Aug 21, 2011 - 7:48 pm
I've had a chronic disease my entire life, so I'm familiar with the importance of being financially savvy about health issues. I'm neither an insurance agent nor an attorney, but thought we all might benefit from some tips. Assumptions: You are a US citizen between the ages of 18-65, not covered by Medicare, or 18-26 not covered on your parent's policy.
Things you should know:
Tip 1: Keep your health insurance. Never assume that you're fine now, even if you are. Even just the history of previous cancer can bar you from future coverage.
Tip 2: If you lose your job (or get divorced and lose coverage), COBRA your current health insurance for as long as possible, 18-36 months depending on the situation. It's expensive, $300-400/month for one person is common, but that's less expensive than having a gap in coverage.
Tip 3: When you get a new job, you get all sorts of new health care opportunities you may have missed before. First, companies are required to cover you under group coverage, regardless of pre-existing conditions -- that's the beauty of group insurance. (You will no longer qualify for individual insurance.) But be sure to note any waiting periods. Some companies "opt out" of the requirement of providing "continuous coverage" to anyone who came in with health insurance from their previous job or COBRA. Continue COBRA through any waiting periods. Because it will be new coverage, you can get long-term health care and short & longer-term disability without having to provide EOI, Evidence of Insurability (proof of good health, no previous diagnoses). Take advantage of those opportunities when first offered. You won't be able to add them later unless you can prove EOI, which you can't.
Tip 4: While most people are covered by SSDI (Social Security Disability Insurance), if you are a teacher, judge, or other govt employee, you may have had to waive your rights to social security in order to participate in your pension plan, hence the importance of longer-term disability and long-term care insurance.
Tip 5: If you do lose your insurance because you don't work full-time or your COBRA has expired, you may be able to find group insurnace in unexpected places. College alumni associations typically offer group health insurance. Faith-based organizations, professional associations, volunteer organizations, chambers of commerce, and similar entities often offer group health insurance for their members.
Tip 6: Some states offer High Risk Insurance Pools to people with serious diseases. These are great insurance policies with liberal benefits, but they can be extremely expensive. I think I was paying $600/month several years ago. But since my monthly medications alone were close to $1000/month without insurance, it was well worth it. It paid for itself.
Tip 7: Even if you do have good insurance through work, COBRA, or an association, play it smart financially. At some point, you will not only reach your annual deductible, but you will also reach your out-of-pocket expense limit. Exploit that. Once you've paid out all your insurance requires you pay out annually, get anything else done that same fiscal year. For example, I had my kidney surgery in June. My doctor wanted my first follow-up ct scan in early January. Nope, it's going to be in late December. It makes no sense to do something for thousands of dollars in early January that could be done at no expense in late December.
Future health care reforms could change this info favorably, but I wouldn't count on it. The most vocal Americans these days seem least interested in helping the ill and uninsured. Be prepared to protect yourself as much as possible.