Tips or Links on Avoiding Health Insurance Pitfalls

[Kristi in MD]

I am very fortunate to work for a public school system in Virginia that is self-insured. The person in charge of the health insurance will go to bat for an individual when the company the monitors the fund tries to deny a claim. She has a kind heart and makes the insurance fund pay the claim when she feels it is warrented, regardless of pre-exisiting condition status. I think it is horrible when you pay and pay in to an insurance fund and then when you need it you are told NO!

 

[Guest]

I am very fortunate to work for a public school system in Virginia that is self-insured. The person in charge of the health insurance will go to bat for an individual when the company the monitors the fund tries to deny a claim. She has a kind heart and makes the insurance fund pay the claim when she feels it is warrented, regardless of pre-exisiting condition status.

She sounds like a gem of a person to have in your corner .

I think it is horrible when you pay and pay in to an insurance fund and then when you need it you are told NO!

AMEN!

 

[Kathy4Ryan]

Insurance Red Tape

Insurance Red Tape

I completely understand. Our son was scheduled for a pulmonary valve replacement July 7th and on July 1st it was denied by our insurance company, Western Health Advantage. There telling us we have to go through another hospital and different doctors. It is so FRUSTRATING! So it's as if we're starting from square one again. The emotional roller coaster is unreal. They just don't care anymore!

 

[carista]

3) Forget about being an entrepeneur or independent contractor, I'd never be able to find insurance to cover me. The last point was the toughest for me.

Right now I work at my fiance's gym which he is either selling or closing down by the end of the year. My plan is to open a tanning salon with my mom, so I've been doing a lot of research into what I'm going to do for health insurance once this happens. I found out that as long as there are 2 full time employee's or owners we can get small group health insurance. I don't know if it's the same in all the states, but in Minnesota they cannot refuse me because of any health conditions, they also cannot raise the price of it past a certain point. Independant contracting would be out of the question, but as long as you can work a way to have 2 full time people, one including yourself, being an entrepeneur is not out of the question...

 

[Guest]

Cort - definitely talk to the Sears HR person - I know that we don't have any time constraints on how long you have to take Cobra. Cobra is paid month by month by the individual. I'm sending an email to our broker to find out if this is true. I'll let you know.

Yes, to let me know.

The Sears HR person never returned my calls, but after a bunch of calls to the 888# established, I think I'm finally signed up for COBRA. I'll know next week when I get the paperwork.

*shakes head*

I'm paying for 2 months ... when I only need it 1 week. Best not get me started.

If, in fact, they have something like that, look into a short-term policy, such as Assurant Health. We had a situation here where our company "forgot" to put someone on the policy and then wouldn't (ARRGGGHHH). So, we got the individual a short-term policy through Assurant for a very minimal cost. The details of hers was that it was the up front cost of the whole policy for a set period (like $300 or so for three months), with a $500 deductible, no copays or anything, just the $500 and once you hit the $500, everything was covered 100%. Check it out. It certainly worked for her.

Most HR professionals will go to bat for the employee. I run an HR department and I feel that the #1 priority in my job is making sure that an employee's benefits are in order and that they have no problems. When I took this position, I asked the employees, "what can I do better than my predecessor?" And the overwhelming answer was "help us!" She would just give them the carrier phone # and say handle it yourself. Now, when people have problems, they know they can come to me with bills/issues and I will get on the phone with the carrier and get it figured out. Plus, it does help to have a self-insured policy. It's more "user friendly" for lack of a better term.

Sure wish you were my HR person ....

I haven't let the new company what is going on because I don't want them to "accidentally find out" about my health issue ... until I'm "established" with their insurance, ya know?