Just before Medicare...

[midwestbroker]

All right all you health gurusÂ…

I seem to have an influx of people who are getting ready to hit Medicare with spouses who are not 65 yet, but will be loosing coverage due to they are covered by the plan that is about to default to Medicare.

The last couple I talked to, the husband wants to retire, is 66 and if he stops working will loose group coverage. She does not work and is covered by the same plan. Talking to her about her health, she has had numerous operations that deemed her uninsurable (benign cancer cells, had both knees replaced, HBP, all in the last 2 years). She is only 60.

So, what to do?

Cobra would run out in 18 months. Can she carry cobra if the primary is covered by a different policy?

What about short term insurance? What is the limit on that?

Any ideas???

 

[Guest]

So, what to do?

Cobra would run out in 18 months. Can she carry cobra if the primary is covered by a different policy?

What about short term insurance? What is the limit on that?

Any ideas???

"Good short-term is a year. If she is 60, fergetaboutit.

She can take COBRA (assuming she can afford it) and then migrate to the HIPAA plan when COBRA terminates.

This is a perfect example why group medical coverage is a crappy deal. Lose our job or retire and kiss coverage goodbye. I advise everyone who can get it, to drop group and buy into an individual plan. Happily more and more people are seeing the value in that... especially with the new HSA plans that are coming out.

Al

 

[aufan]

Yes, an unfortunate situation, but again a perfect example of how the group plans have "spoiled" a lot of people and given them misguided information on how health plans should be administered.

I believe the next two years are going to expose a lot of things for the health care industry as a whole...from provider to insurer to patient and all points in between.

I myself believe that health care is a privilege and not a right. For example, is personal health a right? Of course not. So why do we assume that health care should be a right?

 

[cadylou]

COBRA

If the spouse is the primary on the group, then he cannot go to another plan & keep her on COBRA for the group. Family members don't get to stay on when the employee no longer is a group member.

correct me if I'm wrong, but I've never seen it happen . . .

 

[cadylou]

State pool

I forgot to add that she'd have to go to the State pool with the ailments you've outlined - individual won't have her . . .

 

[Guest]

Re: COBRA

If the spouse is the primary on the group, then he cannot go to another plan & keep her on COBRA for the group. Family members don't get to stay on when the employee no longer is a group member.

correct me if I'm wrong, but I've never seen it happen . . .

If the primary is losing group, wouldn't this be considered a "life event" that would trigger COBRA for the wife?

Al

 

[Guest]

Re: State pool

I forgot to add that she'd have to go to the State pool with the ailments you've outlined - individual won't have her . . .

If she can get on COBRA, she should be able to transitiion into GI HIPAA after 18 months (36 in CA in some instances). The big question is if she can afford the HIPAA rates. If not, then the state pool is the last/best option.

Al

 

[Jenananda]

If..... her health is not bad, meaning the other conditions have been resolved, she could get guaranteed issue insurance. It's pretty good as long as no major conditions need to be treated. An organization I work with offers this type of health indemnity insurance, yet there are many others on the market as well. She might last long enough to become eligible for Medicare or Medicare Advantage (I'd recommend Medicare Advantage).

If the health is not that great, then the COBRA benefit should probably be taken to the max.

In Michigan she could get BCBS, each state varies.

 

[midwestbroker]

Thanks for all your input here.

I have some clients who are staying employed just for this reason, the spouse is in a spot because the other would loose coverage.

Humana One is working on a plan for this situation, but it is still on the drawing board. If it makes it off of it, they are saying that it would hit the market at the earliest in 2 years.

I do not know if the wife can take COBRA and the husband leave the coverage. Even so, in KS it last only 18 months, and leaves her 62 and no coverage.

UPS and Barnes & Noble offer health benefits to PT employees. So does Lowes (I think). I have several clients that had PT jobs for benefits to ride it out to Medicare.

Will work for benefits

 

[cadylou]

What about Starbucks

I'd heard Starbucks did that too - offered benefits to part timers. That would be good - plus you get all of those free Lattes!! :lol: