Medi-Cal for Now, then Better Insurance if Serious Illness?

[switcheroo]

Hello everyone,

Currently I pay $323 per month for a Blue Shield of California PPO (deductible only $1800). But I'm jobless, and my current and future employment prospects seem to be poor, so that expense is becoming a problem.

I qualify for California's Medicaid program, Medi-Cal, so I'm thinking of switching to that for coverage of emergency room type situations.

But I've gotten the impression that Medi-Cal would be unsuitable if I developed a non-emergency medical condition. One reason is that specialist doctors don't want to take new Medi-Cal patients. The other reason is that the HMOs associated with Medi-Cal in my county (San Diego) would be cheapskates and avoid medically appropriate diagnostics and other expenses; that's the impression I've gotten from reading online.

If I developed cancer or some other condition, could I then switch to some PPO outside the government healthcare exchange marketplace, and force that new insurer to accept my pre-existing condition? Could the new insurer invent excuses for rejecting my application?

Ordinarily I would never consider this approach, but my economic situation is bad enough that I'm getting "creative".

Maybe there is a totally different solution I haven't considered, so I'm open to other ideas.

Thanks for any guidance you have!
Erik

 

[Yagents]

You can buy an off exchange policy for Jan 1st effective dates only each year.

 

[DS4]

Currently I pay $323 per month for a Blue Shield of California PPO (deductible only $1800).

This policy is grandfathered, and, it uses the legacy PPO network with BS of Ca which is just about every dr.

If you drop this policy, you will never get it back.

 

[Quotebroker]

You can buy an off exchange policy for Jan 1st effective dates only each year.

What Yagents is trying to say is you can certainly jump to a PPO if you develop a condition- but only if that condition develops in the 3 month open enrollment period each year. That period is currently set to start 10/15, but will likely move to mirror the federal period starting 11/15.

Keep the grandfathered PPO if at all possible. If not, when you get a job and your income situation changes ( you earn more than ~16k/year) you may be eligible for financial assistance through CoveredCA. This may be a happy middle ground between Medi-CAL and the grandfathered PPO