Health insurance coverage expert? HELP!
 

Okay. Need help.

I've been on COBRA for 6 months.

On January 1 the insurance company raised our rates by $200/month. We weren't notified so we paid our usual premium. On Feb 1 we paid our premium again.

Today we noticed they hadn't cashed the check and we called them. We were told they dropped us. So while we were still under the 30 day grace period for the February payment - we are more than 30 days from the January "under" payment.

So now it looks like my daughters VERY expensive pre-existing condition is not covered.

If they won't re-instate us - what can I do? I think if I take new plan from anyone we will never have continuous coverage with respect to the pre-existing condition and will never be covered on this.

Do I have any options?

ACA (Obamacare) plans do not exclude prex conditions. And may be cheaper than COBRA too.

I sell group health. You will be ok. Promise.

1. Call HR and tell them you are militant about losing your COBRA tomorrow. If you were not informed of the price change, it is their fault. You will be consulting legal help immediately if they don't reinstate.

2. Call an individual health insurance agent. JYL is right. The ACA removed pre-existing conditions. At least get coverage for your kid ASAP. You will wan to know who is good at this. Get someone in your area. Ask friends who have individual coverage.

As JYL says, you will be ok. Now get some sleep and kick some azz tomorrow.

Thanks guys.

It would certainly be cheaper than COBRA. It is also certain those plans have a very limited panel of providers, due to the compensation being about 70% of what a "normal" plan would be. They also are high deductible plans, so you may be out of pocket more in the end, even with the lower premiums.

Get back on the COBRA plan. They will reinstate you because they don't want you killing their golden goose.

Worth noting so much of this is completely different state to state. Rules, what plans are available, ability to purchase individually, etc. In my state the individual market is almost non-existent so buying on our own directly is a poor option.

Pricing of COBRA depends on the group demographics as well as the level of benefits.

Individual could be much more or less. Only one way to find out.

I am looking into this myself. My COBRA premium looks about the same as for a “Moda Bronze HSA” plan through the Marketplace.

The health insurance through my former work was not great - high deductible plan, the only $ we ever got was annual physicals and routine dental, so we pretty much paid for everything using the HSA. The Bronze plan might not be any better or worse.

Assuming no obvious difference in premium, coverage, benefits, is there any rule of thumb that you either go COBRA or go marketplace?

As was mentioned earlier, there are brokers out there who are licensed to give advice by your state insurance commission on individual plans. My wife has met with one annually as she has to buy her insurance on the marketplace. One of the many flaws with the ACA is that employer plans, at least in our state, have pretty much stopped covering spouses even if the employee pays 100% of the cost. It's left us with no option but for her to buy crappy insurance and the broker has helped her navigate the choices each year. I think your time on COBRA is limited to 18 months so you have to get coverage at some point on your own.

^^^correct.

I am at a disadvantage on the individual benefits. We don't sell it in my firm so it is a little like a different language. Jerry is right. Find an individual benefits person.