Question: If a medical condition was over 15 years ago, is it considered pre-existing?

Answer: The underwriting guidelines for most individual health insurance carriers will usually draw the line for serious preexisting conditions at 10 years. That is to say, if you’ve had no treatment or symptoms for that previous condition in over 10 years, that previous condition will not cause your application to be declined automatically. However, your overall health risks will be evaluated, however you could still be refused coverage. The outcomes of individual health insurance underwriting are very difficult to predict right now.

Question: Can an HRA reimburse employees for Medicare premiums?

Answer: Yes. In 2002, the IRS issued Notice 2002-45 and Revenue Ruling 2002-41 that opened the door for employers to legitimately reimburse non-group health insurance premiums to their employees as a tax-free fringe benefit. When an HRA is combined with non-group health insurance, including MediCare, the HRA can reimburse the employees’ premiums. The HRA and high deductible individual health insurance combination is absolutely the cheapest health plan available today.

Question: If I am covered by group heath insurance, should I pay more for my wife?

Answer: Yes. In employer-sponsored group health plans, employees pay more to cover their spouse or children than they do for themselves. There are 2 reasons for that. First, the insurance companies set dependent rates higher than employee rates. Secondly, employers must pay a substantial portion of the employees’ premium (varies by state), but no such requirements exist for dependent premiums.

If your spouse can qualify for individual health insurance, you’ll probably find that you can insure her at less cost outside the group. Get a quote now.