I'm 18 right now so i know its early to worry about this. My parents provide my health insurance now but i have a a degenerate disk in my lower back (which pretty much means i have a bad back in general) and this is an issue that will stick with me for life.

Will I be able to get health insurance and disability insurance when I'm older? how much more will it cost me?

Hi Hoyt I will try to answer your questions, I worked in this field for 15 years,
As long as you do not have a lapse of coverage of medical insurance of more than 60 or 63 days you should not have a problem. When you leave your parents ins company, that company will mail to you a HIPPA Continuation of Coverage form, which states your effective date and your termination date with them, you give that to your new medical ins company and you should have no problem with your back problem.

Now if you go past 63 days from the date your coverage under your parents
terminates, then your new med ins company may consider your back problem to be Pre Existing and may penalize you by not paying for any expenses due to your back problem, all plans area different when it comes to a pre existing medical condition, so my advice to you is, get your medical ins coverage in place before your coverage under your parents terminates

The cost, sorry my friend can't tell you that, because what you pay for your medical coverage is different for everyone due to the company that the employer uses for med insurance.

Disability insurance, is when you are working and say you fall and break your leg, not necessarily at work but say home on ice, then you would go out of work on FMLA which is Family Leave and you would get disability because of that injury from your employer, but that lasts only for 12 weeks, and your medical condition has to meet the disability carriers guidelines.
If you got hurt at work and it just so happened to be your back, then you will have to prove that this latest injury is just that and not a old injury or not your disc problem that you already had and if you get hurt at work then you go on Workmans Comp, it could turn into a mess if you did hurt your disc problem at work, because this is a previous condition.

So how did I do? did I answer all of your questions? :)

Steph

Dear Stepahieanne:

Since you are so knowledgeable I thought maybe you could help me out. I am sorry Hoyt to be horning in on your thread. Here is my dilemma:

I work for a small family business. They have Kaiser insurance in California. I was on my husband's Blue Cross insurance policy. He left his job to work at the same small family business that I work at. He did not want to be on Kaiser Insurance so he put us (2 adults and 2 young adults under 22) on COBRA through his old employer. The COBRA is exhausted and Blue Cross will not take us and he wants to go on HIPAA through Blue Cross (State of CA insurance) instead of the small company's Kaiser insurance.

All along we have been paying part of the insurance premium that is in excess of Kaiser Insurance that is offered by our small family business employer. Now the HIPAA premium will be even more.

I do like how with Blue Cross you can go to any doctor anytime and with Kaiser your hands are tied.

I am afraid of going on HIPPA because there is a pre-existing conditions clause for 12 months and the premiums and out of pocket are so high.

I am also afraid that if later down the road we decide to go with Kaiser they won't take us because we were on HIPPA. Then they will know that we were rejected by Blue Cross and they will reject us too.

My husband does not care how much it costs because he is so against Kaiser.

My question is this:

1) Am I stupid not to just go on Kaiser?

2) If I go on HIPPA will Kaiser reject us later on if we choose to be part of the small family business insurance plan?

Thank you for any words of wisdom.

Hi Belle

1st, HIPAA is like a rule a goverment rule and it means that if you have coverage [like cobra] and you go from that cov'g to another without a lapse in coverage, then nothing will be pre exisitng, the old insurance will send you a HIPAA form stating your dates of coverage, you give that form to you new insurance carrier, HIPAA is not "insurance" but I don't understand how ya'll can go on BC of CA and not be under a employee plan.

2nd yes go with Kaiser, sure it is not BCBS but it is coverage, they must have a network of physicians, hospitals, labs etc that you can use. I agree that BSBC is great because most providers are participating and you pay a copay and out you go, but Kaiser is a big name in Health care and they must have a plan similar to BCBS, but your hubby is against Kaiser :confused:
Well it is better than nothing and what if someone gets sick?

Personally, I was diagnosed with MS 12/2004 which is when I lost my job, I carried the medical insurance for my husband and I, I paid for 2 weeks of cobra thru my old job, then went on his plan, which is nothing like our old plan, but at least we have coverage, and yeah, we have to pay more, but I was able to use all of our medical expenses on our taxes this year, so it worked out in the end, his plan has changed to a more economial [sp] plan for this year.


It is a hard decision, but what if....... even if Kaiser is horrible, I am very pro active in my health care and I speak up and make sure that I am getting the best care. I really think that we all should be doing that.

Hope this helps :)

Thanks StephanieAnne:

In California, Kaiser is a chain of hospitals/clinics. They are not only your insurance carrier, but your doctor too. In an emergency you can only go to a Kaiser hospital. You can only see a doctor in a Kaiser facility. They decide if you need an operation, you cannot get a second opinion unless you go outside the Kaiser facility and pay for it on your own. Kaiser pays the doctor, nurses, technicians their salary. The insurance company is the employer to the doctors so the doctors do what ever is the rule of the insurance company (Kaiser). Many people compare it to socialized medicine.

My husband does not want to be a part of Kaiser because they are always looking for the least expensive way to treat you. So they don't use the newest medications because they cost more, etc. They don't have the latest technology, etc.

From what I understand Blue Cross will manage our HIPPA for $1,366 a month. I was just worried that if we can't stand the new coverage would Kaiser still take us knowing we were already rejected by Blue Cross as an individual family account.

It is just so frustrating to have to worry about insurance. I know that people say socialized medicine in Canada and England is not very good, but it would sure be nice to always know that you are covered.

Oy vay so Kaiser is like a HMO? yep been there, and done that, now I know why your hubby doesn't want to be a part of Kaiser. :eek:

I would pay the high premiums and go with BC for your medical coverage, I get confused when you say BC will manage your HIPAA. As long as you do not go without med coverage for 63 days, and you want to change cov'g Kaiser should accept you. BC denied you because you are not in a employer group, but remember this BCBS has individual plans and that must be what you are enrolling under. It is very confusing I know :confused:

HIPAA, which stands for Health Insurance Portability Accountability Act of 1996 was created to assure the privacy of personal health history [PHI] with the advent of electronic filing of claims and the paperless society that is fast becoming the medical/claims world, the gov't [you can thank Bill Clinton for this] wanted your PHI to be private, HIPAA is a good thing :)

When I worked in Medical Claims I had to pass a HIPAA test on privacy. When you go to the DR they have you sign a form stating that they explained HIPAA to you, it is all to secure that your medical history is confidental.

Are you totally confused or what? Hope this info does help you and I didn't mean to confuse you.

Thanks StephanieAnne! I did understand what you were saying. I could understand why Blue Cross rejected my husband and one of my daughters, but I could not understand why they rejected my oldest child and myself.

My oldest has never been sick except for developing an ulcer where she is taking prevacid for a few months until it is healed. She had no endoscopy or any expensive procedures for it.

I don't take any prescriptions, but three years ago I had a cornea transplant. I have no health problems and only go to the doctor for yearly checkups.

I think when you apply for a individual health insurance policy with Blue Cross they will only accept you if you are a doctor phobe and have never been to one your entire life. If you take even one prescription it seems like you are rejected.

What do you think?

Hi Belle

Those 2 diagnosis [dx] are probably enough for them to not accept you two. When it comes to individual policys, they [the ins carrier] can review your past history and make a decision to accept or deny you based on your past. It is different with group policys, they don't review your past history they accept you with all your bells and whistles :bouncing:

When it comes to BCBS accepting and denying, even though they are a non profit organization,[well atleast the bcbs here is] they still have guidelines when it comes to individual policys, what if your past med problems were to rear their ugly head again, then they bcbs would be liable to pay your medical charges and what if those med charges went way beyond what your premiums are, then you would be a ........ liability :eek: meaning you would not be profitable for them~~~~ even tho' they are non profit :rolleyes:
yeah go figure?

See the crazy world of Insurance, they get you any way they can, or is it called covering their butts :)

Best of luck to you and your family