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View Full Version : guarantee issue/high risk pool states


consused101
04-27-2008, 05:46 PM
Please let me know if I am wrong in my understanding of this issue. I live in NJ and NJ is guaranteed issue state. Basically I think it means that everybody in NJ can get health insurance insurance regardless of pre existing conditions. It also means that entire state population is in the same insurance pool and pays rate according to age/sex and without any regard of health conditions. There are may be separate plans for children. But basically entire group of people in a state get increases at the same time. I am currently covered by employer health insurance, but expect to get COBRA soon. My understanding that I have to exaust COBRA before getting individual policy.
I want to move to CA after COBRA ends or if I can have my plan in CA but CA is not guaranteed issue state. But my understanding that HIPPA will require CA to insure me and can not deny insuarance for preexisting conditions. I also understand that rates that I will be paying will be spread across high risk pool where I will be and increases will be for entire pool and I can not be cancelled as long as I pay premiums regardless how much I utilize the system.
Am I correct so far?
My next question is regarding rates and increases I will be paying. It looks like insurance is actully more expensive in NJ. Should I be afraid to be in high risk pool? I am assuming it is only one pool. While the only condition I have is high blood presure that is controled with medication, my concern is that I will be paying for people with more serious conditions because we all in one pool.
Thank you very much.

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madera74
04-28-2008, 08:40 AM
Everything you said about guarantee issue in NJ sounds correct up (although to clarify, you don't have to exhaust COBRA to get an individual policy - but you do have to exhaust COBRA to get a guaranteed issue policy) until you said that a health plan in CA would need to cover your pre-ex conditions - I don't think that is necessarily true, since CA is not a guarantee issue state. Unless you were asking if your guarantee issue plan in NJ would be portable -- that I don't know. However, if high blood pressure controlled by medication is your only health concern, it is definitely in your best interest to try to get regular (non guarantee issue) health coverage if you are able. You might get a rate increase due to your blood pressure, but your premiums should still be much, much lower than you would get on a guarantee issue plan, and those plans are typically guaranteed renewable - meaning that you can keep it as long as you pay the premium. Think of the risk pool/guarantee issue plans as plans of last resort. Also, in some states you need to show proof that you were denied by other carriers in order to be accepted - and based on what you've said of your health history, I wouldn't foresee you being denied. Good luck!

 
 
 




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