Insurance for Deviated Septum
- Thread starter arash12345
- Start date
- 3,384
Age 20, Los Angeles County:
PCIP - $152 per month
MRMIP Anthem Blue Cross - $486.40 per month
MRMIP Kaiser Permanente - $307.19 per month
You defintely want the PCIP over MRMIP if eligible. For PCIP you have to meet residency requirements, be declined for a private plan and have been uninsured for the 6 months prior to application submission.
I will call PCIP in the morning and get clarification on residency. For MRMIP (MRMIB runs both MRMIP and PCIP programs), as follows:
Shoot me an e-mail so I can get back to you off forum with regard to the PCIP.
Dave
[email protected]
If you qualify for PCIP, you enroll by 10th of a month and coverage starts 1st of the next month. Once coverage starts, PCIP has NO WAITING PERIODS for services so you can get the surgery any time after the PCIP goes into effect.
Once you enroll in PCIP, you pay the monthly premium for your age group and county (see above rates). PCIP pays covered claims immediately with no waiting periods. You will have a share of cost with PCIP in terms of deductible, co-pays or co-insurance (see handbook for full benefit summary). You don't have to pay the plan back for any covered benefit that the plan paid for, even if you are only on it for a couple of months.
Once you have the surgery and the doctors says you are symptom free from the deviated septum (and your are healthy otherwise), we can apply to a regular individual health plan with Anthem Blue Cross and leave the PCIP (or you can stay on it if you really want to-your choice).
PCIP - $152 per month
MRMIP Anthem Blue Cross - $486.40 per month
MRMIP Kaiser Permanente - $307.19 per month
You defintely want the PCIP over MRMIP if eligible. For PCIP you have to meet residency requirements, be declined for a private plan and have been uninsured for the 6 months prior to application submission.
I will call PCIP in the morning and get clarification on residency. For MRMIP (MRMIB runs both MRMIP and PCIP programs), as follows:
Shoot me an e-mail so I can get back to you off forum with regard to the PCIP.
Dave
[email protected]
If you qualify for PCIP, you enroll by 10th of a month and coverage starts 1st of the next month. Once coverage starts, PCIP has NO WAITING PERIODS for services so you can get the surgery any time after the PCIP goes into effect.
Once you enroll in PCIP, you pay the monthly premium for your age group and county (see above rates). PCIP pays covered claims immediately with no waiting periods. You will have a share of cost with PCIP in terms of deductible, co-pays or co-insurance (see handbook for full benefit summary). You don't have to pay the plan back for any covered benefit that the plan paid for, even if you are only on it for a couple of months.
Once you have the surgery and the doctors says you are symptom free from the deviated septum (and your are healthy otherwise), we can apply to a regular individual health plan with Anthem Blue Cross and leave the PCIP (or you can stay on it if you really want to-your choice).
- Thread starter
- #14
arash12345
New Member
- 4
Thanks Dave,well I have been uninsured for the 6 months prior to application submission for sure,it's been only 8 months I've been here...and I don't have any insurance from any other company...but I've never been declined for a private plan!(what should I do about that?and why is that?)about residency, I'm gonna be in CA for at least 2 years for sure...but I guess I need to be here more than 1 year already to be considered as a resident,I had the same problem with college!
So if I get PCIP,I will just pay the $150 for 2 month,and after that I would be able to do the surgery,right?I want to know if I'd be able to cut the plan after the surgery or not?
based on what you said,I guess I can not cancel the plan after the surgery(you talked about applying for another health plan),I kind of need the insurance just for this surgery and cancel every payment that will come after the surgery(if possible!)
btw,I'm from Iran
one other thing I'm confused about is that I don't know who I have to meet or which company I should talk to?because in Iran it was like talking to people who works for companies...now I guess I have to talk with somebody who works individually (like taking an attorney)I guess,(since you guys were already talking about your shares with David
)thank you...
- 7,790
Come on he is 20, and in college, and he lived in Iran, we should be glad he got out of there, welcome to america, study hard. as i said before. you may want to just check out some clinics, your college may have one or the community. it will be based on what you can afford.
- 3,384
Because you are a candidate for surgery, you are uninsurable for private health insurance until the surgery is completed and you are sign, symptom and treatment free.
To get a denial from a health insurance company, you could either submit an application (long process) which would be denied or use the Anthem Program Request Form which saves you having to fill out a full application. It's only a one-page form and you tell them what it wrong with you and they deny you and mail you out a denial letter.
Yes, you could drop the coverage plan after the surgery, you would not be required to stay on PCIP if you don't want to.
My suggestion is that you go to PCIP so that you can get insurance coverage for your surgery. After that you can either go back to being uninsured or look for a lower-cost private policy so that you have insurance coverage in case of another problem in future.
The PCIP situation for you right now is favorable but the program may not be easy to get into or have openings for new people should you need to do this again in future. Having your own coverage, through school, through parents or on your own would eliminate the need to have to try and do this again later and find out PCIP is closed or not accepting new people (the pool is limited to 23,000 maximum).
btw,I'm from Iran
one other thing I'm confused about is that I don't know who I have to meet or which company I should talk to?because in Iran it was like talking to people who works for companies...now I guess I have to talk with somebody who works individually (like taking an attorney)I guess,(since you guys were already talking about your shares with David
thank you...
Using an agent (generally health insurance companies don't hire captive agents, they contract with independent agents) costs you nothing and you save no money buying direct from a health insurance company.
For example if you bought a policy directly from Anthem Blue Cross you would work with an employee in direct sales who, once you were enrolled on the plan, would make you "property of the membership unit" and turn you over to them so you'd still be paying the commission % for the agent service but there would be no agent service since you bought directly from the company and lost that privaledge.
- 15,041
So if you're young and from another country, its ok to want something for nothing?
