Interesting Stoke Case, Need Help in NC

[Mehler91]

I have a lady whose cobra is running out 11/19. She was turned down for coverage from 11/15-12/31 by BCBS and Humana. She has stroke in her history and is 62 yrs old with no adverse effects from the stroke other than some mess she is on now. I have her setup on a 2014 plan for January and then a Medicare advantage plan for February (she gets on early due to disability).

She is freaking out about coverage for this gap.

I know Assurant won't write her for their short term policy because of the stroke and that is where my companies end.

Any ideas?

 

[yorkriver1]

It would be expensive, but check with carriers about a guaranteed issue policy under HIPAA rules. (HIP stands for Health Insurance Portability) If she has had continuous coverage she should have rights to coverage--at a non-standard price. Will need to show proof of prior coverage to the carrier. Bonus, no medical questions, simplified issue. I am not aware of any state exceptions to HIPAA eligibility.
I have a client with a very serious medical condition just coming on to Medicare for two months, then turning 65.
Client has been on a HIPAA guaranteed issue policy since COBRA ended some months ago. The lower costs of MAPD and then Med Supp at 65 will be a huge relief.

 

[goillini52]

It would be expensive, but check with carriers about a guaranteed issue policy under HIPAA rules. (HIP stands for Health Insurance Portability) If she has had continuous coverage she should have rights to coverage--at a non-standard price. Will need to show proof of prior coverage to the carrier. Bonus, no medical questions, simplified issue. I am not aware of any state exceptions to HIPAA eligibility.
I have a client with a very serious medical condition just coming on to Medicare for two months, then turning 65.
Client has been on a HIPAA guaranteed issue policy since COBRA ended some months ago. The lower costs of MAPD and then Med Supp at 65 will be a huge relief.

This sounds like your best bet.

A short term policy wouldn't do her any good because they don't cover pre-existing conditions.

 

[yorkriver1]

Check with Blue Cross Blue Shield of North Carolina in your search, even if you aren't appointed with them, it's only one month.
Commission on the guaranteed issue policies is usually really tiny. Here it's 2% or under. Helping the clients in these situations has taught me information that I now have in hand for the next time;

 

[Mehler91]

Check with Blue Cross Blue Shield of North Carolina in your search, even if you aren't appointed with them, it's only one month.
Commission on the guaranteed issue policies is usually really tiny. Here it's 2% or under. Helping the clients in these situations has taught me information that I now have in hand for the next time;

BCBS already turned her down and they don't offer their guaranteed issue product in NC any more. Assurant also said no without me submitting because the stroke is a knockout question. A company called Allied said no because she had been turned down by another carrier.

 

[BeeSelective]

BCBS already turned her down and they don't offer their guaranteed issue product in NC any more. Assurant also said no without me submitting because the stroke is a knockout question. A company called Allied said no because she had been turned down by another carrier.

COBRA exhausted??? HIPPA = Solution

That is what hippa is about. You have to complete the application correctly.

 

[Mehler91]

COBRA exhausted??? HIPPA = Solution

That is what hippa is about. You have to complete the application correctly.

Not in NC. The only state sponsored plan is for people without coverage of any sort for more than 6 months. We had inclusive health until April but they shut down due to the ACA.

 

[goillini52]

Is she on Disability Medicare? I don't know about your state, but in Illinois they have the GI for the 1st 6 months on Disability Medicare just like with Medicare.

 

[Mehler91]

Is she on Disability Medicare? I don't know about your state, but in Illinois they have the GI for the 1st 6 months on Disability Medicare just like with Medicare.

Yes but that doesn't matter in NC

 

[yorkriver1]

I just read a run down on a benefits site of HIPAA GI policies state by state. Interesting that the way it was handled in NC was to have the state sponsored plan, which is no longer in existence. You could call your department of insurance and ask if any other options exist. NCDOI | Smart NC Home