Individually-written family health insurance plan options?

zhen_rogue

Currently, I have a job (in Nebraska, US) which offers access to a group health insurance plan.
It's Blue Cross/Shield, and I am the primary with my wife and daughter on the plan as dependents.
I'm considering taking a new job in June, which is a much better situation for my family in all respects except one: it does not offer access to a group health insurance plan.
I need to determine what my options are in the US these days, with the following background info:

I am a healthy young buck, no pre-existing conditions. My daughter has no pre-existing conditions.
My wife does have pre-existing conditions; clinical depression, bi-polar disorder, fibromyalgia, and chronic fatigue syndrome.
My wife is a stay-at-home-mom, and works from home, and therefore has no access to a group plan either.
My wife has been turned down for an individual health insurance plan in the past, based on her pre-existing conditions.
I have never been turned down, and have had our current coverage for more than one year.

Ideally, I'd want an individually-written family health insurance plan, with me as the "primary", and my wife/daughter on the plan as dependents - but i'm not sure if this is possible.
I don't know if my wife's pre-existing conditions will prevent us from writing a family plan, even if i'm the primary.
Does the current state of the Obama health care plan provide some avenue for us to get coverage on my wife by herself? Or with me on a family plan?
I don't mind writing one policy for myself and my daughter, and one for my wife, so long as we can get good coverage - one way or another.

Any advice/guidance/experience here is most appreciated, I really don't have any idea what my options are here.

Thanks!

Deebaser

It all depends on what state you are in

zhen_rogue

Nebraska - land of corn, cows, and despair.

Giggles_Funsworth

Is COBRA not an option for whatever reason?

JHunz

Giggles_Funsworth wrote:

Is COBRA not an option for whatever reason?

I believe COBRA maxes out at 18 months for a voluntary departure, so it would be a stop-gap solution at best.

witch_ie

Currently, the health care reform law does not have a solution for individual/family coverage for adults to my knowledge. Right now children cannot be denied coverage regardless of pre-existing conditions, but adults can still be denied. Assuming no changes are made to the law, starting in 2014, no one will be able to be denied for coverage regardless of pre-existing conditions. My understanding is that they can also not be charged additional premium for pre-existing conditions with the exception of smoking (there may be other caveats, but I think that's the major one).

Underwriting policies/practices can vary from insurer to insurer, especially in the individual market due to the risk involved to insurer. If you are thinking about making an employment change soon and health care coverage is a deal breaker, I would suggest you try applying at multiple places now and see what they come back with.

Maguano

i think nebraska has their own pre-existing coverage plan
https://www.pcip.gov/StatePlans.html#StateInformation

Jasconius

There are a lot of state laws that impact this, but last year I had to go through individual insurance and it sucked ass.

If an insurance company detects ANY uncertainty in the insured, then they will decline, and ask you to get tests to assuage their doubt.

Frankly I think given the nature of your wifes conditions, you are adopting a severe risk by going the individual route, because even if you do get covered, I think you'll be paying out of your eyeballs.

At the very minimum, my recommendation to you is to get an absolutely thorough bill of health under your current plan so you can go to the individual brokers and shut them up.


I tried for 18 months to get individual insurance and I was turned down a huge variety of reasons that included:

* Being 5 pounds underweight
* Having a white blood cell count a few percentage points out of norm
* Having a blood test on record from several years ago that indicated potential liver problems, despite having recent doctors vouchers that the test was erroneous and I had no problems with my liver

And really all of the above despite having a full physical and blood work conducted in the previous three weeks showing a perfect bill of health

I eventually had to give up and get under Obamacare Pre-existing condition insurance (my "condition" was a slightly out of norm white blood cell count with no formal diagnosis), but you can't do that unless you are uninsured for at least six months.


Proceed with extreme caution is my advice.

Thanatos

The best advice I think any of us are going to be able to give:

Find a job that offers health insurance.

The odds of you being able to find an affordable individual plan that is going to cover your wife are long, indeed.

Feral

zhen_rogue wrote:

Ideally, I'd want an individually-written family health insurance plan, with me as the "primary", and my wife/daughter on the plan as dependents - but i'm not sure if this is possible.

It is possible, but one of three things is likely to happen:

1) They will cover your family, except they will not cover any treatment related to your wife's pre-existing conditions.
2) They will cover your family, except for your wife because of her pre-existing conditions.
3) They will cover your family, including your wife, at an astronomical premium.

JHunz wrote:

Giggles_Funsworth wrote:

Is COBRA not an option for whatever reason?

I believe COBRA maxes out at 18 months for a voluntary departure, so it would be a stop-gap solution at best.

Correct. However, many companies voluntarily offer conversion plans where, at the end of your COBRA period, you may opt to convert your COBRA plan to a family plan. There is also what's called a HIPAA plan, which is similar. When your COBRA ends, you can contact the health insurance company to get on a HIPAA plan.

Under federal law, there is no guarantee that a HIPAA plan or conversion plan will have the same premium as your group plan. However, there may be state laws that require that your premiums remain the same.

The best-case scenario here is you live in a state where the law requires them to offer you a conversion plan at the same premium. As far as I can tell from Google, Nebraska is not one of those states, which means you have 18 months of COBRA until you're screwed. But I don't know for sure.

Who can tell you for sure? Your current company's HR person. Ask them what your COBRA and post-COBRA options are.

zhen_rogue

Great advice so far, thanks so much for the replies!
I'm investigating things locally and with my corporate HR department as we speak.