Author Topic: Health Insurance advice (Read 291 times)

tbrannon · « **on:** May 22, 2007, 12:29:50 PM »

Over the past couple of years, I've grown to really appreciate the wealth of knowledge and the quality of advice I've seen doled out on this forum- I'm hoping that somebody might be able to help me out right now.

My family (wife and 2 yr old) are moving back to Southern California from New Zealand. Some family issues require our attention and we've decided to pick up and move back the 2nd week of July. My job has already been filled here in New Zealand, the house and cars are on the market- it's all go.

I started making calls 2 days ago trying to organize short-term health insurance for the time period between when we arrive and when I start teaching again in late August. Additionally, we just found out that my wife is 8 weeks pregnant (Yay!), and so far every insurance company has told me that they won't cover us- not short term, not long term- because pregnancy is a 'pre-existing' condition. I'm aware of why they do this, but I'm looking for 2-3 months insurance (baby delivery won't be included obviously). I know that it will be costly AND I'm not fussed about paying for it- I'd GLADLY pay if somebody would even offer my family coverage.

I can't put the brakes on this move- airline tickets are bought and I'm already replaced job-wise, but I can't stomach the thought of having my family in a position where we couldn't be serviced by the medical industry because I can't find insurance.

Any suggestions?

rraymond · « **Reply #1 on:** May 22, 2007, 01:21:07 PM »

Hi Toby,

Congrats on the new baby! Here's some information and a couple of links that might help. Good luck with the move!

http://www.medhealthinsurance.com/california.htm

If you have had Group Health Coverage= If you do not have a long break (63 days or more) in prior health coverage, you will be eligible for creditable coverage

http://www.disabilitybenefits101.org/ca/programs/your_rights/hipaa_ab1672/hipaa/faqs.htm

How do I use creditable coverage from prior health coverage to reduce or eliminate a pre-existing condition exclusionary period under my new employer-sponsored health plan?

Pre-existing condition exclusionary periods are reduced by the amount of time you had creditable coverage under a previous plan. If you had 4 months of creditable coverage under your previous plan, your pre-existing condition exclusionary period will be reduced by 4 months. To utilize creditable coverage, you must not have had a gap between prior coverage and new employer-sponsored coverage of more than 63 days. In California, if your prior coverage was through an employer, and you lost that coverage because your job ended, or you employer stopped offering or contributing to health coverage, that gap can be up to 180 days.

tbrannon · « **Reply #2 on:** May 22, 2007, 02:13:04 PM »

Reid,

Thanks for the congratulations and the link- there was some helpful stuff there, but alot of it seems to be aimed at lapses in coverage that can be covered through COBRA coverage.

Since I've been away for 4+ years, COBRA coverage is not a possibility for me. Additionally, I've been living in NZ, where medicine is socialized, so I haven't had 'health insurance' since I left the US.

bsee · « **Reply #3 on:** May 22, 2007, 02:25:31 PM »

Sounds like a special case, assuming US citizenship the whole time. It is arguable that you did have health insurance through living in New Zealand. The intent of the gap provisions is so that you don't go entirely without coverage until you have some major issue and then buy insurance for a few months to cover it. Not sure who you would appeal to on this, though. It might take discussions with more senior people at the insurance companies if you present it well.

Have you tried contacting your future employer? Maybe you can get on the books for summer school session and start your insurance coverage more rapidly. Maybe they can add you in early if you're hired for the fall if you pay more/all of the premiums?

tbrannon · « **Reply #4 on:** May 22, 2007, 02:41:45 PM »

Bob,

We're US citizens- I'm well aware of the gap provisions for insurance companies- but like you said, this is a strange situation.

In terms of contacting my future employer- I don't have one yet. Schools are only now beginning to find out who is/isn't returning for the '08 school year. I'm not too concerned- I teach Science- and there is always a need for Science teachers.

I've been hit with a stone wall from the insurance companies so far- been told no coverage- absolutely not from a few. They did point me towards a few government agencies, but I'm not looking for a handout and I'm not interested in waiting 6 months and doing the government red tape dance to get coverage. I don't mind paying, I just need to find somebody that will take my $. =)

I'll keep plugging away. I've contacted several districts where I am applying and am fairly confident of finding a job. I'll see what they have to say, but at this point I know that I'm going to still need interm coverage from July through my hire date.

rraymond · « **Reply #5 on:** May 22, 2007, 03:40:07 PM »

Toby,

Found a listing of an Insurance Agent @ Halper Storz Insurance Services, Inc.
Telephone: 408 395-3303 bhalper@health-ins.com

They should be a licensed agency in the State of California and will know how to direct you if there is a way.

My wife found this, as well as the other links and info. We don't know the guy, or agency, but they may be able to help. She used to work in the Individual Plans department of a health insurance company here in Oregon. She doesn't know Cali insurance rules and thought getting with an agent might be the fastest way to get some info.

Good luck,

Reid

tbrannon · « **Reply #6 on:** May 22, 2007, 03:45:41 PM »

Reid,

Thanks so much- it's been a mission trying to sort this all out from halfway across the world. I was up at 4AM this morning making phone calls so I could catch people in the States.

It's a bit daunting and I so appreciate the efforts you and your wife have made for us. I'll give them a call tomorrow morning and see what they say.

I've called several large agencies and been basically told that I won't get insurance- I think it's time to call the small guys and see if I can find somebody who actually cares.

Toby

adriaan · « **Reply #7 on:** May 23, 2007, 02:28:24 AM »

Check out Michael Moore's latest documentary, Sicko. Of course you have to stomach the demagogy, but as usual he has a point.

Best of luck on all scores.

tbrannon · « **Reply #8 on:** May 23, 2007, 02:31:14 AM »

Adriaan,

I try to avoid Michael Moore like the plague...

Honestly I do though, but that's another topic.

Thanks for the best wishes- I'll be making plenty of phone calls over the next few days.

Toby

adriaan · « **Reply #9 on:** May 23, 2007, 04:13:02 AM »

Toby,

You probably already know MOOREWATCH - Watching Michael Moore's every move?

The $12,000 history is interesting on a number of levels, from both sides.

the_8_string_king · « **Reply #10 on:** May 23, 2007, 08:52:17 AM »

Toby, why are you leaving beautiful New Zealand to come HERE???

At any rate, while I don't have any healthcare advice as such, I'll tell you that the Clark County school district here is Las Vegas is DESPERATE for teachers... and the property values are a LOT cheaper here. It's a MUCH less expensive place to live than California -although it's nowhere near as nice and pretty.

Still, I prefer the tradeoff. I'd never consider living in California due to the ridiculous taxes and costs.

My girlfriend had surgery through MediCal a few years ago. She couldn't afford it at the time, and got what she felt was a top-notch surgeon to give her the surgery she needed -for uterine fibroid tumor. We don't know if there are certain income requirements... but maybe you could inquire about it.

Good luck with the move, and everything else... it's quite a thing!

tbrannon · « **Reply #11 on:** May 23, 2007, 10:28:51 AM »

Mark,

It's kind of ironic, but we're coming back because of some family health issues. The irony of course being that we're returning because of health issues, and in doing so created a health issue for ourselves.

It will all work out in the end- it's just slightly less manageable from halfway around the world.

Thanks for pimpin' Vegas, but my family is in SD, which is where we need to be for the time being.

Toby

tbrannon · « **Reply #12 on:** May 23, 2007, 11:09:07 AM »

Reid,

Thanks for that link you sent me- I called Brian and he was incredibly helpful and informative.

Looks like I'm going to try to purchase private insurance here in NZ with Southern Cross and if that fails to cover me when I move overseas, Brian will set me up with an international policy with IMG. Maternity coverage will be excluded, but I can get general health insurance for the 90 days before I get hired, which is what my concern was from the beginning.

Thanks a bunch to those who chimed it-

Toby

rraymond · « **Reply #13 on:** May 23, 2007, 11:39:09 AM »

Toby,

We are glad to be of help. My wife did the research and forwarded me the links. I just told her that it looks like your problem has been resolved and she got all teary eyed and gave me a hug. Aww!!

Good luck with the move!

Reid

tbrannon · « **Reply #14 on:** May 23, 2007, 11:51:48 AM »

Reid,

Give your wife a hearty hug back- tell her it's from our family to yours. We sincerly appreciate your help. I called every large insurance company I could find before I began this thread- all of them said No- definitely not- I even called 4 insurance sales companies similar to the one you linked for me and they too, were incredibly unhelpful, short and rude.

Your wife might have just stumbled across Brian's company webpage, but in doing so she has eliminated a ton of stress from our otherwise hectic lives. Thanks again.