Losing my group health insurance--now what?
December 29, 2009 12:32 PM   Subscribe

I'm losing my group health insurance. My wife has a pre-existing condition. Now what?

I have received notice that my employment will be terminated at the end of January. At the moment my family (wife and two kids and I) all have insurance coverage through my businesses group insurance plan. However, COBRA does not apply (there are fewer than 20 employees), and I am being told that there is no way to continue my health benefits, even though I am willing to pay the whole premium myself. As far as I know, we can't get coverage on the individual market, since my wife has a pre-existing condition (although the rest of us may be able to.)

It is probably going to be a while before either of us can get another job with benefits. Is there some avenue for getting my wife insured that I don't know about? Some applicable law other than COBRA?

(Currently in North Carolina, planning to move to Texas soon, but not before our benefits are gone.)
posted by D+ to Health & Fitness (7 answers total) 6 users marked this as a favorite
I would check with Inclusive Health, they seem to be a gov't regulated high risk pool insurance. I don't know if you'd be eligible, but it sounds like you might be. (guidelines).

I don't have any personal experience with them and you should be careful, but I think that this might be the type of insurance you're looking for. It probably won't be cheap (if it is, I would be worried), but it should provide real coverage.

On first read, this seems like a pretty awesome program. Good luck!
posted by mercredi at 12:47 PM on December 29, 2009

If you will qualify as low-income once your job is over, look into Medicaid. It looks like a family of four that makes less than $594 per month qualifies (using the top line of page 2 of this PDF).
posted by soelo at 12:57 PM on December 29, 2009

Best answer: Okay, you can get coverage with a pre-existing condition. All you need is a letter of credible coverage from your existing carrier.

Insurance companies are insistent about the pre-existing conditions bit because they don't want people to wait until they get sick before getting insurance. If you've already got insurance, you should be fine. Ask your current carrier for a letter and submit it with your application.
posted by valkyryn at 1:00 PM on December 29, 2009

Best answer: Your wife may be able to get coverage, depending on the pre-existing condition. The issue is that insurance companies typically require your wife to exclude any coverage for anything having to do with the pre-exsiting condition, but not necessarily so. You'll have to ask each provider.

The Texas Health Insurance High Risk Pool is a resource that may be able to help your wife become insured for a typically "uninsurable" condition. It looks pricey, and I don't know how good they are (but the American Diabetes Association refers you to them). You can also call the Texas Dept. of Insurance for assistance.

If there is any type of national or local association related to the condition, then contact them; they may have good resources, and may also provide insurance options.

Good luck.
posted by jabberjaw at 1:00 PM on December 29, 2009

Best answer: If she has had continuous "creditable coverage" and has used up her COBRA eligibility (none, in this case), she should be eligible for HIPAA plans. They are often expensive, though. There's a little bit about it here.
posted by needs more cowbell at 2:10 PM on December 29, 2009

Yes hipaa plans will cover her assuming you have creditable coverage. Try ehealthinsurance.com or another insurance broker. Make absolutely clear to the broker that you need a hipaa policy.
posted by bananafish at 2:54 PM on December 29, 2009

Response by poster: Thanks, everyone--this is very helpful!
posted by D+ at 5:48 PM on December 29, 2009

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