Health Insurance Blog

State legislators in Wisconsin want to tighten individual health insurance regulations, reports Guy Bolton in the Milwalkee Journal-Sentinel. Currently, medical coverage can be denied or taken away if a person fails to disclose any pre-existing medical condition. The bill, which is supported by the state’s Insurance Commissioner, is said to be more consumer-friendly. For example, it would narrow the standard for a “pre-existing condition”: only conditions that were diagnosed by a doctor would qualify. 

Under the law, Wisconsin health insurance companies would also be allowed to look for only pre-existing conditions that occured in the past year, as opposed to being able to look back on whole lifetimes for the purposes of rescinding health insurance. Among other provisions, it would also appoint an independent regulator to examine rejections.

Judith Graham from the Chicago Tribune recently wrote about the Illinois Comprehensive Health Insurance Plan, and its coverage for those individuals unable to buy Illinois health insurance elsewhere. There is a cap on the number of people that can enroll (currently almost 6,000) in order to ensure that its costs are fully covered by state funding and its premiums, which can’t be higher than 150% of what a regular insurance premium costs in the market. This program is reserved for U.S. citizens and legal residents, and has a $2.5 million cap on lifetime benefits, according to Judith.

Currently, Illinois has about a thousand slots remaining in ICHIP’s traditional pool, so it’s worth looking into if you have unsuccessfully attempted to buy individual health coverage or suffer from certain chronic, uninsurable conditions including:

• Juvenile diabetes
• AIDS
• leukemia
• Parkinson’s disease
• multiple sclerosis
• cystic fibrosis

This program is different from the HIPAA plan, which is intended for those who have lost their employer-sponsored health insurance and exhausted their COBRA unemployment insurance.

The top four providers of Florida health insurance recently met to discuss health care under a Barack Obama administration, says Jeremy Cox of the Jacksonville Times-Union. Representatives from Humana, UnitedHealth, Blue Cross Blue Shield of Florida, and Aetna were in attendance.

The insurers believe that President Obama should enact a health insurance mandate for all Americans if, as they predict, he will require insurers to cover individuals with pre-existing conditions. They think that the cost will be prohibitive for carriers otherwise. At the moment, Obama has not publicly supported a mandate, and how exactly one would be carried out is unknown. He has supported a role for the private sector in universal health care, but that role will most likely be a change from the current market.

Instead of the plans Obama and congressional Democrats have proposed for health care reform, the insurance companies would prefer that the government focus mainly on enrolling eligible but currently uninsured individuals in federal-run programs like Medicaid and Medicare, Jeremy says. While the insurance companies agreed that greater coverage is a priority, they claim the task of covering other Americans should be left to them through innovative new plans.

The baby boomer generation (ages 45 to 64) is worried about losing their health insurance, and the current economy is even more cause for concern. Many baby boomers have been either laid off or forced to retire early, and with that comes the loss of their employer sponsored health insurance plan. Meanwhile, they’re not yet old enough to enroll in Medicare.

There are still several options available to people in this age group, says Emily Brandon of U.S. News and World Report. They include:

1. Continuing your former employer’s coverage through COBRA, which they are required to offer unless they go out of business. However, you will have to cover the entire cost of the plan, plus a 2% administrative fee, yourself.
2. Getting on your spouse’s health insurance, if they have continued to work and their employer allows it.
3. Finding another job and continuing to work until you turn 65. Some companies even offer health insurance benefits to part-time employees working as little as 20 hours per week.
4. If you’re lucky to have worked for a firm that offers health insurance coverage to retirees (a steadily declining percentage), take advantage of it. Don’t rest easy, though; many companies are failing to keep their promises and are shifting a higher portion of health care costs onto retired workers.
5. Buy yourself individual insurance. Individual health insurance policies can be expensive, with premiums of over $300 per month according to the Commonwealth Fund. It also may not cover you if you have a chronic, pre-existing condition (and will be even more costly if it does), but if you are relatively healthy it may be your only option. A high-deductible plan could save you money on premiums, although you run the risk of catastrophic out-of-pocket costs. If you go down this route, make sure to research the most affordable health insurance quotes.

There is also the option of forgoing health insurance, but it’s not recommended. You’d either have to cover all of your medical expenses out-of-pocket, or go without some needed medical care.

Judith Graham from the Chicago Tribune’s Triage blog has mentioned that the state of Illinois is now suffering from an epidemic of 50 to 64 year-olds without health insurance. These individuals are caught between a rock and a hard place–they often suffer from pre-existing conditions that preclude buying individual health coverage on the open market, but aren’t yet old enough to qualify for Medicare.

An AARP/Disability Advocates of Chicago report found that over 287,000 (13.3%) adults in the 50-64 age group are uninsured. 44% of poor adults in this age range lack health insurance.

Unfortunately, the current corruption scandal involving Ill. Governor Rod Blagojevich is distracting the state from its governing duties, including dealing with health care. Get the best Illinois health insurance quotes, regardless of your age.

(Photo credit: Cuksis under CC 2.0)

The UnitedHealth Group is now offering UnitedHealth Continuity, a policy for those that already have health insurance but are worried that they may lose it in the future. These people may be considering early retirement, or may fear unemployment and the resulting loss of health care coverage. Reed Abelson says in the New York Times that applicants must pass a medical review before being accepted. However, many individuals who have been unable to get insurance on their own are those with pre-existing conditions. The Continuity plan doesn’t seem to be helpful for them.

The UnitedHealth Continuity policy charges members 20% of the current health insurance premium to reserve the right to future coverage, and varies due to age, gender, location, and level of coverage selected. The monthly fee is also subject to increase in the future. There is also the danger of the plan becoming a costly high-risk pool that attracts people more likely to develop serious conditions.

Reed also speculates that proposed health care reforms from the incoming Obama administration include a requirement that private insurers offer individual health coverage to everyone, no matter the state of their health. That type of law would make the new UnitedHealth guarantee unnecessary. The president of UnitedHealth’s individual insurance unit, Richard A. Collins, claims that political wrangling and legislative delays make the Continuity plan viable, at least in the short term.

UnitedHealth Continuity is currently available in 25 states in which UnitedHealth already sells individual insurance. It believes that it will soon be able to offer the Continuity plan in 15 more states.

(Photo credit: Shahram Sharif under CC 2.0)

To date, more than thirty states have set-up high-risk pools to address the issue of the those who go without health insurance coverage because they are deemed “uninsurable” by private health insurance companies.

For many of these “uninsurables” these high-risk pools are their only means for acquiring health insurance, because they don’t have access to an employer-sponsored health plan, and as mentioned above, private health insurers won’t cover them because of a pre-exisitng condition such as diabetes, depression, or high-blood pressure.  About 175,000 people nationally are covered under these high-risk pools and that number should grow as more states launch similar programs.

High-risk pools are generally similar to health plans offered by private health insurers, but in some cases may offer more limited benefits.  However, the costs for these health plans are pretty steep ( 1.5 to 2 times that of similar private health plans which is understandable due to the expensive nature of the customers medical conditions that drive people towards these plans to begin with.

Despite their high cost, these state run health plans are a very important instrument for individuals with health conditions and as a last resort, they should certainly be considered a favorable option to going without health insurance altogether.

If cost is a concern, you should first see if you qualify for individual health insurance from a private health insurer, and then look to high-risk pool as a last resort.

States that currently have high-risk pools include:  Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin, Wyoming.