Continuing health care coverage PPO (Health Alliance) Posted: 06-25-08 12:34pm
My husband was/is working at a job where
he pays $123. a week for coverage out of
his paycheck, supposedly the company pays
the other half of that coverage (2 adults,
2 under 18's). It's PPO with a $1000
deductible and then 80/50 (25 office visit
50 emergency room).
He just got a form
from his current employer that says that
if we want to continue coverage for July
we only have to pay the $490 that we'd
normally pay and then in August pay $1000+
for coverage per month after that.
Anyway, he's moving to a new job, and we
called the insurance company to see about
continuing coverage with them. They just
gave me a quote of $530 a month which is a
little bit more than what he's paying a
month, and something doesn't feel right
here. (this will relate to question 1)
First of all, it's not continuing coverage
per se, we do have to reapply for the
coverage, which means that I suppose they
will change the quote, due to a minor
health problem I have.
Question 1. Does something about this
situation sound fishy? If we are paying
$490 a month from his boss, and will be
paying $530 a month if we go it ourselves
- where does his boss get the $1000
figure? (all figures are estimated. It
seems to me, that his boss is just
"telling" his employees that he's paying
for 1/2 of the coverage, when really they
aren't.
Question 2: Did I not ask the insurance
company the right question perhaps about
coverage. I asked to continue coverage,
and they said that we couldn't do that,
but we could reapply for coverage with an
application, but they didn't say that they
would re-evaluate our coverage costs. My
husband says not to trust this original
quote, and frankly I'm new to all of this
insurance stuff and have no clue what to
do now.
Question 3: We are both diabetic, and he
has slightly elevated blood pressure, I am
insulin dependent and he isn't. I have a
minor blood disorder (Polycythemia Vera)
that requires blood work and phlebotomies
once in awhile - I'm overweight and take
medications for depression. Does stuff
like this figure deeply into being
accepted for coverages?
If you can dumb down your answers for a
confused woman - it would be appreciated.
I'm in Illinois, if that helps at all.
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clc6583
New User, Becoming EHEALTHy
Joined: 25 Jun 2008 Posts: 2
Posted: 06-25-08 13:18pm
Well I just looked at their webpage and it
says this, so this may not be an issue
anyway - sigh
Obesity-being greater than 40 percent
overweight for one's height and weight**
Polycythemia Vera**
I'm not sure what they mean by 40%
overweight for height and weight...
and I've got Polycythemia Vera. Crud
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Coast Life and Health
New User, Becoming EHEALTHy
Joined: 12 Jul 2008 Posts: 5
Posted: 07-12-08 14:06pm
I would have to say if you are paying $123
and that is just %50 you must have pretty
good insurance.
To answer most of your questions though I
would need to know what state you are in.
All state have differences and without
that info anyone here would just be
guessing.
Also were did you get your quote, from
your husband current employers co. or an
independent agent or?
As far as your health problem make sure
you tell your agent. If he know this info
he can guide you to the right co. All co.
have different underwriting criteria. Some
might raise your rate and some might not.
Far that matter some state are guarantee
issue.
He just got a form
from his current employer that says that
if we want to continue coverage for July
we only have to pay the $490 that we'd
normally pay and then in August pay $1000+
for coverage per month after that.
