26 YO Buying Health Insurance with Pre-Existing Condition

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26 YO Buying Health Insurance with Pre-Existing Condition

Postby tnhooper45 » Fri Aug 30, 2013 3:44 pm

HELP! 26 years old, recently took my first full-time job as a high school teacher/coach but as of now the school is paying the fine instead of offering insurance to it's employees. Going off my parent's health insurance for the first time in a month when I turn 26. I have a pre-existing condition (epilepsy) and I've been declined by Humana. Only option that is guaranteed so far is the government's COBRA program which gave me quote of $550 a month. Any advice is appreciated. Thank you.
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Re: 26 YO Buying Health Insurance with Pre-Existing Conditio

Postby BruDude » Fri Aug 30, 2013 4:07 pm

Take the COBRA until end of the year, then enroll in a new plan for January 2014 since they will all be guaranteed-issue regardless of health. You could also look into a short-term policy to cover you through the end of this year but it won't cover any pre-existing conditions. A short-term policy will probably be $100-150/mo versus the $550/mo for COBRA. Depending on the plan and your state you are probably looking at $150-400/mo next year.
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Re: 26 YO Buying Health Insurance with Pre-Existing Conditio

Postby lindisfarne » Fri Aug 30, 2013 4:08 pm

Lucky for you, you have a gap of only a few months. As of Jan 1, 2014, you can get insurance through ObamaCare - check out how your state is dealing with this. Try & get your prescription for meds renewed & order what you can before you go off your current insurance.

COBRA at $550 a month is probably the best option until Jan 1, if your current coverage is good. It's probably not smart with epilepsy to opt for going without insurance or even coverage that does not cover the epilepsy - that's taking quite a risk.

Since you're a teacher, you know there's a lot of good info on the internet - use it! Contact your state government agency that deals with this.

Be glad the system changed a few years (due to ObamaCare) ago to let you stay on your parents' insurance until 26.
Last edited by lindisfarne on Fri Aug 30, 2013 4:10 pm, edited 1 time in total.
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Re: 26 YO Buying Health Insurance with Pre-Existing Conditio

Postby baw703916 » Fri Aug 30, 2013 4:10 pm

The ACA should solve your problem as of Oct. 1 [edit: Jan. 1]. That's the whole point of it, that you can buy an individual policy w/o being rejected if the insurance company decides they don't like your health.

Because there may be a brief gap (between the time you leave your parents' policy and when you can sign up for the "exchanges" under PPACA, it may be prudent to do a COBRA conversion at least temporarily. The implementation of the exchanges could be delayed, there could be some other issues, so it's good to have covered just in case something happens in the mean time.

Technically, COBRA isn't really administered by the government. It's a legal requirement that if you lose eligibility for a group policy (e.g. if you leave your job or as in your case, age out as a dependent) you have the right to convert to an individual policy for up to 18 months with no underwriting or change in rates based on your health. So the COBRA would be an individual policy with your current insurer.

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Last edited by baw703916 on Fri Aug 30, 2013 6:08 pm, edited 1 time in total.
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Re: 26 YO Buying Health Insurance with Pre-Existing Conditio

Postby lindisfarne » Fri Aug 30, 2013 4:12 pm

To clarify post above:
As of Oct 1, you can start going in & choosing your insurance under the ObamaCare (ACA) system, but you're not insured under that until Jan 1, 2014.
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Re: 26 YO Buying Health Insurance with Pre-Existing Conditio

Postby baw703916 » Fri Aug 30, 2013 4:18 pm

lindisfarne wrote:To clarify post above:
As of Oct 1, you can start going in & choosing your insurance under the ObamaCare (ACA) system, but you're not insured under that until Jan 1, 2014.


Good point, and thanks for the clarification. Since here will be a gap of at least a few months (or more if there are unforeseen delays), the OP should definitely get COBRA.
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Re: 26 YO Buying Health Insurance with Pre-Existing Conditio

Postby tnhooper45 » Sun Sep 01, 2013 7:52 pm

Thanks guys.
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Re: 26 YO Buying Health Insurance with Pre-Existing Conditio

Postby jsong23 » Mon Sep 02, 2013 11:18 pm

I agree with the advice mentioned above.

I also have these suggestions. From your description, you have until September 30th until your medical insurance runs out.

Make sure you go before that date and get an annual physical by a general internist and have one more visit with your current neurologist for your epilepsy. Also obtain refills if you need any.

Hopefully, you will get COBRA and sign up for your new insurance for 2014 in time but it's always better to plan ahead.
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