I should have moved to Canada while I still could

February 2, 2009 8:14 PM

I just found out that in six months, I'm going to lose my student health insurance. There's no COBRA on student insurance, as far as I can tell. I have a pre-existing condition of a sort that will, I think, totally rule out getting private insurance. Assuming that I don't find a job with benefits, is there any way that I can stay insured? If this is a huge priority, which it is, then are there better or worse states for me to move to in order to maintain my insurance status? How on earth do I figure out how to negotiate this mess?

My state has an insurance pool for people with pre-existing conditions, but there are only a certain number of slots, and I've been told it fills up fast. I know that unless I maintain continuous coverage, I'll fall under pre-existing condition exemptions even if I find a job with benefits later on. I'd really like for that not to happen. If worse comes to worse, I can move soon, while I'm still covered, and establish residency in a state where the pool is better. I can borrow money from family members to pay for the move and the premiums. But I don't even know how to begin to do that.

Obviously, my best bet is to find a job with benefits, which is my goal. But in this economy, I'm trying to deal realistically with the fact that it might not happen. What on earth do I do in this situation? Are there any resources to help me negotiate the health insurance morass?

posted by craichead to Health & Fitness (24 answers total)

I am not an expert by any means, but I looked into this for one of my kids a few years ago and I believe you have to have had coverage within the last six months to qualify for the state coverage.

When it comes to insurance, ya do what ya gotta do, as they say. Get a job ANYWHERE that will give you benefits until you can find a more permanent working solution. I believe Starbucks offers benefits at like 30 hours a week or something ridiculous like that.
posted by Edubya at 8:18 PM on February 2, 2009

Take a look at Massachusetts. My understanding is that everyone there is required to have health insurance, and insurance companies must accept you. Details here.

Good luck. My wife also has a pre-existing condition, and if I hadn't been able to obtain group coverage for us, I don't know what we would have done.
posted by Pater Aletheias at 8:23 PM on February 2, 2009 [1 favorite]

I was in a somewhat similar position last year. I dropped out of full time status in August since I was planning to file my dissertation in December. I lost my student insurance at that point. However, I did not have pre-existing conditions and just needed worst case insurance.

Have you talked with the student insurance office? They referred me to an insurance broker who helped me find a temporary plan. Talk to such a person and see what you can figure out. It may not cost what you think.

This is in California. But yes, try to get some job that will cover your insurance. Hopefully things will be better in six months.
posted by special-k at 8:25 PM on February 2, 2009

Response by poster: I don't think your situation is analogous to mine, special-k. It's the pre-existing condition that makes this a challenge.

Both Massachusetts and Starbucks are definite possibilities.
posted by craichead at 8:49 PM on February 2, 2009

As long as you don't have a gap in coverage greater than 63 days, the pre-existing condition shouldn't count as a pre-existing condition. Is there some reason why it would?
posted by zsazsa at 8:52 PM on February 2, 2009 [1 favorite]

Starbucks offers benefits at 20 hours (I'm in Canada, but this is true in the US as well).
posted by thisjax at 8:53 PM on February 2, 2009

i was surprised last year to learn that my current insurance plan defines "continuous coverage" in the context of pre-existing conditions, as having gaps in coverage of less than 60 days. it took some pressure off me when i was transitioning from one job to another; my new job had a 30 day waiting period before i could be covered by their insurance.

i don't know if that's helpful to you since you don't know what plan you'll end up with, just something to be aware of. i will second the suggestion to talk to your student insurance office. they should be familiar with situations like yours.
posted by beandip at 8:54 PM on February 2, 2009

Response by poster:

As long as you don't have a gap in coverage greater than 63 days, the pre-existing condition shouldn't count as a pre-existing condition.

I'm worried that I'm going to have a gap in coverage. I'm going to start looking for a job with benefits tomorrow, but this isn't a great economy in which to be job-hunting. I can't extend my insurance past August, no matter what, and I don't think they have to sell me individual insurance in my state. So unless I find a job with benefits by August, the gap happens.
posted by craichead at 8:55 PM on February 2, 2009

There's no COBRA on student insurance, as far as I can tell.

If you haven't already, you should call your student insurance office and verify this. When I was in grad school, I helped design the student insurance program at my school, and we specifically included an option for students who were leaving or graduating to stay on the plan for six additional months. It was more costly than the student insurance for full-time students, but far superior to private options, and many students used this option to help ease the transition into real life.

This may not be an option where you are, but it's not uncommon for student insurance to do this, so it's worth checking on it.
posted by dseaton at 11:33 PM on February 2, 2009

I don't know if it is still the case, but back in the late 1990s circumstances were such that I had to research the pre-existing condition/health insurance issue. Even if I found a job with benefits, many health plans did NOT cover PE conditions (particularly those companies who belonged to an HMO). At that time, in Michigan at least, the only insurer that would cover a person despite any PE conditions was Blue Cross/Blue Shield. Of course (and probably partially because of that fact), their individual plans were not cheap. Mr. Adams and I signed up for our own BC/BS policy when the company I worked for had crap insurance, no Rx coverage, etc. We paid just over $800 per month, but since I have Lupus and he has Ankylosing Spondylitis, it's a necessary evil, if not just for the prescription coverage.
posted by Oriole Adams at 11:53 PM on February 2, 2009

Why are you losing coverage? Graduation? Is there a way you can just not do the graduation paperwork for a while?
posted by amtho at 2:12 AM on February 3, 2009

A couple other options:

Get married to someone with health insurance in the next six months. Just don't tell Metafilter.

Or you could see if your state allows your parents to put you back on their insurance. For example in the following link they list several states that allow your parents to keep you on their insurance until you are 30. I don't know if that is an option for you, but you did mention borrowing money from family members in your post.

I did search google quite a bit to figure out which states force the health insurance to take you with a PE condition and didn't find much information. Good luck!
posted by aetg at 3:47 AM on February 3, 2009

Relevant data from the states:

Eleven states this year and 26 overall have increased the maximum age for dependents in private insurance plans. Here are measures passed this year:

Connecticut: Up to age 26 for unmarried full-time students
Idaho: Up to 25 for unmarried people financially dependent on their parents
Indiana: Up to 24 for all dependents
Maine: Up to 25 for unmarried dependents
Maryland: Up to 25 for unmarried dependents living with their parents
Minnesota: Up to 26 for unmarried young adults
Montana: Up to 25 for unmarried dependents if their insurance premium would be equal to or more expensive than coverage through their parents' insurance
New Hampshire: Up to 26 for unmarried dependents
South Dakota: Up to 29 for full-time students
Washington: Up to 25 for unmarried dependents
West Virginia: Up to 25 for unmarried dependents
posted by aetg at 3:51 AM on February 3, 2009

This website has a chart and talks about moving in and out of states with a helpful DANGER! if the state does not mandate preexisting coverage. I will leave it to you to decide if the website looks legit or not.
posted by aetg at 3:56 AM on February 3, 2009

When I was in a similar situation (had a job, but no health insurance and in a state where insurers are not required to offer coverage), my solution was actually to reenroll for one grad-level class at a local university. That was enough to qualify me for the student insurance, and though the tuition portion of it was pricey, the cheapness of the student plan evened it out somewhat.

Several people I know have also gone to (or at least started) grad school largely to get the health insurance (and if you are a TA, the cheap COBRA rates for the 18 months after)...what a broken system.

Good luck!
posted by susanvance at 6:43 AM on February 3, 2009

I know the pre-existing condition is causing trouble, but since you have a little bit of time, find out just how much a private policy would be and whether you can get enrolled. My roommate just went through this exact thing, and the small town insurance agent who lives near my parents figured something out and got her enrolled with premiums that are not terribly high. Its a short-term policy and is only renewable for 18 months, but other than that, its pretty acceptable and even has some prescription coverage. You might be pleasantly surprised.
posted by mjcon at 6:59 AM on February 3, 2009

Massachusetts does indeed have guaranteed coverage. There is a waiting period if you don't have insurance when you apply, but it kicks in immediately if you already had insurance.

IIRC they can't charge you differently whether or not you have a preexisting condition.

Because of the combination of those things, insurance is stupidly expensive here for the average person, though potentially cheaper for someone like you with a preexisting condition. My insurance costs almost triple what I paid in Florida and finding a decent doctor is almost impossible.
posted by thekiltedwonder at 8:15 AM on February 3, 2009

As long as you don't have a gap in coverage greater than 63 days, the pre-existing condition shouldn't count as a pre-existing condition. Is there some reason why it would?

This is true if one is going from a group plan to another group plan. However, if you are going from a group plan to a private policy, pre-existing conditions CAN be excluded. It's up to the discretion of the insurer.
posted by Thorzdad at 10:00 AM on February 3, 2009

In addition to Starbucks, restaurants owned by Outback Steakhouse Corp. (Outback, Bonefish Grill, Carrabas) give their employees benefits around twenty hours a week, if you have wait staff experience. You'll probably make more money waiting tables than barista-ing, to boot.
posted by PhoBWanKenobi at 10:33 AM on February 3, 2009

Sorry, that might have been unclear. Any Outback employees working over the minimum number of hours get benefits, not just those with wait staff experience--it just might be difficult to get those jobs without experience. In retail, benefits almost always kick in after a certain length of time working, so if it's something you might consider, I'd start applying to places now.
posted by PhoBWanKenobi at 10:39 AM on February 3, 2009

I just ran into the same issue getting off my student insurance and found out that despite having continuous, credible coverage since birth (and how many people can say that!), the fact that I have a medical condition (PCOS) prevented me from getting on to a standard plan. Like Thorzdad said, some things can be excluded. My parents have helped me work with an insurance broker to get onto a guaranteed acceptance plan- we applied for two plans and will go with the cheaper one. My premium is about $200/mo but the deductible is very high.

If you have 6 months left on your student insurance, you can still start talking with an insurance broker now about your options and find out whether or not you condition is actually a deal breaker. They want to work on this for you because they get a cut from getting you on a plan. It took about a month for all of the paperwork to be processed and multiple errors were made on the insurance company's and broker's end, so don't feel bad about insisting on updates. Good luck!
posted by Mouse Army at 11:53 AM on February 3, 2009

Apologies if someone's already said this, but have you talked to an insurance broker? They can help you navigate all the plans and tell you what your odds are of getting coverage on your own given the pre-existing condition.

It can't hurt to try, and maybe you won't have to scramble for a job or move to another state.

Good luck and please let us know which strategy works out.
posted by zippy at 12:15 PM on February 3, 2009

I've been in the same situation and also recommend using an insurance broker. Mine helped walk me through applying for the state high risk pool plan and later helped me get temporary health insurance. I used Fortis for short-term insurance, which is now Assurant I think.
posted by ahdeeda at 1:43 PM on February 3, 2009

Definitely, look for a broker. Though, that's not always a guarantee that they know exactly what you're buying.
Oh, and, if you do go shopping for insurance, steer clear of MEGA.
posted by Thorzdad at 1:58 PM on February 3, 2009