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Medical insurance?

Aug 27, 2011

Same problem here. My Wifes cobra ran out. Tried to get ins through blue cross and got denied. Really??? We currently have no insurance and its a bit scary.

Guest

Sorry to hear that Larry. Perhaps someone will chime in with a good idea. I have a lot of research to do either way and will advise if/when I fine decent alternatives.

Roof Cleaning West Chester PA · Premium Member Roof Cleaning Institute of America

Finally something I can bring to the table, here's the deal guys ...

If you have COBRA, it expires, and you are not eligible for Medicare, Medicaid or a group health plan, HIPAA laws make it MANDATORY for EVERY state to offer at least 2 similar plans.

You MUST apply for health insurance for which you are HIPPA eligible within 63 days of losing your prior coverage.

If you applied for a plan within 63 days after COBRA expired, and were denied, you simply didn't apply to the insurance carrier that your state designated.

example: In PA, which uses Blue Cross/Blue Shield as the company that has to offer at least 2 plans, if I were to apply to United Health, I'd be denied. I might even be denied if I just randomly applied through Blue Cross/Blue Shield, you have to specify that you're applying for the HIPAA designated plan, and EVERY state has at least 2.

Unfortunately there is no public awareness on this topic, nobody will hold your hand, and you have to figure out which company your state designated. The best way to navigate the system is start by googling "HIPAA" + "your state."

Also, the plans they offer are pretty fair, all rates are aged based, preexisting conditions are not allowed to be used. I have a preexisting condition personally but since the plans are age based, I pay what any other 30-35 year old would pay. In fact my insurance is actually cheaper and better than what it was on COBRA. All states are different though, they just have to meet the federal mandate (which is actually generous), some states, like PA go above & beyond (good luck if you live in NJ).

Here's what PA looks like.

Maverick Contracting · Premium Member Roof Cleaning Institute of America

Good insight Mike.

I use to work for an insurance broker, did auto home and bus ins. but not health ins., sharing past work experience knowledge with others here is what makes networking so valuable.

I'd advise anyone looking for such info to consult a broker, not an agent. A broker is independant and works with many co.'s and is not loyal to any one, they will benefit you the consumer better than an agent that works for a specific co.

A broker won't (shouldn't) charge a fee, but will find what policy works best for you and priced best. They make money thru a comission on the co.'s side and will service you better than an agent and will know things that you might not be aware of that are beneficial to your decision and when different ins co.'s change their requirements/cost structures, they should notify you to when you would benefit from a different policy/company in the future.

Not only will consulting with a good broker benefit you pricewise, if they know what your line of work is, they can taylor design a policy that is best for you, agents are cold blooded much like a Gecko. wink

Roof Cleaning West Chester PA · Premium Member Roof Cleaning Institute of America

Maverick Contracting wrote:
Good insight Mike.
I use to work for an insurance broker, did auto home and bus ins. but not health ins., sharing past work experience knowledge with others here is what makes networking so valuable.
I'd advise anyone looking for such info to consult a broker, not an agent. A broker is independant and works with many co.'s and is not loyal to any one, they will benefit you the consumer better than an agent that works for a specific co.
A broker won't (shouldn't) charge a fee, but will find what policy works best for you and priced best. They make money thru a comission on the co.'s side and will service you better than an agent and will know things that you might not be aware of that are beneficial to your decision and when different ins co.'s change their requirements/cost structures, they should notify you to when you would benefit from a different policy/company in the future.
Not only will consulting with a good broker benefit you pricewise, if they know what your line of work is, they can taylor design a policy that is best for you, agents are cold blooded much like a Gecko.

If shopping for insurance, I'd definitely use a broker if I wasn't too sure how to look into it myself, but in the case of COBRA running out, the HIPAA laws and corresponding plans are pretty cut and dry. Typically there are only 2 plans each state offers, 1 of which MUST offer comprehensive benefits. If you're having trouble, contact your state's Department of Insurance and ask for "mandated health care benefits through HIPAA." If you have trouble picking a policy, save yourself the money you'd spend on a broker and give me a call, I'll look at it for free.

opie451 · Aug 27, 2011

I wish I could afford ins. I had Oxford for two years but things got bad and I lost it. It was only basic and essential but it helped alot. That was $200 a month for just me.(Kids are covered through my ex-wife)

Guest

Roof Cleaning West Chester PA wrote:
Maverick Contracting wrote:
Good insight Mike.
I use to work for an insurance broker, did auto home and bus ins. but not health ins., sharing past work experience knowledge with others here is what makes networking so valuable.
I'd advise anyone looking for such info to consult a broker, not an agent. A broker is independant and works with many co.'s and is not loyal to any one, they will benefit you the consumer better than an agent that works for a specific co.
A broker won't (shouldn't) charge a fee, but will find what policy works best for you and priced best. They make money thru a comission on the co.'s side and will service you better than an agent and will know things that you might not be aware of that are beneficial to your decision and when different ins co.'s change their requirements/cost structures, they should notify you to when you would benefit from a different policy/company in the future.
Not only will consulting with a good broker benefit you pricewise, if they know what your line of work is, they can taylor design a policy that is best for you, agents are cold blooded much like a Gecko.
If shopping for insurance, I'd definitely use a broker if I wasn't too sure how to look into it myself, but in the case of COBRA running out, the HIPAA laws and corresponding plans are pretty cut and dry. Typically there are only 2 plans each state offers, 1 of which MUST offer comprehensive benefits. If you're having trouble, contact your state's Department of Insurance and ask for "mandated health care benefits through HIPAA." If you have trouble picking a policy, save yourself the money you'd spend on a broker and give me a call, I'll look at it for free.

Thanks for the PM my friend. I'll give you a ring soon.

Soft Wash Wizard - Harrisburg, NC · Guest

Ted,

I just went thru this same thing. I felt one of the biggest benefits of being a premium member 12 months ago was AC was working on getting an Insurance company to offer all RCIA members a competative medical insurance which I needed. That effort went South earlier this year when AC departed which I wish RCIA would get serious about this again. I had Cobra insurance for my wife & I like several others that are full time in our treatment / cleaning business. Once my Cobra was coming up to expire I was denied health insurance by several companies because of my hip replacement in June. What we ended up doing was I called Inclusive Health State Option here in NC which will write health insurance for anyone if you have been denied by all other insurance companies. There are several different diductable programs to chose but I currently have health insurance for $481 / month with a $5K deductable per year. For more information in NC possible VA & other states call 866-665-2117 or www.inclusivehealth.org. Unfortunately my wife currently does not have health insurance due to the extra cost for her.

I believe as a small business owner being able to purchase health insurance for my wife & I at a reasonable cost is as important as marketing / selling profitable jobs. If RCIA really wanted to offer a value to members health insurance is the #1 issue for all of us whether you have a spouse who works & can offer your family health insurance or not.

Maybe there are enough of us RCIA members in the same situtation that we can bring Heath Insurance to the from & center for everyone's benefit.

deleted member

I almost accepted a position last year with a company that offered a HSA (Health Savings Account). Since I did not accept the job, I never learned what that is, but the employees spoke highly of it. Do any of y'all know what it is? If someone does know, I'm curious how they compare to conventional health insurance. I'm all for the Premium Members, maybe a group of thirty or more of us, forming a group to elicit a group rate if possible, but we should explore all options. I'm certain it will be a tall order since we're in so many different states, but perhaps it could be a worthwhile endeavour.

P.S. I used spell-check & although endeavour looks funny, it's spelled correctly.

Roof Cleaning Bradenton FL 941-822-2454 · Guest

Maybe a poll should be started to see if the numbers are there to pursue any group health insurance via RCIA?
I am sure that minimum requirements would be involved for any insurance co. to entertain us as a group?
and would that also mean that RCIA would need to have a corp. or LLC etc. formed to engage in offering this to members?
Kim R

garyw · Aug 28, 2011

OK, Lets start this ball rolling again. I will do a "curiosity post" here and in the open section to see what and how many people may have a need or interest if the rates are better than what they have. Then we can start looking for a company to provide the service.

Gary

Kleen Roof and Exterior Cleaning · Aug 28, 2011

I just last week got insurance thru priority health here in Grand Rapids. Its a $4000/$8000 deductible plan for a family. Pay $321 a month.
I also opened a HSA ( Health savings account) This is used to pay for any out of the pocket medical costs. The idea behind this is to help on the tax end of the year. There are tax savings with using a HSA. I did go thru a broker for my insurance. He checked into 4 different companies, explained the dif. between them, and helped us decide on which one to go with. We picked the one we did because of price, and the fact that they own the hospital here in town.

Roof Cleaning West Chester PA · Premium Member Roof Cleaning Institute of America

Roof Cleaning Wilmington NC (910) 622-7942 wrote:
I almost accepted a position last year with a company that offered a HSA (Health Savings Account). Since I did not accept the job, I never learned what that is, but the employees spoke highly of it. Do any of y'all know what it is? If someone does know, I'm curious how they compare to conventional health insurance. I'm all for the Premium Members, maybe a group of thirty or more of us, forming a group to elicit a group rate if possible, but we should explore all options. I'm certain it will be a tall order since we're in so many different states, but perhaps it could be a worthwhile endeavour.

P.S. I used spell-check & although endeavour looks funny, it's spelled correctly.

in a nutshell an HSA is an account used for medical expenses where contributions aren't subject to federal income tax (think 529 or IRA) ... if the employees spoke highly of it it's either because their employer made contributions or they don't realize that their health care plan has a higher deductible than most plans, a prerequisite in order for any company to provide an HSA

The Roof Cleaning Institute Of America Training & Certification Forum "Find A Certified Roof Cleaner Directory"

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"Find A Certified Roof Cleaner Directory"