Kaiser turned us down - need broker maybe?

[DTisme]

Well Kaiser turned my husband and I down for health insurance due to preexisting conditions - I have no idea what conditions they're talking about - we're relatively healthy - some blood pressure, RSI issues, both of which have been fixed when we left our jobs. So who knows. I thought they couldn't turn you down if you were presently covered (we're in the last couple months of COBRA) - but apparently they can. "We wouldn't do it if it weren't legal," says Ms. Kaiser person on the phone.

SO - has anyone used an insurance broker they're happy with or have any suggestions for us? We need to get coverage by the end of Oct. and time is ticking away.

[Kelena]

Perhaps you should call your elected representative?

[dcl]

It is my understanding that in Hawaii it is required that there be insurance for businesses to buy, based on 1-50 employees, you can open your own small business and buy into that coverage. I am not exactly sure how this works so maybe someone else can jump in with specifics.

[Devany]

You can get a policy through Kaiser or HMSA if you do it at the end of your COBRA (do not let it lapse.) It is part of the HIPAA (Health Insurance Portability and Accountability Act of 1996)Though the coverage is expensive and not as good as either of their other policies. It only covers people that have run the full course of COBRA, nobody else is entitled to it. OH, you must mention HIPAA coverage when you call, they will not "inform you" that you are eligible for it.

If anyone in the house is on anti-anxiety drugs (often prescribed for high blood pressure)that will prevent either of our island's carriers from underwriting a policy. Also, if you enroll at the university or community college you can get coverage there, you must enroll and attend 2 courses a semester though.

Aloha au i Hawai`i,
devany

www.myhawaiianhome.blogspot.com
www.eastbaypotters.blogspot.com

[kani-lehua]

renee was denied health insurance through kaiser because of asthma/pneumonia related issues. she had to have her primary care physician on o'ahu (not a kaiser doc)send them a letter stating that she was healthy. once they received the letter, she was granted the insurance. i got kaiser with preexisting conditions such as high blood pressure and high cholesterol with no problems.

as i recall, both kaiser and hmsa denied coverage for businesses with rental income only. have you tried summerlin?

"chaos reigns within.
reflect, repent and reboot.
order shall return."

microsoft error message with haiku poetry

[wyatt]

You only have 63 days from the time your COBRA ends to apply for a HIPAA plan. They can not turn you down for a HIPAA plan once your COBRA expires. If you have problems with this you can call the Hawaii Health Branch of the Insurance Division. As I did. 808-586-2804 you can also file a complaint online.
I now have Kaiser

www.hawaii.gov/dcca/areas/ins/consumer/

Aloha
Wyatt

"Yearn to understand first and to be understood second."
-- Beca Lewis Allen

[Carey]

Do you want to go back to school?

The question may not seem to make sense, but there are some students that are going to the University for the insurance (half time - 6 hrs- or more at the Community college or UH are able to be covered). coverage link:
http://www.hmsa.com/portal/?gid=student&pg=8

I found out about this when I went to a community meeting & one of the neighbors asked if I was going to the university for insurance. I replied that I knew they had many very good programs, but didn't know they even had a study program for insurances.... the neighbor looked very confused then explained that some of her friends were taking college courses to be able to get the student insurance HMSA program.

ETA If you do want this option, the fall sign up period has been extended until Sept. 25, 2009 (but you have to be a registered student by then... so hurry!)

[DTisme]

Thanks all for your help - we'll know more how to handle this once we get their letter w/the specifics in it. I didn't know we even had the 63 days from end of COBRA - that at least makes me feel a little better. How much more is the HIPAA plan than the regular Kaiser plan I wonder. Wyatt, did you end up with that one when you got covered? Is it much more expensive? We're paying like $1300 now a month for the both of us thru COBRA (PPO) - which is crazy. We were looking forward to saving some money. Maybe that wont' happen now. Getting old sucks.

[Kelena]

Call your representative. If this is solved on a national level, you won't have to enroll in any classes, or worry about the complexities of COBRA.

[Bob Orts]

Cobra and HIPAA are both laws governing health insurance continuation and portability. They can compliment each other but are two different items.

There are some common pitfalls with the most common being applying for an individual underwritten plan without letting the insurer know you are exercising your HIPAA rights.
Another is forgetting the 18 month coverage rule. Many people with under 18 month coverage may not realize they are not automatically covered under HIPAA for portability if they were not covered for 18 months with the last being in a group plan.
Of course the preexisting condition aspect has some very little known time periods. This is a problem because people may try to get in and have things done right before their coverage ends and they don’t realize that anything treated within the last 6 months can impact pre-existing exclusions.
Also Cobra is group plan to group plan.

So I would recommend that before plowing through this minefield, do as Wyatt said and call the State and ask them what is and isn't allowed, what is and isn’t covered by COBRA and HIPAA. Also as Devany said, these guaranteed issued plans are not priced like group or individual plans and can be expensive compare to what your paying now. If all else fails, do as Glen said, call your elected Sate or Federal representative.