 year longer for an extra $100 a month... and I had planned on getting it.

Well, they were on crack.

I just found out that it's actually over $400 a month, and there's no way I can afford that.

The enrollment for insurance at my job won't start until Oct.. and then I won't have any coverage until next year. So I need something to cover me for 3 months that will take care of my pdoc visits and the meds they prescribe.

I've been looking over the BCBS plans online since that's who I'm with now & (if I'm understanding it correctly) their temp coverage doesn't cover prescriptions and their other options mainly take care of "Family Physicians - whose primary specialty is Family Practice, General Practice Internal Medicine or Pediatrics" & that doesn't cover the pdoc. So I have to look under specialists, right?

Then, instead of the upfront co-pay; it talks about the Calendar Year Deductable "This requirement, when applicable, must be satisfied by each Insured each Calendar Year, as determined by BCBSF, before any payment will be made by BCBSF for any claim" + 30%... but it doesn't give any real numbers. So what the hell would I have to pay my pdoc? Would that mean I have to pay it all until their CYD (whatever that my be) is met & would that end up being any less that not having insurance at all, given that it would only be 3 months? *sigh*

I thought about maybe just going without prescription coverage and trying for assistance, but given that it's based on household income and my roommate just got a huge promotion, I don't think that our combined 30,000 is eligible. (Even though mine's less than 10,000 at the moment.) And it could take 4 weeks for the meds to arrive according to the form.

I don't know what to do. It sounds like there's alot more processing time involved for regular insurance too, and I don't have time to wait for that.

Does anyone have any suggestions for what I should do or what plans (from anywhere) would be good for this situation?

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I would suggest that you talk with an insurance broker who handles BCBS, as well as others. They are the experts and can find the answer to your questions.

I'm not sure about the coverages you are talking about. I checked out Temporary Insurance, and like you found it to be around $400 a month for my age and state. The offerings were for selectable terms from one month up to twelve, though they, and other places said that 6 months was the reasonable limit for temporary insurance. Any longer and you are better off getting a regular personal policy.

Temporary policies are really meant to be for catastrophic coverage for a short time, to bridge you from one policy to another. The fine print was quite clear that the policy did NOT cover chronic conditions, and that if you used the benefits for such a condition, you likely would not be able to extend the policy or ever obtain another from the company. Which is reasonable. Again the policy is meant to protect you if wind up in intesive care from a car wreck, not to provide routine meds and GP office visits.

Deductibles? I think they would be the same for any policy. If you have a $300 annual deductible, then the first $300 you pay out of pocket. After that the insurance company will pay the standard rates, and you have to pay the copays.

Again, I would urge you to talk to an insurance broker (who you intend to give your business to. Don't waste his time).

Good luck, a.m.

p.s. You might ask your new employer for the name and phone number of their local insurance broker. Since you have a connection with his client, you will probably be treated well, since he wants to keep their business. Plus, he is intimately familiar with their insurance policy and can tailor something to fit perfectly.

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I would suggest that you talk with an insurance broker who handles BCBS, as well as others. They are the experts and can find the answer to your questions.

Yeah, I tried to get a sales dept. for BCBS on the phone today.. the number the phone rep gave me was restricted. I'm going to have to look up their main number for non-policy holders. I know they can give me more detailed information.

I was hoping to find more general, "this company costs less, while this one covers more, or these may have something to offer" type of thing or alternative solutions (like needymeds) by posting here. I'm also wondering if it would just be better to stock up now on meds and try to coast through.

I'm not sure about the coverages you are talking about. I checked out Temporary Insurance, and like you found it to be around $400 a month for my age and state. The offerings were for selectable terms from one month up to twelve, though they, and other places said that 6 months was the reasonable limit for temporary insurance. Any longer and you are better off getting a regular personal policy.

Temporary policies are really meant to be for catastrophic coverage for a short time, to bridge you from one policy to another. The fine print was quite clear that the policy did NOT cover chronic conditions, and that if you used the benefits for such a condition, you likely would not be able to extend the policy or ever obtain another from the company. Which is reasonable. Again the policy is meant to protect you if wind up in intesive care from a car wreck, not to provide routine meds and GP office visits.

Maybe the temporary plan I found is just an unique case then. There's the 'continuation coverage' for the $400 - which is just keeping what you had before, and a new 'temporary' plan (under the low-cost section) just for people with gaps in coverage. It actually mentions people who just revolved off a plan and it's supposed to cover any in-network office visits - just not perscriptions.

http://www.bcbsfl.com/index.cfm?fuseaction...dualUnder65.BOT

So, I surmise from what you said that I'd be hard-pressed to find something like this with other companies & they probably wouldn't cover the MI stuff even if they did?

Deductibles? I think they would be the same for any policy. If you have a $300 annual deductible, then the first $300 you pay out of pocket. After that the insurance company will pay the standard rates, and you have to pay the copays.

So then, getting a standard policy for a short time would end up not really saving me any money. I didn't know if that's the way it usually works with office visits or not. My parents' plan is federal, so it's always just the copay for that.

p.s. You might ask your new employer for the name and phone number of their local insurance broker. Since you have a connection with his client, you will probably be treated well, since he wants to keep their business. Plus, he is intimately familiar with their insurance policy and can tailor something to fit perfectly.

That's a good suggestion; I hadn't thought of that. Perhaps Aetna would have something I could use to extend coverage sooner...

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i don't know if they have any such thing in your state, but i live in ohio and we have free mental health clinics (like the one i go to) for low/no income people. i got hooked up with this clinic because i had to go to a state mental hospital when i was unemployed, and then they made sure i got my aftercare.

however, here at this clinic you don't have to go to the hospital to get in there.

i don't know where i'd begin to find out about where your clinics would be or how to get involved, except maybe NAMI would know, or the mental health board in your area, if you have one. i get my mental health care for free because of this clinic. now that i have ssdi i'll be able to pay them through my medicare/medicaid, but since my hospitalization it hasn't cost me anything.

you would have to see their pdoc for the time being, but the help and meds would be free, or low cost, depending on your clinic.

it would be really nice if they have them in your area. i happened to get hooked up through the hospital, and then i helped other people around here find them as well. not knowing what resources are in your state makes it hard to make suggestions.

best of luck. health care is horribly expensive and it seems like no one cares about the consumers, we're just money to them. money in and money out.

i attempted to get short-term coverage awhile ago before i found out about this clinic, and i couldn't get it when i disclosed my mental health conditions and drugs i take. would you even be eligible for their plan?

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I'm not discouraging you from talking to BCBS directly, you may be able to get the answers about their policy from them, though I've had the same run around from a big company.

To clarify, when I say "insurance broker" I don't mean the company. I mean an independent insurance broker who represents several companies, i.e. "Fred Jones Insurance".

If you can get an extension policy from your present company, that is probably a better deal than you will get from other companies. If you can do this without a break in coverage the rates will probably be lower, you wont' lose your paid deductible, and you won't have non-covered pre-exhisting limits.

Good luck,

a.m.

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BCBS are a bunch of fuckers.

I am going through the exact same situation, down to turning 22, they told me a bunch of stuff that wasn't true, and we're talking about BCBS federal.

I'm still being run around by them a little, but I think what is going to happen is I signed up for regular individual coverage- I can't remember what my deductible is (rather large), but I at least have $20 office visits and something to cover me if I'm in a car accident or something. It's a little over $100 a month.

BCBS has told me that since I had prior coverage with them (you have a 60 day window or something like that?) that the processing time would be fairly quickly- but since they're a bunch of fucking liars, who knows what that means. Right now they're telling me they can't get the apartment number for the forms, which is stupid because I've called it into them MORE than once. And it's on the billing part, just not the mailing part.

I don't have a ton of advice, since I keep getting the run around, as well. But I just wanted to tell you that you are not alone, that BCBS can rot in hell, and that I think if you have prior coverage with BCBS that the deductible will carry over and it'll wind up being cheaper to just get a regular individual plan. That is what I have surmised.... but again, I don't trust these people as far as I could throw 2 pianos strapped to an elephant.

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I tried to get an individual plan with BCBS after my cobra benefits ran out. They said they do not cover any types of mental illness.

Luckily, my H was able to get me on his policy during open enrollment at his job. Since I had not had a lapse in coverage (thank God), they are covering my MI.

Insurance sucks!!!!!!!!

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i don't know where i'd begin to find out about where your clinics would be or how to get involved, except maybe NAMI would know, or the mental health board in your area, if you have one. i get my mental health care for free because of this clinic. now that i have ssdi i'll be able to pay them through my medicare/medicaid, but since my hospitalization it hasn't cost me anything.

you would have to see their pdoc for the time being, but the help and meds would be free, or low cost, depending on your clinic.

it would be really nice if they have them in your area. i happened to get hooked up through the hospital, and then i helped other people around here find them as well. not knowing what resources are in your state makes it hard to make suggestions.

best of luck. health care is horribly expensive and it seems like no one cares about the consumers, we're just money to them. money in and money out.

i attempted to get short-term coverage awhile ago before i found out about this clinic, and i couldn't get it when i disclosed my mental health conditions and drugs i take. would you even be eligible for their plan?

The clinics sound like a great idea if I can't get my new plan to cover my pdoc - or if I can't manage free samples. I'm sure my doc would know if this kind of stuff is in my area & how to get into it. You're right about health care not giving a damn - you're screwed if you seek treatment and screwed if you don't...

Unfortunately, either way, I still have to get a new plan to have "continuous coverage" for when my work benefits kick in.

I'll be eligible due to the fact that it's a temporary one. The question is whether or not they'll allow a waiver for MI treatment.

Thanks for the suggestion & well wishes!

I'm not discouraging you from talking to BCBS directly, you may be able to get the answers about their policy from them, though I've had the same run around from a big company.

Yeah, they've been less than helpful so far. Although, I've probably gotten better responces since they're also who I've been under for the past 22 years.

To clarify, when I say "insurance broker" I don't mean the company. I mean an independent insurance broker who represents several companies, i.e. "Fred Jones Insurance".
Ahh...ok. I figured that they were all "brokers".. just that someone from say, personnel, at work would have broader information. Thanks for the claification.

If you can get an extension policy from your present company, that is probably a better deal than you will get from other companies. If you can do this without a break in coverage the rates will probably be lower, you wont' lose your paid deductible, and you won't have non-covered pre-exhisting limits.

Yeah. That's what I'm trying for now.. I've filled out the form, so now I'm waiting to hear back from them. I basically went for the easiest one to get and the quickest turn around. (About 2 days) It won't cover prescriptions and I'll have a huge deductible if I have to go the ER; but it will cover any doc for a flat $35.

The pre-exhisting limits are a question; it will allow my new insurance next year to cover the MI stuff, but I may still have to fight with them since the old policy was technically my parents and not mine.

BCBS are a bunch of fuckers.

I am going through the exact same situation, down to turning 22, they told me a bunch of stuff that wasn't true, and we're talking about BCBS federal.

Same here. The real screwed up thing is that when you extend the federal, the goverment stops paying their portion of the insurance.. so the continuational $400 is the same for the standard BCBS - even though you still have the better coverage. The government's a bunch of cheap-asses. And doing COBRA isn't any better - it's $350.

I'm still being run around by them a little, but I think what is going to happen is I signed up for regular individual coverage- I can't remember what my deductible is (rather large), but I at least have $20 office visits and something to cover me if I'm in a car accident or something. It's a little over $100 a month.

BCBS has told me that since I had prior coverage with them (you have a 60 day window or something like that?) that the processing time would be fairly quickly- but since they're a bunch of fucking liars, who knows what that means. Right now they're telling me they can't get the apartment number for the forms, which is stupid because I've called it into them MORE than once. And it's on the billing part, just not the mailing part.

Yeah, I looked at those BlueOptions & BlueChoice plans. The only problem is trying to make them apply the deductable from your parents' insurance onto yours.. If they don't, you have to meet your CYD before they'll pay their % for any non-"Family Doctor". Meaning that since my pdoc specializes in Psych.; she's concidered a specialist. If you get your stuff through a GP, then your fine... otherwise, it's a nightmare. Might as well not have any insurance at all.

And of course nobody can give a straight answer whether or not it's even possible to transfer your deductable between contracts. Plus, since it's federal - office visits don't effect the deductable so my parents probably haven't met theirs anyway since all of our hospitalizations in the last year have been for accidents (and therefore covered %100) so nothing has really gone towards it.

Right now, my apt # isn't on my form either (even though I put it there). But according to them, after the 2 days, I can call and get my card information & use the insurance without it. The payment will go through without the number for me since I used my debit card and I work at the bank. Hopefully this crap doesn't cause too much of a problem.

I don't have a ton of advice, since I keep getting the run around, as well. But I just wanted to tell you that you are not alone, that BCBS can rot in hell, and that I think if you have prior coverage with BCBS that the deductible will carry over and it'll wind up being cheaper to just get a regular individual plan. That is what I have surmised.... but again, I don't trust these people as far as I could throw 2 pianos strapped to an elephant.

Thanks.. It's good to know that I'm not alone in this (although I'm sorry you're going though this shit too). I'm just really pissed off that the good insurance kicks you off so early. My roommate has crappy coverage until she's 24 with being in college. Now THAT should be the norm! You can't even be considered an independant with the government; yet, you're on your own with medical insurance?!

I tried to get an individual plan with BCBS after my cobra benefits ran out. They said they do not cover any types of mental illness.

Luckily, my H was able to get me on his policy during open enrollment at his job. Since I had not had a lapse in coverage (thank God), they are covering my MI.

Insurance sucks!!!!!!!!

*Nods* It's a rarity for BCBS apparently. It seems that there's a separate catagory just for this, and alot of plans don't have it. Luckly, the temporary one does... I just have to get past the previous condition part.

Why can't we be civilized and have free health care for all?

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  • 2 weeks later...

Well even though I talked to the stupid insurance company extensively about exactly what I was doing, they turned me down for an individual plan and tried to sell me on the Oregon Medical Insurance Pool, which is a crock of shit and won't cover pre-existings for 6 months and is therefore worthless.

Have you found any answers yet? At this point I'm considering a plan for recent graduates through my university that wouldn't cover outpatient but would cover inpatient. I figure if I freak out and don't keep my job (I'm still a temp so they might let me go even if I don't freak out) then that might be an option?

If they keep me, eventually I'll get signed onto their insurance plan. But there will be a lapse in coverage, which will probably fuck me.

I'm not doing really well with this search. COBRA is not affordable in any way and so might as well not exist.

The health care system sucks ass.

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Well even though I talked to the stupid insurance company extensively about exactly what I was doing, they turned me down for an individual plan and tried to sell me on the Oregon Medical Insurance Pool, which is a crock of shit and won't cover pre-existings for 6 months and is therefore worthless.

So you're in Oregon then? Let me see if what I got applies there.. Is there any paticular zip you want me to put in?

I'm not surprised that they gave you a hard time about the regular plan.. it has all that pre-qualification crap and all to jump through.

Have you found any answers yet? At this point I'm considering a plan for recent graduates through my university that wouldn't cover outpatient but would cover inpatient. I figure if I freak out and don't keep my job (I'm still a temp so they might let me go even if I don't freak out) then that might be an option?

Yeah, I did the 90 day coverage without the rx precription plan. It will cover my doc visits with a $35 co-pay and no deductable unless I have to go to the emergency room or have tests done. It's pretty basic and $89 a month. It said in the small print that pre-existing conditions aren't supposed to be covered, but that there is an ability to get that wavied or shortened. (Which I plan on making them do, in the event my pdoc's paperwork gets sent back). Would the graduate plan constitute continuous coverage?

If they keep me, eventually I'll get signed onto their insurance plan. But there will be a lapse in coverage, which will probably fuck me.
Having a lapse really would screw you up from what I've read. You definitely need to avoid that if at all possible - even if it means getting something temporary that doesn't do shit, just so you don't have a break in coverage.

Even if all that's avaliable is the Oregon Medical Insurance Pool & the grad plan.

I'm not doing really well with this search. COBRA is not affordable in any way and so might as well not exist.

The health care system sucks ass.

They sure as hell don't make it easy, that's for sure. You're right about COBRA - it's a load of crap. Probably even costs more that paying for everything out of pocket, minus the ER.. maybe.

In the long term, I really think that employee health care is the way to go. You wouldn't get turned down & with continuous coverage you can get them to cover the pre-existing stuff. (At least in my case.)

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Yeah it sucks big time. I bought an individual BCBS plan, just covers tests and stuff in hospitals, big deductible, no prescription coverage....

What happened for me: had continuous coverage under a group plan for a million years.... I was allowed to have a lapse in coverage for up to six months (I think) and still have bcbs cover preexisting conditions...which surprised me....Maybe it was just a 5 month lapse allowed. Somehow, having been covered in a group plan for years (united Health Care)....that was the key. If I'd had an individual plan for a million years, and then had the same lapse in coverage (5-6 months) and then bought the individual BCBS plan, no preexisting conditions would be covered.

It is quite a maze.

Here in Michigan there are community mental health clinics for folks with no insurance or some kind of medicaid... each county kind of runs their own bunch of clinics...low income, for sure. Meds & pdocs, and sometimes really good pdocs...

Well anyhow, had to chime in. It really sucks. I'm glad you asked about this. AM has good advice.

Luli

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Well even though I talked to the stupid insurance company extensively about exactly what I was doing, they turned me down for an individual plan and tried to sell me on the Oregon Medical Insurance Pool, which is a crock of shit and won't cover pre-existings for 6 months and is therefore worthless.

So you're in Oregon then? Let me see if what I got applies there.. Is there any paticular zip you want me to put in?

I'm not surprised that they gave you a hard time about the regular plan.. it has all that pre-qualification crap and all to jump through.

Well.. I put in the zip for your Chamber of Commerce and the only thing I found with short term is this:

https://secure.regencelife.com/section.cfm?...p;ZipCode=97401

And down at the bottom it says:

Important Note: There is no continuous coverage between policies. Any condition which may have existed or occurred under one policy will be a pre-existing condition under the subsequent policy, and therefore, will not be covered under the subsequent policy.

Such bullshit - I can't believe things vary so much between states!

So, I would say; go with the university plan as long as it will count with your new employee plan as continuous coverage..

And check and see if the job one will actually cover the pre-existing conditions like mine will.

What happened for me: had continuous coverage under a group plan for a million years.... I was allowed to have a lapse in coverage for up to six months (I think) and still have bcbs cover preexisting conditions...which surprised me....Maybe it was just a 5 month lapse allowed. Somehow, having been covered in a group plan for years (united Health Care)....that was the key. If I'd had an individual plan for a million years, and then had the same lapse in coverage (5-6 months) and then bought the individual BCBS plan, no preexisting conditions would be covered.

It is quite a maze.

None of this really makes sense. People should just be covered for things regardless of when it started...it's crazy that you're screwed over like this for actually trying to help yourself.

Here in Michigan there are community mental health clinics for folks with no insurance or some kind of medicaid... each county kind of runs their own bunch of clinics...low income, for sure. Meds & pdocs, and sometimes really good pdocs...

Well anyhow, had to chime in. It really sucks. I'm glad you asked about this. AM has good advice.

Luli

Yeah. It is an option.. a hard one if you've already found a good pdoc/patient match-up (I certainly can't see myself switching - rather go without groceries), but an option nonetheless.

And yes, AM always does.. <g>

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  • 2 weeks later...

Ok. I got screwed.

Apparently only long-term health insurance will cover mental health.

Short term will cover any other specialist, except for my pdoc.

*Curses under breath*

So, I'm limiting myself to a visit once a month, talking to my doc over the phone, and picking up sample meds.

Love my pdoc; hate the system.

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