Questions About Individual Coverage

[lenny]

I recently moved to Dallas, TX. I'm currently unemployed and my wife is working at a school district where having coverage for a spouse would cost close to $300/month. Our generous PPO coverage from NYC schools will end at the end of the month so I was thinking about purchasing individual coverage - something I've never done before.

How does the process work?
How long does it take?
Do you have to come in for a checkup or do they simply look at your medical records?
Do you have to provide a list of all doctors that you've seen your whole life?
Or do they have some automated system between all insurance companies that aggregates everything?

About me- 32y Male 5'8" 155lbs - no medications - healthy

1.Have seen a therapist for a few years for mild depression(stopped going recently and don't plan on ever going back)

2. Carelessly told my PCP 3-4 years ago that I may smoke once every 2 months at bars. The guy actually reported this information on his computer!!!

3. 8 years ago another PCP saw a slight abnormality on my EKG. Specialist did an echocardiogram and told me that my heart was perfectly fine.

Would any of these items cause my premium to go up?

I was thinking of getting short term coverage for 6-12 months and paying up front as the premiums seem to be much cheaper. If some long term catastrophic event were to occur could the insurance company drop me after the contract was over?
Would I get a refund if I found a job with health coverage?

Any help would be greatly appreciated. Thanks.

 

[dgoldenz]

1. Humana tends to be the best carrier to work with anxiety/depression if you aren't taking any meds or currently seeing a therapist. They may be able to issue with standard rates, while another company might exclude treatment or charge a higher rate.

2. If you haven't smoked in the past 12 months, you would have non-smoker rates

3. If the issue was checked out and fully resolved, there shouldn't be any problem with it

A short term policy will not cover any pre-existing conditions and if something happens to you while on short term, you might end up having to go on your spouse's plan through work for the $300/month at that point. You can lock in your insurability now and likely for a much lower premium. A plan that is compatible with a health savings account would probably only run you $100-125/month for something like a $2500 deductible with 100% paid afterward. Health insurance is guaranteed renewable so you won't be dropped as long as you keep paying premiums. You would be refunded for any unused pro-rated premium.

 

[STIBROKER]

First step is to stay away from the short term medical option.....ran some dallas rates on you for HSA plans and was coming up with $70 To $80....

I was thinking of getting short term coverage for 6-12 months

 

[superfly33]

Being only 32 y/o with no major health problems, the process is really painless and you shouldn't worry too much about it.

It's best to stay away form the short term policies if you're not looking to get group coverage in the near future. The company can cancel you due to medical reasons after the contract. At least in CA that's the case.

 

[MzRSmith]

I think the best option in Texas is Blue Cross, most of the things you have mentioned, as long as there were no lasting results due to the medical tests, like a clear EKG-most of the time, the underwriter will review the Medical notes-which most go back 5-10 yrs, and then if everything looks pretty normal-your rates will still go in as prefferred or whatnot , I do not agree with short term plans, because if you do end up having something go wrong, and can't get group coverage, (which there is normally still a 3 month wait after being hired) then you need long term, so you aren't immediately cut off of that term, and then left uninsurable. a 32 Yr old male-fairly healthy should be able to get a good plan less than $300 per month..( I sell in Dallas, and all over central TX), and the rates are not that high. Most companies do not cover mental health, without paying either a high deductible, or having it excluded from the policy period....Furthermore, if you have taken care of it, and aren't seeing a therapist anymore, for the short term, it is okay to sign up for a plan that doesn't carry it, unless you think you'll need it (humana is good for that)

P.S. A (longer term) insurance doesn't mean that you MUST stay with the company necessarily...alot of my clients jump from plan to plan throughout the year, searching for better, or cheaper coverage, not to mention if they get a job offer...with benefits..etc..Good Luck! --and I think you will find it fairly cheap anyways....with a good outcome..

 

[AllenChicago]

In Illinois, Blue Cross is the LAST company we send applicants to who have seen any type of mental counselor or therapist in the past 10 years. Since 1992 I have yet to get one applicant approved with BCBS of Illinois who has undergone emotional counseling.

 

[669comche]

I hear all sorts of issues that agents have the the blues.......I have never had an issue........not in the 10 years I have been doing this.


They are my preferred carrier........

 

[AllenChicago]

I hear all sorts of issues that agents have the the blues.......I have never had an issue........not in the 10 years I have been doing this. They are my preferred carrier........

Comche, I'm glad that you've had a good experience with Blue Cross over the past 10 years. I've tried to make Blue Cross customers a larger part of my portfolio on repeated occassions, but Blue Cross of Illinois turns down anyone with a recent history of any mental issues, Cholesterol, etc.. Maybe it's time for me to try again. Since BCBS-IL is the only major health carrier in Illinois (that I know of) complying with all the benefits of Obamacare this Fall, now would the time for me to give it another shot with selling BCBS.
-Allen