Q: How does the Affordable Care Act help young adults?

A: Before the President signed the Affordable Care Act into law, many health plans and issuers could remove adult children from their parents' policies because of their age, whether or not they were a student or where they lived. The Affordable Care Act requires plans and issuers that offer dependent coverage to make the coverage available until the adult child reaches the age of 26. Many parents and their children who worried about losing health insurance after they graduated from college no longer have to worry.

Q: What plans are required to extend dependent coverage up to age 26?

A: The Affordable Care Act requires plans and issuers that offer dependent coverage to make the coverage available until a child reaches the age of 26. Both married and unmarried children qualify for this coverage. This rule applies to all plans in the individual market and to new employer plans. It also applies to existing employer plans unless the adult child has another offer of employer-based coverage (such as through his or her job). Beginning in 2014, children up to age 26 can stay on their parent's employer plan even if they have another offer of coverage through an employer.

Q: I'm a young adult under the age of 26 and I'm on my parents plan now, but I'm scheduled to lose coverage soon. How can I keep my health insurance?

A: You have a number of options. First,check with your insurance company. Private health insurance companies that cover the majority of Americans have volunteered to provide coverage for young adults losing coverage as a result of graduating from college or aging out of dependent coverage on a family policy. This stop-gap coverage, in many cases, is available now. Second, watch for open enrollment. Young adults may qualify for an open enrollment period to join their parents' family plan or policy on or after September 23, 2010. Insurers and employers are required to provide notice for this special open enrollment period. Watch for it or ask about it. Finally, expect an offer of continued enrollment for plans that begin on or after September 23, 2010. Insurers and employers that sponsor health plans will inform young adults of continued eligibility for coverage until the age of 26. Young adults and their parents need not do anything but sign up and pay for this option.

Q: I'm under the age of 26, and I used to be on my parents' plan, but I recently lost this coverage because I graduated from college. Can I get coverage?

A: Yes. Check with your insurance company to see if they will provide that coverage to you now. If not, watch for the special open enrollment period and sign up then.

Q: Now that the regulation is published, are plans required to immediately enroll eligible young adults in their parents' plan?

A: No. The law says that the extension of dependent coverage for children is effective for plan years beginning on or after 6 months after the enactment of the law - that means plan years beginning on or after September 23, 2010. However, the Administration has urged insurance companies and employers to prevent a gap in coverage for young adults aging off of their parents' policy prior to this effective date. To date, over 65 insurers have volunteered to do so. You should check with your insurance company or employer to see if they are offering this coverage option.

Q: Will young adults be given a special chance to enroll after September 23, 2010?

A. Yes. For plan or policy years beginning on or after September 23, 2010, plans and issuers must give children who qualify an opportunity to enroll that continues for at least 30 days regardless of whether the plan or coverage offers an open enrollment period. This enrollment opportunity and a written notice must be provided not later than the first day of the first plan or policy year beginning on or after September 23, 2010. Some plans may provide the opportunity before September 23, 2010

Q: Will young adults have to pay more for coverage or accept a different benefit package?

A: Any qualified individual must be offered all of the benefit packages available to children who did not lose coverage because of loss of dependent status. The qualified young adult cannot be required to pay more for coverage than similarly situated individuals who did not lose coverage due to the loss of dependent status.

Q: Can plans or issuers who offer dependent coverage continue to impose limits on who qualifies based upon financial dependency, marital status, enrollment in school, residency or other factors?

A: No. Plans and issuers that offer dependent coverage must provide coverage until a child reaches the age of 26. There is one exception for group plans in existence on March 23, 2010. Those group plans may exclude adult children who are eligible to enroll in an employer-sponsored health plan, unless it is the group health plan of their parent. This exception is no longer applicable for plan years beginning on or after January 1, 2014.

Q: Does the adult child have to purchase an individual policy?

A: No. Eligible adult children wishing to take advantage of the new coverage will be included in the parents' family policy.

Q: Will Medicare cover adult children in the same way that private health insurance will?

A: No. The provision does not apply to Medicare.

Q: Are both married and unmarried young adults covered?

A: Yes

Q: Are plans or issuers required to provide coverage for children of children receiving the extended coverage?

A: No

Q: Why is there a special exception for group plans in existence on March 23, 2010?

A: Our goal is to cover as many young adults under the age of 26 as possible with the least amount of burden. If a young adult is eligible to purchase other employer-based health insurance such as through her job, the law does not require the parent or parents' plan to enroll that child if the parents' plan is a grandfathered health plan (i.e., in existence on March 23, 2010). Of course, all group plans have the option to cover all adult children until the age of 26 or beyond. In 2014, this exception will no longer apply.

Q: What happens if a young adult under the age of 26 is not eligible for employer-sponsored insurance and both parents have separate plans that offer dependent coverage?

A: Neither parent's plan can deny coverage.

Q: Does the law apply to plans or issuers that do not provide dependent coverage?

A: No. There is no federal requirement compelling a plan or issuer to offer dependent coverage at this time. However, the vast majority of group health plans offer dependent coverage and many family policies exist in the individual market.

Q: I understand that there are tax benefits related to the extension of dependent coverage. Can you explain these benefits?

A. Under a change in tax law included in the Affordable Care Act, the value of any employer-provided health coverage for an employee's child is excluded from the employee's income through the end of the taxable year in which the child turns 26. This tax benefit applies regardless of whether the plan or the insurer is required by law to extend health care coverage to the adult child or the plan or insurer voluntarily extends the coverage.

Q: When does this tax benefit go into effect?

A: The tax benefit is effective March 30, 2010. Consequently, the exclusion applies to any coverage that is provided to an adult child from that date through the end of the taxable year in which the child turns 26.

Q: Who benefits from this tax treatment?

A: This expanded health care tax benefit applies to various workplace and retiree health plans. It also applies to self-employed individuals who qualify for the self-employed health insurance deduction on their federal income tax return.

Q: May employees purchase health care coverage for their adult child on a pre-tax basis through the employer's cafeteria plan?

A: Yes. In addition to the exclusion from income of any employer contribution towards qualifying adult child coverage, employees may pay the employee portion of the health care coverage for an adult child on a pre-tax basis through the employer's cafeteria plan - a plan that allows employees to choose from a menu of tax-free benefit options and cash or taxable benefits. The IRS provided in recent guidance [(Notice 2010-38)] that the cafeteria plan could be amended retroactively up until December 31, 2010 to permit these pre-tax salary reduction contributions.

Q: It seems like plans and insurers can terminate dependent coverage after a child turns 26, but employers are allowed to exclude from the employee's income the value of any employer-provided health coverage through the end of the calendar year in which the child turns age 26. This is confusing.

A. Under the law, the requirement to make adult coverage available applies only until the date that the child turns 26. However, if coverage extends beyond the 26th birthday, the value of the coverage can continue to be excluded from the employee's income for the full tax year (generally the calendar year) in which the child had turned 26. For example, if a child turns 26 in March but is covered under the employer plan of his parent through December 31st (the end of most people's taxable year), the value of the health care coverage through December 31st is excluded from the employee's income for tax purposes. If the child stops coverage before December 31st, then the premiums paid by the employee up to the time the plan was stopped will be excluded from the employee's income.

Answer: A three month stay in another state would seem to be the typical situation for short-term or temporary health insurance. Qualified applicants can get instant approval and can be insured as early as tomorrow. Short Term health insurance covers many medical services including: in-patient hospital services, outpatient surgeries, prescription drugs, x-ray and lab services. However, one of the caveats of buying short-term insurance is that preexisting conditions are not covered, nor are routine office visits or preventive care. Temporary insurance is for illness or accident only.

If your daughter is currently insured, there is probably no need to make a change in her medical insurance coverage. Her current policy will cover her while she's in California. Note that if she has HMO coverage, she'd be covered for emergencies only while out of her local network.

If she's currently uninsured, I'd suggest getting health insurance quotes for regular individual health insurance. The coverage is better than short-term health insurance, even though it costs is a little more. Then she can keep it if she extends her stay for a longer period of time.

Answer: No. Only people in new insurance plans beginning after Sept. 23rd or in existing plans that change substantially will be able to get the discounted preventive services. The health care law exempts so-called grandfathered plans offered by employers that have not substantially changed since the legislation was signed in March. To maintain grandfathered status, employers cannot substantially raise co-pays, deductibles and other employee contributions or lower their contribution to their employees' premiums by more than 5 percentage points.

Answer: Even though your bariatric surgery removed your previous health risks - obesity and diabetes. The surgery itself created new risks - the possibility of additional surgical procedures. So I can say with assurance that you will not qualify for individual medical insurance before you turn 65. At that time, you will qualify for Medicare. What to do before you turn 65?. If you can pay $400 per month, I suggest that you put that money into a savings account, call it your medical expense account. Use it to pay your out-of-pocket medical expenses for the next 2 years. If you're lucky, you'll get to 65 with a medical nest egg.

Answer: The federal government and some state governments will begin accepting applications July 1, 2010. for new health insurance coverage designed to cover people who have been denied health insurance because they have preexisting medical conditions. People who apply by July 15 will begin receiving coverage by Aug. 1. However, this is not a low-income program as there are no premium subsidies for low income applicants. Premiums, as well as benefits, are expected to vary greatly from state to state, with some plans charging as little as $140 a month and some as much as $900 a month. Visit the federal government's new healthcare Web portal is at http://www.healthcare.gov, for instructions. Read more about preexisting conditions insurance...

ANSWER: Your husband will not be able to purchase affordable health insurance until January, 2014, but with a little planning you can help him get there in good shape without health insurance and hopefully without huge medical expenses as well. To avoid catastrophic medical expenses over the next 3 plus years, you'll have to make sure that he watches his diet, keeps his weight down, and gets regular exercise. He also needs frequent doctor visits for preventive care. People without insurance usually cut back here and it's really stupid. He could see his doctor every month and your cost would be still lower than the insurance premium for a healthy man his age, Also you mentioned he takes the following prescription meds: Simcor, metformin, and trandolapril. The Simcor is a relatively expensive brand name drug for lowering cholesterol. It is simply the generic drug simvastatin including timed release niacin. Ask his doctor to prescribe the generic simvastatin and buy the niacin over the counter. You'll save over $100 per month doing it that way, Please read my article, 7 Ways to Get Cheaper Prescription Drugs.

Answer: Under the Medicare Part D program, seniors pay 25% of their drug costs up to $2,830 a year. After that they pay 100% until their out-of-pocket total reaches $4,550, at which point catastrophic coverage kicks in and seniors pay just 5% of the cost for the rest of the year. The gap between the yearly limit and the point where catastrophic coverage kicks in is called the "doughnut hole."

In 2010, seniors who reach the coverage gap will be eligible for a $250 rebate. Starting in 2011, the government and pharmaceutical makers will begin phasing in subsidies and discounts on brand-name and generic drugs purchased in the gap. By 2020, this program will have eliminated the gap entirely by covering 75% of seniors' drug costs up to the catastrophic coverage limit.

Secure Horizons is a Medicare Advantage Plan. The new law will not ban Medicare Advantage plans, but it will change the way they are paid. Some regions may see cuts in payments to such plans, and plans that score well on customer satisfaction, effectiveness and outcomes will receive bonus payments. Some Insurers have suggested that the new payment structure could cause them to stop offering Medicare Advantage plans, but that would be the insurer's decision, not the government's.

You can keep the plan that you had through your job under COBRA rules, but your former employer is not required to continue paying a share of your premium. Government subsidies are currently available to cover 65% of the premium for 15 months. But once that expires, you'll need to find insurance on your own.

If you are unable to buy insurance because of your preexisting condition, you will qualify for HIPAA guaranteed issue coverage. Basically that's a high deductible health plan at a higher that average rate.

The health care overhaul law is going to be taxing "Cadillac plans" -- high-cost coverage plans provided by some employers. The "Cadillac tax" will cap the tax-free status of health benefits starting in 2018. That's plenty of time for your company to adjust their plan to continue to provide 100% tax-free health insurance for its employees.

Answer: Nothing right away, but by 2014, the federal government will provide subsidies to help you buy insurance if you earn less than 400% of the federal poverty level. Those subsidies will be based on income. If you earn $30,000, you will pay about $2,600 a year for insurance. A family of four with a yearly household income of $60,000 will pay about $5,200. Also by 2014, you will need to buy insurance on your own or purchase it through your employer or pay a fine.

Answer: States and the federal government must create a process for reviewing health insurance rate increases starting with plans issued in 2010. Although this will not keep insurers from raising rates in, it is designed to discourage them from making unreasonable increases.

Answer: There are signs that the underlying cost of health care services, largely hidden from public view, may become more transparent. The California legislature, for example, is beginning to turn its attention to rising hospital and provider costs, and not just the rising cost of premiums. Just in time, the U.S. Justice Department announced last week that California's largest health care purchasers can proceed with an extensive study of the costs of care at more than 300 hospitals statewide. The California Hospital Association tried to block the project claiming antitrust concerns, but the Justice Department rejected the claim. Only by addressing costs throughout the health care system will the nation begin to slow the overall cost of health care and truly deliver on the promise of health care reform. Transparency remains a very important part of the equation.

Answer: You're fortunate that you have COBRA if at all possible keep it until it expires. When your COBRA health insurance coverage expires you will qualify for guaranteed issue health insurance coverage under the federal HIPAA law.
Most health insurance companies who market individual health insurance offer HIPAA qualified coverage. HIPAA plans are usually high deductible PPO plans at a substantial mark-up over the standard rate for a "healthy" applicant. The idea being that HIPAA applicants are a greater risk as a group. You may be able to purchase a HIPAA plan from your current insurer, but can shop for HIPAA plans from any other carrier in your state.

Answer: Under the health insurance overhaul law passed by congress last month, starting September 23, 2010 young adults will be able to stay on or return to a parent's insurance plan until age 26. There is no requirement for your son or daughter to be dependent or a student. Their residency, marital status, or employment is also immaterial. So your daughter turning 19 can continue on your family plan with no interruption.

Your son who will be 23 in July appears to be caught in the gap between July 4th and September 23rd. But he should be able to stay on your plan as well because most health insurers are stepping up to cover people like your son even earlier than the law requires. United Healthcare, which includes individual plans offered by Golden Rule and PacifiCare, has announced that it will make the extension of coverage immediate. Wellpoint, which includes Anthem Blue Cross in California, as well as Blue Blue Cross Blue Shield Plans in 13 states, has announced the will extend coverage starting June 1st, so that leaves a small gap that will catch some children loosing family coverage in the next couple of months. Humana will also extend coverage before Sept 23rd, but we don't know precisely when that will begin yet. More individual health insurance carriers are expected to follow suit in the next few days. Be sure to check with your insurer for details.

Answer: You won't be eligible for the federally-funded risk pool even though the coverage will be better than what you currently receive and less expensive than what you currently pay. Because only individuals who have gone at least six months without health insurance coverage are eligible for the federally subsidized high-risk coverage. So unless you're willing to drop your current coverage for six months you are locked in to your current coverage until 2014. This "Catch 22" situation exists because there's only so much money -$5 Bil - to fund the coverage of an additional 350,000 uninsured people with conditions that make them uninsurable in the current market and can afford to pay for this coverage. If the 200, 000 people currently in existing state risk pools were to move into the new risk pool the money would be half gone right off the bat.

Answer: Great question, Renee, I'm sure many of our customers have been wondering the same thing. The quick answer is, yes, health insurance rates will continue to go up. Health plan premiums are a symptom, not a cause of the problem. The cause of high health insurance premiums is high health care costs. State insurance regulators have no control over that, nor over the administrative costs of the insurers. If insurance company profits are abusive, then regulators can pare back profits to a reasonable level. The problem is that insurance company profits are an almost undetectable portion of our $2.5 trillion national health expenditures. Dramatically reducing insurer profits will not even appear as a footnote in the report of our health care spending.

Unfortunately, the health insurance industry has been and will continue to be ineffective in controlling rising costs. The government must provide the solutions to rising costs, but under the reform model approved by Congress and the President, there are no effective solutions.

The new insurance options do not take effect until 2014. By then states will have created insurance exchanges, in which people who don't get insurance from an employer or the government will be able to shop for policies.

The policies sold on exchanges will be subsidized for many low- and middle-income Americans.

Answer: First, congratulations and I apologize for not answering sooner, but I've been inundated with questions about the new health insurance reform law. In the future, if you'd like a personal response, just include your e-mail address. I won't publish it and I'll respond to you directly. So let me cut right to the chase, no there is no way you can get your prenatal visits, diagnostics, and normal vaginal delivery paid for by insurance at this point. However, I will point out that your existing major medical policy will cover any medical complications due to your pregnancy or the birth of your child. These are the expenses that could really break the bank.

Answer: As you said, most of the big changes like no pre-existing conditions and premium subsidies won't go into effect until 2014. But there are some consumer protections that go into effect sooner.

If you've been denied health insurance because of pre-existing medical conditions, help will be available by July 2010.

1. You will be able to enroll in a new federally subsidized major risk insurance program. The legislation appropriates $5 billion for this. Premiums will be subsidized, but It's not clear how much 0ne would pay as their share of the cost.
2. Children's health insurance coverage cannot contain exclusions for preexisting conditions starting in September, 2010.

If you already have health insurance, these changes will take effect by October 2010.

1. All existing insurance plans will be barred from imposing lifetime caps on coverage. Restrictions will also be placed on annual limits on coverage. What that means to you is your existing coverage, with a lifetime maximum of $2 mil to $6 mil will be amended to unlimited lifetime max.
2. Insurers can no longer cancel insurance retroactively for things other than outright fraud. Previously, the insurance company could rescind your coverage if it appeared to them that you had omitted information or lied on the application. Sometimes, policies were rescinded after a provider submitted claims for serious illnesses like cancer. The insurance company then claimed that the insured certainly knew that he or she had symptoms or even a diagnosis of the disease and withheld that information on the application. Now, the insurer will have to prove that the applicant committed fraud by intentionally lying or withholding pertinent information on the application for coverage in order to rescind coverage. This makes your health insurance coverage much more secure.
3. If your health insurance policy includes your children, you will now be able to keep them on your family policy until they are 26 years old.

For Medicare beneficiaries, some improvements in Medicare coverage will begin within months.

1. Medicare beneficiaries who hit the so-called "doughnut hole" in the program's drug plan will get a $250 rebate this year. In 2012, the cost of drugs in the coverage gap will go down by 50 percent.
2. Preventive care, such as some types of cancer screening, will be free of co-payments or deductibles starting in 2011.

Small business owners with fewer than 25 employees and average wages of less than $50,000 could qualify for a tax credit of up to 35 percent of the cost of their premiums for the 2010 tax year.

In order to win passage of the Senate bill, House leaders probably would need to agree to make changes later. Those changes would be crafted into a budget reconciliation bill, which would need just 51 votes to pass the Senate. But budget reconciliation bills can only relate to items that involve spending -- not issues such as abortion, on which some House Democrats want tougher provisions than the Senate approved.

Can't Congress just start over?

In theory, yes. But getting a brand-new bill through the Senate without sparking a Republican filibuster might be impossible. Obama has suggested that Congress could craft a bill around the items "that people agree on," but the idea of refusing to compromise was key to Brown's victory in Massachusetts. Many analysts doubt Republicans would abandon what looks like a winning strategy.

Is politics the only obstacle to just passing what "people agree on"?

Not really. It's almost impossible to isolate and approve one provision by itself. The healthcare system is so interconnected that changing one part affects other parts. That leads to consequences and pushes the debate into areas where not everyone agrees. That's why getting a scaled-down bill through Congress is harder than it sounds.

So it seems like it's all over?

Maybe not. Democrats have invested a lot in the healthcare overhaul effort. On reflection, they may conclude that the cost of outright failure would be too high, which would make compromises possible. Besides, voters may decide that the status quo will be expensive for them too.

Answer: Most of the health insurance reforms in the new legislation won't take effect until after January 2014. However, there is one exception that could help you. Soon after the health care reform bill becomes law, current provisions call for federal funding of an interim health plan for people like you that need coverage without regard to pre-existing conditions. But it's not a done deal yet. Stay tuned.

Answer: I assume your current policy is individual health insurance rather than group (employer) health insurance. If so, call your insurance agent or your insurance carrier directly and ask this: "What plans with lower premiums can I transfer to without going through underwriting?" Whatever the answer will be your only options for a change of coverage at this point. Because of your height / weight ratio and related health conditions, you would be declined for any health insurance coverage that requires underwriting. That leaves out all plans with other health insurance carriers as well as most plans with your current carrier.

Sorry for the bad news, especially after the nice things you said about me. On the bright side, you have health insurance. If you did not, you couldn't buy it at this point.

Answer: Congratulations on your pregnancy. You should be OK with your insurance. Usually, the date of conception is not the overriding factor. If you did not know you were pregnant when you bought the maternity rider, your pregnancy will be covered. Most maternity riders have a waiting period so I hope you've checked that out.

Answer: As you say, a bi-polar diagnosis makes it virtually impossible to get individual health insurance coverage. Some cases (on a single medication, no hospitalizations), can be covered by Aetna.

ANSWER: Yes. Once your COBRA coverage expires, you and your wife will qualify for guaranteed issue HIPAA coverage.

Answer: When your COBRA health insurance coverage expires you will qualify for guaranteed issue health insurance coverage under the federal HIPAA law.
Most health insurance companies who market individual health insurance offer HIPAA qualified coverage. HIPAA plans are usually high deductible PPO plans at a substantial mark-up over the standard rate for a "healthy" applicant. The idea being that HIPAA applicants are a greater risk as a group. You may be able to purchase a HIPAA plan from your current insurer, but can shop for HIPAA plans from any other carrier in your state.

Answer: Since your husband's job was the source of your health insurance coverage, your husband will have to elect COBRA for his wife to be covered. Yes, when the baby is born he/she will be covered on the COBRA plan. Your son could start on his own health insurance plan now, but since you will deliver in a month he might as well go on COBRA with the rest of the family. Once your baby is born, shop for a health insurance plan for your whole family.

Answer: I'm going to have to redefine your question because you have intorduced complications by mentioning COBRA.

1. The only way your husband can qualify for COBRA coverage would be from a previous job where he had group coverage. If he is within 62 days of leaving that coverage, he may qualify for COBRA coverage. If that is the case, his preexisting health conditions do not matter. He can be covered.

2. More likely, his new employer is offering to pay for individual health insurance for your husband and you during the group waiting period. Based on what you have told me about his health history, UnitedHealthcare will probably offer your husband individual health insurance with an exclusion for any care regarding his back. That might be the best you can do for the next three months.

Answer: No. HIPAA laws do not apply to Medicare Supplement insurance. You will have the option to continue your Medigap policy, by taking over payment of the entire premium.

Answer: From my expertise in health insurance, I would say no. I have never seen a situation where an employee could not be terminated because of their health or a dependents health.

Having said that, you should ask an employment lawyer.

Answer: Unfortunately, there is no obvious option for your wife. If she cannot qualify for individual health insurance because of preexisting medical conditions (her prescription medications), your only option is to enroll her on your employers group health plan.

Answer: If you cannot afford health insurance for the whole family you can analyze your family's risks and protect yourself from the biggest risks with the least amount of premium. So let's take a look at some scenarios.

If one or more of your children are still infants, purchase child health insurance for the infant only. That child will need to see the doctor frequently for well-baby visits and is more at risk for minor illnesses than your older children. Buy a plan thet covers preventive care and doctor visits for a copay for that child. It will cost you about $100 monthly. If that's all you can do right now. So be it.

Let's say one of your children has a chronic illness - like Asthma. That condition could lead to a very expensive emergency room visit. You could cover that child with a low-cost high-deductible health insurance plan for about $60 per month. If he or she has an emergency room visit without insurance, your cost might be $25,000, with cheap insurance your portion might be as low as $2,000. If that's all you can do, just do it.

You can insure all your children against the most expensive risks (hospitalization) for a lot less money than you mentioned - $590 minimum (assuming you don't have 10 kids.) You were probably looking at plans that cover doctor visits, diagnostic exams, etc. These are not high-dollar expenses and health insurance plans that include them are too expensive for you. Check locally for "free clinics" or low cost community clinics that can provide your kids with treatment of minor illnesses and immunizations.

Hope this helps.

Answer: Your Mom qualifies for HIPAA guaranteed coverage provided she has exhausted her COBRA coverage. HIPAA coverage is offered by most insurance carriers. HIPAA guaranteed plans are usually lighter on benefita and higher than standard rates, but she cannot be denied coverage regardless of her health. Given that she has a year or less until she 's covered by Medicare, it's a no brainer.

Answer: If you are only concerned with the cost of your birth control pills, you don't need to buy health insurance. Get a prescription from your doctor for generic birth control pills. Ask for a 90 day supply per refill. Then go to Wal-Mart or Wallrgeens (there may be other discount sources but I know these for sure) to fill the prescription. You will pay $12 for a 3 month supply.

ANSWER: It's possible that a court could specify that you use your employer group policy to cover your dependent child. However, that would be exceptional. We have many clients who cover their children on individual health insurance policies to satisfy a court order.

Answer: As far as health insurance goes, you will be insurable once you have 10 years free of sarcoma symptoms or treatment. I don't know what the underwriting guidelines are for life insurance.

If you should loose your group health insurance, you will qualify for COBRA coverage for 18 months. Take it. You will have no other options at that time. Your children and husband could qualify for individual health insurance based on their individual health conditions. Unless they are rated up due to prexisting conditions, the individual health insurance will be cheaper for them than COBRA. When your COBRA coverage expires, you will qualify for guaranteed issue coverage under the HIPAA laws. If you choose not to take the COBRA when you are eligible, you will also loose your HIPAA option. Once 10 years has passed since you had the sarcoma, you may then qualify for health insurance at a lower rate than the HIPAA guaranteed coverage.

Sound dismal?. Not really. You're lucky. If you had no group health insurance right now, all of your COBRA and HIPAA guaranteed options would be off the table. If you loose your job, you will have health insurance options, even if your coverage will be more expensive than it would be without the sarcoma history.

Answer: As you know, your daughter will no longer be covered on your family health insurance coverage once she turns 19. She will need her own insurance coverage at that time. If she has been diagnosed with both Bi-Polar Personality Disorder and Post Traumatic Stress Syndrome she will not qualify for individual health insurance.

Illinois is one of the states with a Major Risk Insurance Pool. The plan is called ICHIP for Illinois Comprehensive Health Insurance Plan. Find the link to the ICHIP website at HealthcareShopper's Risk Pool page.

Answer: Your mom's diabetes and your dad's high blood pressure are not, by themselves, contitions that would make them "uninsurable" for catastrophic health insurance.

In the case of diabetes, the first question I would ask is if she is insulin dependent. If not, she could be covered if she is a non-smoker, without kidney, vision, or circulation problems. As for her weight, her BMI would have to be 28 or less. The number and cost of medications will be a factor as well.

The additional risk factors for your dad's hypertension includes: smoking, cholesterol, weight, age, overall number of medications.

But every case is unique, so have them give me a call at 800-557-5693 and I'll try to help them .

Answer: You are too heavy in relationship to your height to get medical insurance. While you may be healthy now, you are statistically more likely to have expensive health problems in the future. That's why you were denied coverage.

Answer: Lexapro for depression and/or anxiety is not a condition that most carriers will automaticly decline an application for health insurance. Please have your daughter call our office at 800-557-5693 so that we can help her get affordable health insurance coverage.

Answer: Rest assured, the personal information you enter on an online health insurance application is secure. When you enter your information and press the "Submit" button, your browser first will communicate with the health insurance carriers' server to establish a secured, encrypted connection. This is sometimes referred to as a "handshake." Once this connection is established, the data is then sent via secure means to the carriers' web server. We use 128-bit encryption, the highest encryption available to most browsers, with a public key length of 1,024 bits. This provides the necessary security and privacy our customers expect.

Anwser: Possibly. It depends on the reason(s) you were declined 3 years ago. If you'd like to call my office at 800-557-5693. One of our health insurance experts should be ablt to answer your question if not immediately, certainly within 24 hours. Here's some information about us.

Answer: Your question is not entirely clear to me, but I'll try to answer what I believe you are asking. If your family income is too high to qualify for your state's Children's Health Insurance Program (CHIP), you will be faced with purchasing individual health insurance for your child. Premiums for the most basic plans are a minimum of $50 per month.

Answer: Yes, individual health insurance can be obtained for your grandson alone. Your son does not need to apply for coverage at the same time. The best way to approach this would be for you to complete the application form in your grandson's name. As his guardian, your son will need to sign the application, however you can be noted as the payor if you would prefer. You can review possible quotes at the health insurance quote page of our website or contact us at (800)557-5693 so that we can help you find affordable coverage for your grandson.

Answer: Thanks for your question. Can you give me more information about the symptoms and treatment? Also, it sounds like you do not have a definitive diagnosis. Is that accurate?

In the absence of this information I can give you some general advice. It is sometimes worth making an appeal if you have new or different information than was originally provided on your application otherwise it can be a lengthy and fruitless process. Have you consulted your broker on the possibility of submitting an appeal or did your submit your application direct to Golden Rule Insurance Company? Part of the broker's job is to help the client provide information on or with their application that allows the underwriter to make a good decision. The space available on most applications does not allow for much of an explanation of a given health condition so a supplementary letter is often helpful. The underwriter's job is, as you correctly state, to review the cost of medications. They also need to know the diagnosis so that they can accurately assess the overall risk of the condition. It may be that, without a diagnosis, they are unable to get a good picture of the risk involved and had no alternative but to decline your application.

Get back to me on my questions if you can and I'll try and guide you further.

Answer: Thanks for your question. It is never a good idea to falsify information on an application for health insurance even if you consider yourself healthy and have no associated health conditions that would make you a higher risk. Quite simply, taking such an action could have negative repercussions for you and could even result in an insurance company rescinding your coverage if it is found that you had "intent to defraud". There are other ways to approach this. A good broker should be able to point you in the right direction regarding alternative insurance companies who might have less stringent height/weight guidelines. Hope this helps.

Answer: Thanks for your question. Your insurance company cannot change your coverage as a result of claims submitted. There are several possibilities regarding what's happened here and I'll run through the ones I can think of. First, it may be that your insurance company has withdrawn your old plan from their portfolio and placed all members in a new similar plan type, i.e. they have not targeted you specifically. If this is the case they would have written to you to give you notice of the change, usually 60 days prior to the change. Second, and this is the most likely scenario, your plan has always been structured in this way and you need help from your broker or your insurance company to understand how it works. In actual fact, this should be part of the education process when you buy a plan. I can get you started on understanding your plan if you can give me the names of the plan type and insurance company.

Answer: Not at this time. That would be a non-medical withdrawal and as such be subject to penalties and taxes. This begs the question: what is a qualified withdrawal? A qualified medical withdrawal is one for medical care as defined by Internal Revenue Code Section 213(d). The expenses must primarily be used to alleviate or prevent physical or mental defect or illness. A partial list is provided in IRS Pub 502 at the IRS website. Examples of expenses that cannot be included would be maternity clothing, cosmetic surgery, health club dues or toiletries.

Answer: Yes and no. Let me explain. United Healthcare's HSA administrator, Exante Bank, require that you choose a predetermined amount to deposit each month so that they can routinely collect this by electronic funds transfer. You can always send in additional lump sum deposits by check, however, which would achieve your end result of variable deposits. And yes, you're correct in that $25/month is the minimum deposit. If you wanted to change this to another set amount, say $50, this can be arranged at any time.

Answer: The short answer is yes. You will want to check with your HSA administrator about how best to do that. Most administrators will accept checks. You will also want to ensure that you do not exceed the maximum annual contributions of $2,850 if you have an individual plan or $5,650 if you have a family plan. Additionally if you are over the age of 55 you can make catch-up contributions. For 2007 the maximum amount you can contribute is $800 as a catch-up contribution. You might find the US Treasury website helpful. Hope this helps.

Answer: Unlike a cafeteria plan or Flexible Spending Account, any funds in your Health Savings Account remain yours and will grow, tax deferred, until you reach age 65. You never lose the money. Even if you need to use the money for anything other than qualifying medical expenses related to medical, dental or vision, you can do so with a 10% penalty and payment of taxes on the amount withdrawn.

Answer: Thanks so much for your question. You may want to check with your local bank as they may offer Health Savings Accounts. Alternatively Exante Bank have excellent online resources. Their accounts have a Mastercard for debits and allow for additional cardholders.

Answer: Thanks for your question. It's unlikely that your new employer will offer the same type of group plan that you have with your current employer. Group plans are not portable. If you are looking for a plan that you can take from employer to employer you may want to look in to the possibility of buying an individual plan. If you need help with this please visit our individual coverage resource area.

Answer: You've asked a great question here and one that I know comes up for a great many people. There are many factors affecting the cost of insurance and I won't go in to them here for the sake of brevity. I will say that, in my experience, all insurance companies increase their premiums annually. You say that your insurance premium has increased twice this year. My guess is that this is due to the regular annual increase and may also include an age-related increase. It's worth checking with your insurance company to see what these increases represent. One thing worth noting is that all policy holders of the same age in a given zip code receive the same percentage increase. It is never a person-specific increase. You also asked whether there is an insurance company that recognizes good customers. The only insurance company I know of that rewards customers for not making any claims is Assurant Health. They will write to such customers after their policy has been in place for one year offering them a 10% discount (subject to a written application).

Answer: Thanks so much for your questions. I'm going to answer them in order as follows:

1. FACT is an organization that provides you with dental and vision discounts. Golden Rule requires that you have membership with FACT in order to maintain a health insurance policy with them. This isn't their only function, however. They also serve as mediators should you have a dispute with Golden Rule regarding, for example, a claim. Not to confuse matters but Golden Rule is a wholly owned subsidiary of United Healthcare. This is a good thing because they wield quite a lot of clout in the health services industry. What this means to you is that their claims discounts are considerable.

2. It's fine for you to use a specialist without getting a referral from your doctor because you have a PPO (Preferred Provider Organization) plan. Practically speaking, however, I have found that specialist MDs require a referral from your primary physician, although this has nothing to do with the requirements of your health insurance plan. To find an in-network provider visit the Provider Directories information area of our website. Once there click on 'Golden Rule - United Healthcare'.

3. Yes, presenting your ID card at the time of service t is definitely the best approach. You will then receive what's called an Explanation of Benefits (EOB) from Golden Rule that should match exactly the bill from your doctor.

Hope this helps!

Answer: I hear many complaints from consumers regarding what they perceive to be discriminatory behavior on behalf of the various insurance carriers. It's certainly a challenge to find insurance when you have certain health conditions. Bi-polar disorder is one such condition. When an insurance underwriter, the person who reviews your application, makes a decision about whether to approve someone for coverage, they refer to a set of printed guidelines that the company has compiled. The guidelines will tell the underwriter if a person can be offered coverage, if they need to be charged an extra premium or, in some states, if their condition should be excluded for coverage. The kinds of things they consider when they look at making this decision include the costs of medication(s) and other current and potential future treatments associated with that particular health condition. It certainly does seem unfair and I can see how you would feel discriminated against. Try visiting the Health Insurance Risk Pools Information Area of our website to see if there are guaranteed coverage options for you in your state.

Answer: This can be challenging but it's doable. In the first instance I would recommend using a paper application rather than completing one online. Let me know if you need help with this part. You will then need to contact the primary care giver for your son in Texas. You'll need to go through the application with them over the phone. They will also need to sign and date the application seeing as they are the child's guardian. You may want to wait until you receive the signed form back before you complete the payor information and submit it for consideration by the insurance company.

Answer: Without knowing what kind of plan you have it's difficult for me to say with certainty whether or not a bone scan would be covered. I can give you some general information about how they are normally covered, however. Typically it is applied to the plan deductible and, if you stay in-network, you will receive a discount on the cost of service. There might be a rare instance where a bone scan is conducted in the primary physician's office, in which case the costs may be applied to the preventive care co-pay if the plan has one. This depends on how the doctor codes the bill, however. I would recommend contacting your insurance company directly and speaking with the Claims Department.

Answer: One of the most prevalent issues in health insurance is that the consumer has not received sufficient education about the plan they have purchased. The responsibility for this education lies very much with the broker who sells the policy in the first place. The consumer also needs to ask a number of different questions, similar to the one you are asking here, to make sure they understand their plan at the point of purchase. Also, as questions crop up once the policy is in place, ideally the consumer would be able to contact their broker with questions or for help with any issues they struggling with. My advice to you would be to speak to an educated broker who cares that you get a plan that both fits your budget and meets your needs.

Answer: I can't comment on the quality of your insurance plan and it so happens that your particular experience has nothing to do with your insurance plan and everything to do with the hospital. If you are about to have a relatively expensive procedure it makes sense that the hospital would want to know that you will be able to pay your bill. Many hospitals are taking this approach nowadays as a matter of financial security. There are still many hospitals that will not require that you pay your deductible upfront, however. Oftentimes you can work out a payment schedule with the hospital that will fit your budget if this is an issue for you. To arrange this you should talk with the hospital billing department. I have found that they are almost always amenable. Best of luck!

Answer: I'll be happy to. This is a very common question amongst health insurance consumers. The first thing to remember is that a copayment is a fixed dollar amount and coinsurance is expressed as a percentage.

Traditional health plans have a copayment for office visits, prescription drugs and occasionally for emergency room visits. A typical office visit copay for an individual PPO plan would be between $25-40, prescription drug copay between $10-50 and ER visit copay $100, though the latter is usually subject to the deductible and coinsurance. I'll come back to what this means later. If your plan has a copayment and you visit the doctor or the pharmacy, you'll be asked to pay a set amount at the time of service.

Coinsurance works differently. There are certain expenses, usually hospital related, that you will need to pay for until you meet your annual deductible. If you meet your deductible you will usually also be responsible for a percentage of your expenses thereafter up to a total out of pocket amount ranging anywhere from $2,000-5,000 per year. A typical coinsurance would be 20% which means that you would be responsible for 20% of your expenses once you have met your deductible. Coinsurance is most often capped which means that, even if you had, for example, $200, 000 in medical expenses in any one year, you would only be responsible for, say, $5000 during that calendar year. Its purpose in requiring that the consumer accept responsibility for a percentage of their health expenses while the insurance company takes on the greater risk associated with critical illnesses means that the cost of the insurance is kept to as low as possible.

Answer: Thanks for your question. You're right in that there is very limited coverage in your county due to its rural nature. I spoke to my underwriter at Blue Cross to see how they would handle your wife's application. As I thought they would want to see her height/weight ratio shift a little if she has been treated for elevated blood pressure. Her BMI (Body Mass Index) is approximately 31.5. They would want her to have a BMI of 29 or less which would make the ideal weight between 104 and 158 pounds. She would need to have maintained this weight for 6 months or more. Additionally her blood pressure would need to be well controlled and her medical records will need to reflect that. The thyroid issue is also a concern. Blue Cross advised that, ultimately, they would need to see her medical records in order to make a final determination. I would go forward with an application but also submit a letter from her doctor giving as much positive information about her health history as possible. It just might help. Sorry I couldn't give you a more definitive answer.

Answer: Thanks for your inquiry. In my experience Aetna is a company that will underwrite a family application and automatically split an application at approval if it's in the customer's best financial interests. Let me give you an example of how this would work: if you are approved at a rate of 25% over standard rate and your wife is approvable at standard rates they would split your application up so that the higher rate applies only to you. This would prevent your wife from being penalized. Various companies handle this situation in different ways. Sometimes it is best to make separate applications. It really depends on the insurance carrier.

Answer: There is no insurance company that I know of that is able to offer insurance to out-of-state residents. The reason for this is that health insurance is subject to state regulations. What this means for you is that you will need to buy two separate insurance plans for your family, one in Texas and one in Oklahoma. Once your family joins you in Texas you can apply to have them added to your plan.

Answer: There's an excellent resource called the Centers for Medicare and Medicaid Services. I see that they advise that yes, you would be able to buy supplemental insurance if you have Medicare Parts A and B. There are exceptions, however, which may include state provisions, so it is worth checking with the Centers for Medicare and Medicaid Services to ensure your eligibility.

Answer: A deductible can range from $250 upwards and is the amount a health insurance company requires that you pay out of pocket towards your health related expenses before they start to contribute. You do not need to pay it each year. It only comes in to play if you have expenses that are subject to your deductible. Oftentimes insurance plans have a co-payment for, for example, doctor visits whereas expenses related to testing, ER visits or hospitalizations are subject to the deductible. In most cases, if you meet your deductible you will then be responsible for a percentage of your expenses thereafter up to a total out of pocket amount. A typical coinsurance would be 80/20 which means that you would be responsible for 20% of your expenses once you have met your deductible. The total out of pocket expense is always capped which means that, even if you had, for example $200, 000 in medical expenses in any one year, you would only be responsible for, say, $5000 during that calendar year. The deductible is based on the calendar year so it renews in January each year. When buying health insurance, the consumer must make a decision around balancing the monthly premium with the deductible. Typically, the lower the deductible the higher the premium.

Answer: It depends. Some insurance companies provide worldwide coverage to their PPO (Preferred Provider Organization) clients. For example BlueCross BlueShield provides its members with access to a network of traditional inpatient, outpatient and professional healthcare providers around the world. The program includes a range of medical assistance and claim support services for members traveling to countries outside their Home Plan service area. It is my understanding however that they do not provide coverage for repatriation in the event that you would need to be flown home to the U.S. For peace of mind it would be my own choice to purchase travel insurance. It's relatively inexpensive. For more information about rates and benefits please visit the Travel Resource Center on our website. Hope you have a great trip!

Answer: A small group policy may be a good way to go if you or your wife has a health condition that would render you ineligible for individual coverage. You would be subject to a Rate Adjustment Factor (RAF) depending on your health, the number of members in your plan and the number of COBRA enrollees as well as the company and state in which you are applying. This could make your group plan premiums expensive especially if you choose a benefit-rich plan however coverage would be guaranteed.

If you are both healthy then individual coverage may be a better choice for you based on the lower premiums. Can you give more information about your health history. Do you or your wife take any prescription drugs? Have you had any surgeries in the past 5 years? Is there a health condition for which you see a doctor or would be considered under a doctor's care for?

Answer: Can you say more about what kind of plan you have, whether it is group or individual, and which insurance company it's with? It may be that you have a PPO, or Preferred Provider Organization, plan. If you see a doctor who has a contract with your insurance company this means that they are "in-network". It sounds like the first doctor you saw had a contract with your insurance company, hence you were responsible for paying a co-payment only. For the holistic practitioner I suspect one of two things has happened. Either they do not have a contract with your insurance company or, as is more typical, holistic services are not covered under your plan. It would be worth checking policy document to see if this is the case. Also, a quick call to your insurance company to see if the doctor concerned is an in-network provider would be helpful. If holistic services are covered under your plan and the doctor is in-network you might then call the insurance company to see why they denied teh claim. Oftentimes it is due to a billing issue. Good luck.

Answer: Yes, you can buy a stand alone dental plan to cover your whole family. To run a quote and read more about various options in your state go to the Dental Resources area of our website. You can choose between a discount plan, which is a better type of plan for you if you need certain services covered immediately, or dental insurance which has waiting periods for some of the more expensive treatments.

Answer: The reason the COBRA option is so expensive is because your employer was previously subsidizing it. Once your employment ceases you are responsible for the entire premium. Depending on the type of plan you had and how heavily your employer was subsidizing it, you can often end up with a hefty premium. So, no your employer is not taking a part of your COBRA premium but neither are they contributing to the costs any longer, hence the big increase.

Taking COBRA can be a good idea in a couple of different circumstances: first if you do not have any other options due to a pre-existing health condition that would render you ineligible for individual coverage; second if, like you, you have another plan lined up for a future date. I would add that you do not need to elect to take COBRA until near to the end of a 63 day period following your employment termination and I would only take the COBRA option if you have had any claims during that period or if your new plan starts after the 63 day period ends. Incidentally I would not recommend taking short term coverage during this time even though it would be considerably less expensive. If you do it would affect your eligibility for HIPAA (guaranteed continuation coverage once COBRA ceases).

Answer: The Blue Cross Tonik plan is an unusual plan in that the underwriting guidelines differ from those of any other plan that Blue Cross of California offers. The rates and benefits are excellent and are set up in such a way that only people without ongoing health conditions, with few medical exceptions, are accepted on to the plan. Blue Cross have many other offerings that your son would be eligible for so I would recommend contacting them again and reviewing those options. Alternately, there are other plans and insurance companies that would accept your son. Be prepared for a possible increase in premium however.

Answer: Yes, it's fine to take out a child-only policy. This is becoming an ever more popular choice given the expense of adding dependants to group policies. You should fill out the application with your youngest daughter as the primary insured and sign it in your name as the responsible party. When you run a quote you should choose child-only plans.

Answer: PDD-NOS or Pervasive Developmental Disorder, Not Otherwise Specified is a condition that I have limited experience with. I suspect that, as you say, it may not be possible to find insurance for your son. There are guaranteed options for children in your state with CHIP. Texas CHIP is for uninsured state residents under the age of 19. Applicants also need to be U.S. citizens or legal residents. Also, family income must fall within the posted family income guidelines. Usually there is a 90 day waiting period before program benefits start.

If you do not meet the income guidelines for this plan I would consider Texas Health Insurance Risk Pool. Coverage is guaranteed and you do not need to meet any income parameters. Good luck.

Answer: Technically speaking, yes those items need to be on the application. Practically speaking, however, I would recommend including recurrent, significant or chronic conditions or those for which you are currently under treatment. Your treatment with hormone replacement therapy (HRT) for hot flashes would fall in to this category but the cold you had last year would not, as long as it was cleared up quickly and without further treatment. Hope this helps.

Answer: You will first need to bring your daughter in to the country before you can make an application. Once she is here you will have all the information that Blue Cross needs for the application. If you already have coverage with them you should call Blue Cross ahead of time and ask for an 'Add Dependant' application form. If the adoption process requires that she is covered immediately upon entering the country it may be a good idea to ask the adoption agency for information because the Blue Cross application could take a while to be processed.

Answer: Yes, it's fine to do this. There are really only two disadvantages. The first is the time it will take for you to fill the applications out. The second is that some insurance companies charge an application fee and almost all require that you provide a check, credit card or banking information to cover the first modal premium. This means that, if you are approved for coverage, you could end up canceling coverage with more than one company and having to wait on a refund. If you can say more about your health issues and the treatment you are receiving, your height and weight and whether or not you smoke, as well as the state you live in, I can give you more specific guidance as to which company might work best for you given your health conditions and the various underwriting guidelines. Good luck!

Answer: Your application can take between one hour and several weeks to process. There are a number of factors that influence this such as your medical history, what state you live in and which insurance carrier you have applied to. The insurance carrier may need to obtain a copy of your medical records from your doctor which will delay your application for several weeks. They may need an ink signature in order to get that process moving. Of course, each carrier has different underwriting processes too. If you can get back to me with more information about your health history, which carrier you have applied to and where you live I will be happy to give you a more specific expectation.

Answer: I hear that you want to ensure that you and your family have continuous coverage. The best way to go about this would be to keep your current coverage so that it runs through August. You will then need to buy short term coverage starting in September so that you are covered continuously. Once you have a new address you should then apply for coverage with a Colorado carrier. In the meantime I would recommend running quotes and gathering information about the plan you would like to apply for so that you are prepared once you arrive in Colorado. The pricing may well change so you should double check the quotes again nearer the time of your move.

Answer: The answer to your penultimate question is yes, insurance companies can deny you coverage if you do not meet their underwriting guidelines, even if you have had previous group coverage with them. In your position I would not make an appeal as I feel it would waste your time and most likely not garner you a different decision. I suspect you were denied coverage due to the expense of your medication. Even so, I would expect you would be eligible for coverage with a different company either with an exclusion rider for gastric reflux or at a higher premium.

Answer: Besides being illegal, it makes no sense to falsify your application. Once you file your first claim for a prenatal visit the insurance company will obtain a copy of your medical records. The records will indicate your due date which will in turn indicate your conception date. The insurance company will then recind your coverage and refund your premiums, minus the amount they have paid towards any other claims you have made. It would be better for you to look at the risk pools or CHIP plans in your state.

Answer: My guess is that Unicare assumed that your employer would be paying them directly and I've found that most insurance companies will not set up an employer as the payor. It depends on the carrier and also the state. The reason they will not accept an employer as the payor is because they do not want an individual plan to be construed as a group plan. Group plans are goverened by entirely different regulations to individual plans.

I think if you called Unicare and explained that you will make the payment yourself and your employer will reimburse you, this would be acceptable.

Answer: This is more common than one might think. The problem, as you've described it, could possibly lie in the way the doctor coded the claim when they originally submitted it to the insurance carrier. To correct this you will need to find out the date of service and then go back to your doctor to ask them to resubmit the claim under the correct coding. You will also need to get a copy of your medical record related to the claim itself as well as a letter from your doctor stating that you have never been treated for elevated cholesterol. This is no easy task, however as not many doctor's offices are willing to go through this process for a patient. To save yourself the time and frustration I would make an application to an alternative insurance carrier.

Answer: Thanks for your question. It is one of the most commonly asked questions for people applying for health insurance. The answer to the question is fairly complicated. In California, state law mandates that, if an insurance carrier offers you coverage, they must cover all pre-existing conditions. The if an insurance company offers you coverage part is very important here because, if a person is considered to be too high risk, they would be denied coverage - as you yourself have already experienced. In your case, because you have a condition that requires you to have surgery, you would not be eligible for insurance with any insurance carrier at this time. Once you have had the surgery and have a certain period, say six months, where you have been what is called sign, symptom and treatment free, you may be eligible at that time. Which begs the question: what do you do in the meantime? Well, in California there is a major risk program called MRMIP (pronounced Mr Mip). Coverage is expensive but it is guaranteed. It would be worth reviewing your options under this program and perhaps signing up for the plan until you are eligible for individual insurance again. If this is too expensive you may also want to look at Medicaid to see if you are eligible.

In most other states insurance companies have the option to place an exclusion rider on a given condition and issue a policy that covers all other conditions. This is beneficial in the sense that a person can get coverage to cover all other risks including accidents and new illnesses while covering the expenses for the pre-existing conditon out of their own pocket. Once they have been sign, symptom and treatment free of that condition for typically one year (depending on the condition) they can apply to have the exclusion rider removed from the policy.

There is one more thing worth noting: if a health condition is deemed acceptable to an insurance company with California offerings, which is to say it does not represent too high a risk, they will often issue a policy at a higher premium. This may range from between 25-400% over the base premium depending on the condition and the associated medical expenses such as doctor visits and prescription drugs. Once issued, the pre-existing condition would be covered from the effective date unless the person did not have prior insurance coverage in which case there would be a six month waiting period.