BC/BS Guaranteed Conversion Plans?

[LJM53]

Hello all. Just found this forum and am hopeful I can get good advice regarding my future health coverage options. Here is my situation:

I am a 58 yo female who has had major medical coverage since 1978 with no breaks in service through my employer group insurance plans and most recently (since 2004) covered on my husband's employers group plan. Our current plan is a CareFirst BC/BS EPO plan out of Maryland. We live in Missouri but husband's employer's corporate office is in Maryland so our providers are in the local Anthem BC/BS network in Missouri.

My husband turns 65 next year and will be signing up for Medicare, plus planning retirement in the next 6-12 months. I plan to Cobra for 18 months following his retirement but at that point become uninsurable other than applying to the Missouri Health Insurance Pool (MHIP) which I fear will be inadequate coverage for my ongoing health needs.

I recently was told by an Anthem agent that BC/BS does provide a "guaranteed conversion plan" to clients currently covered by BC/BS. These plans are not usually mentioned when utilizing the typical "get a quote" sites online so this conversion possibility was news to me.

I understand that the premiums can be very high, but my hope would be to Cobra following my husbands retirement then convert my current group BC/BS EPO plan to a comparable individual BC/BS PPO plan until 2014 if the initiative to remove "pre-existing conditions" becomes a reality or until I become eligible for Medicare (2018)

I have been given the phone number for the Anthem Underwriting Support Dept where I can inquire about their guaranteed conversion plans, however, would like some input from this forum before doing that.

Here are my questions:

1. Is anyone here knowledgeable about BC/BS guaranteed conversion plans? Tips, pitfalls to avoid, insights?
2. While we are able to afford high premiums if necessary to get needed coverage, will refusing an offered conversion plan then negate my chances of getting MHIP?
3. I currently don't expect to need new coverage for at least 18 - 24 months but how can I find out specific details on actual plan benefits, coverage and premiums today? I don't want to mislead an agent by applying now just to get the details and I certainly understand that premiums quoted today will not be the same in 2 years, but how can I be proactive about researching my options otherwise?
4. When I do call the Underwriting Support Dept what is the best way to access information on guaranteed conversion plans? What are the questions I should be asking them? Special language, terminology, codes I can use that will make it very clear what I am needing to know?

I will continue to read though forum threads but also hope to get responses to my specific situation.
Thanks for any advice or input offered!

 

[somarco]

From the KFF site

HIPAA Eligible individuals are guaranteed the right to purchase individual coverage with no pre-existing condition exclusion periods when they leave group coverage. To be HIPAA Eligible, a person must have had at least eighteen months of prior coverage, not interrupted by a gap of more than sixty-three days in a row, and the last day of prior coverage must have been in a group health plan. In addition, upon leaving group coverage one must elect and exhaust any available COBRA continuation coverage or similar state continuation coverage. A HIPAA eligible individual cannot be eligible for any other group coverage or Medicare, and must apply within sixty-three days for HIPAA coverage.

It appears your only option at this point is COBRA.

What is available today, including benefits and premiums, most likely will change in the next 18+ months.

If the proposed changes become law in 2014, expect current premiums to be 2x - 3x higher than current.

On the flip side, if your income is low in 2014, your only option may be Medicaid.

 

[LJM53]

Somarco I appreciate your response and the link to the KFF site. I agree that Cobra is my best option at the point of my husband's retirement. I also appreciate the fact that it is impossible to predict coverage benefits and premiums 2 years in the future.

I was hoping that I might have received additional responses regarding conversion plans in general or specific to BC/BS in Missouri. If I knew that typical benefits in a conversion plan were significantly better, more comprehensive than the MHIP it would be worth the higher premiums to me.

What I'm hearing is that it is unlikely BC/BS underwriters can or will be willing to give me any information about coverage benefits in a guaranteed conversion plan until I am at the point of needing such a plan.

I would still welcome any additional insight or advice from those familiar with guaranteed conversion plans, how they work, typical benefits compared to the current BC/BS Plan the client has at the time of conversion, pitfalls a layperson should be aware of and proper procedure for laying the groundwork to successfully obtain the needed coverage once Cobra expires.