Health Insurance Question - Denton,TX

Updated on November 10, 2008
T.W. asks from McAllen, TX
6 answers

Hi Ladies, I have a question about Health Insurance. Long Story Short, I've never been without Health Insurance. I was on Group Insurance with BCBS/Healthselect, and I quit my job and was going to go on COBRA until I found another job. I found a job, but it may be another couple of months until I can get on their group plan that is BCBS also. SO, I've been without insurance since September 1st. We were going to wait till the last minute to get COBRA because it's expensive 365/month, and we have 105 days to do so. So, my question is this, is it worth it to go ahead and pay the $365 X 3 for September, October, and November when I haven't used it, or should I just wait until my group insurance kicks in in a couple of months and just pay any bills I incur, outright? What about pre-existing conditions? I take blood pressure meds, BC, and anxiety meds. What is considered a pre-existing condition? Thanks in advance!

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So What Happened?

Thanks so much everyone for your help! I'm going to go ahead and pay for COBRA, I'm afraid of not having coverage and am worried about the preexisting conditions. It's alot of money but we'll do it for the peace of mind. Thanks again!

More Answers

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M.A.

answers from Dallas on

Yikes! Definitely do the Cobra! I have a friend who just went through something similar, only her lapse in coverage was VERY short (only a week). And yes, the new insurance claimed everything she had was a "pre-existing condition". If you are on high blood pressure and anxiety meds, then that means you are considered diagnosed with "high blood pressure" and "anxiety dissorder". They will claim they don't have to pay for anything relating to those things. Fact is, insurance companies will look at you closely when you have a lapse in coverage, hoping to get around paying for something. I definitely wouldn't risk it!

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D.J.

answers from Dallas on

I'm not a big risk taker - I would never go without some type of insurance coverage for any length of time but I've had a lot of experience with sickness, unfortunately. My husband spent 1 day in the Baylor heart hospital last December. The bill, had we not had insurance, was $30,000! We had to pay an amount substantially less, around $4,000.

A pre-existing condition is a condition that you have prior to the start of new insurance. Most group policies (a policy through your work) will cover a pre-existing condition. Your COBRA plan should cover pre-existing as it is a continuation of your policy from your old job. You should check with your new insurance to see what their policy is on pre-existing to make sure you are covered for those condiitons.

$365 x 3 mos. is $1,095 - do it for the peace of mind. That amount is a LOT less than what you'll pay if something should happen to you or someone in your family. You could go to Parkland but I wouldn't subject anyone to waiting 10 or more hours to see a doctor for a minor procedure.

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K.B.

answers from Dallas on

If you have pre-existing conditions, it would be best for you to continue your insurance through COBRA, as your new insurance will then cover all your pre-existing conditions. But if you have a gap in coverage, then usually pre-existing conditions are not covered for a certain period of time, usually a year or 18 months. I know it is expensive, but if you are at all able, it will pay off in the long run, plus you will have peace of mind should you need medical care before your new policy becomes effective. Usually anything you have received treatment for in the previous year is considered pre-existing, but the time frame could differ depending on the policy.

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P.M.

answers from Dallas on

T.-

We are kinda doing the same thing right now b/c for us to do COBRA as a family it was over $1000. We just hoped for the best and decided to "wing it" until our new insurance kicked in.

I think b/c you will end up paying out of pocket somewhat with preexisting conditions, it ends up evening out in the end. However, it was a little bit nerve wracking knowing we didn't have any insurance. So...consider if you are the type of person who has ever been to the emergency room or are clumsy, etc. Then weigh both sides and choose what will make you feel like you've made a good choice.

Good luck!

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D.G.

answers from Dallas on

The best advice I can give you is to contact the BCBS plan that will cover you with your new employer to find out what their pre-existing condition policies are. However, the rule of thumb is to not let your employer group health insurance lapse between jobs, even if it means going on COBRA for awhile & paying the higher premiums. A lapse in coverage often means pre-existing conditions will be excluded by your new coverage. I've been involved with medical billing for 3 1/2 years as an end-user & for nearly 10 years as a software developer. Don't take anything for granted!

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L.G.

answers from Dallas on

I was told by my insurance that pre-existing insurance claim means if you make a claim on your new insurance..a doctors or other medical claim that happened before your new insurance has been activated. Stuff happens, it is cheaper to cover yourself and never use it than to take the chance and have something tragic happen and not be covered. Good Luck.

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