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Thread: health insurance worries

  1. #26
    Featured Member tampadancer's Avatar
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    Default Re: health insurance worries

    curious, i disagree

    My boyfriend has suggested getting married "on paper" so that I can be added to his health insurance policy. Sounds great, right? Not really....

    Marriage is a HUGE DEAL, and I dont think health insurance is the right reason to rush into something... whether or not she plans to marry him in the future, she's not ready NOW, so I don't think she should.

    Just my .02, I can relate Bunny

  2. #27
    Sitri
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    Default Re: health insurance worries

    You can always join the army..... health insurance and paid travel expenses.

    I wish I could advise, but since the state governments passed all of the laws in the late 80's to make it affordable, you can't get it and you can't afford it.

    Check out the HMOs and find out when their open enrollment period is.

    United Healthcare is good.

  3. #28
    Senior Member tooma's Avatar
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    Default Re: health insurance worries

    Quote Originally Posted by Melonie
    Unfortunately, private insurance companies and insurance coverage by private employers almost always use 'pre-existing conditions' as an excuse to deny coverage or charge outrageous premiums. About the only way around this is to land a 'straight job' that is civil service or union such that the insurance coverage rules are extremely generous.
    Here in NJ, a group plan for an employer needs only 2 eligible employees, with 1 using the insurance. it's OK to have the other employee waive their coverage if they have it else where. Almost all states have provisions for Small Biz Group plans (usually under 50 participants) where the census is used and adjusted each year. Group plans don't take pre-exisitng conditions into account, only age and location of the person's home.

    If you know someone who owns their own buisness you can have them hire you as an employee, payroll you just what the insurance costs, and have you pay for it 100%. Then you give them Cash in place of it. Basically, they will be payrolling you a $0.00 check every month, since the health premiums are pre-tax, and you give the owner the cash that he is sending to the insurance company. And you don't actually work there. oh, and as a selling point, the business owner gets another employee deduction.

    PM me if this needs more clarification. I know several people that have done this, except most have the person work a few hours every month.

  4. #29
    God/dess Bunny's Avatar
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    Default Re: health insurance worries

    Check out the HMOs and find out when their open enrollment period is
    August there is some sort of open enrollment in Florida. My mom has actually called the board of health (or some agency here) and talked to a very sympathetic person for a long, long time. He told her something about how in the month of August they can't refuse you or that they are more lenient to who they take. Doesn't mean they can't charge you some outrageous amount of money, but it's worth looking into.

    I'm still waiting to hear back from Humana.

  5. #30
    Senior Member Underestimated's Avatar
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    Default Re: health insurance worries

    I too am in the same boat: interstitial cystitis, endometriosis, and spontaneous pneumoniathorax. In most states you can live with someone and get through an insurance loophole. That's what I ended up doing after all my friends got together to 'draw straws' on marriage. Basically you're their dependent. I'm not sure on the policy for parents to continue doing this. If you live with your boyfriend, check out all the insurance plans. My boyfriend/neighbor moved in with me, and added me to his policy with two days to spare. I've spent 40k so far this year in medical, and only had to pay 10%; I feel like I've won the lottery. It's worth looking into. If that isn't an option, call all the drug companies. I know Lilly will add you in their system as someone who doesn't have to pay cost. I paid $5 per script. I've had most of my docs drop the fee to half when I wasn't on insurance. I also tried to get treated, when possible, at religious hospitals. They wrote a lot of my bills off as charity. I am catholic though, so that might have helped. Cobra really only works for you for six months, and is expensive. You can go on disability to get medical help, but that takes two years. Have you met any trustworthy people/customers with their own companies? They could sign you up as an unpaid employee.
    I really feel for you. I've spent thousands over 4 years of being uninsured, and am still paying things off from 2001. Having a disease and not having insurance is the worst!

  6. #31
    God/dess Bunny's Avatar
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    Default Re: health insurance worries

    Well I could marry my boyfriend if I had to get insurance for something really major but as of right now I don't have anything that expensive. and I can't get on his policy just living with him. He already tried that. To get on disability you have to not work and that won't work either becuase I'm a workaholic. I have thought about opening a snowball stand. Maybe I could get a group policy for my employees if I do. I just don't know that I'd have the time to do something like that.

  7. #32
    Pamela
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    Default Re: health insurance worries

    Bunny for what it's worth. I am leaving my hospital job for a time, and am NOT going on the Cobra plan. So i contacted Humana. They have many plans, and even one for pre-existing conditions. PPO's. I hate HMO's. Most doctors here in Florida wont take them.

    I asked for a list of my doctors and they read them off. They are on it. The cheapest plan, is 157.95 monthly, with 25.00 co-pay Primary care. 35.00 co-pay specialist. Hospital visit hmmm don't know, think it's 5,000 deductible. Then 60-20 coverage.
    I am searching for the papers now, and can't friggin find them.

    Let me know of anything better, as i have skin cancer....so i may not get covered if i take another plan.

    Oh and i forgot to ask them, how many visits a YEAR does ANY plan cover, very important.

    Pamela

  8. #33
    God/dess Bunny's Avatar
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    Default Re: health insurance worries

    Pamela, I am trying to get an HSA with a $2600 deductible from Humana. So far they have refused me but after explaining my preexisting conditions one guy asked to see my records from my doctor to try to see if he can get them to change their mind. We'll see. I told him I'll probably never meet the deductible but the tax breaks would be nice.

    I used to work for a healthcare company before I moved here and had great coverage. I didn't take the COBRA when I left because it was so expensive. However, if you take COBRA and let it expire you are then a guaranteed issue. At least this is the way I understand it. I just couldn't afford it though when I left my job.

  9. #34
    Pamela
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    Default Re: health insurance worries

    Bunny i also am going to look into these as well. Terry Leblanc. Midwest Health plans.

    And Mark (forgot company name, as i wrote these for appts.) 321-615-8580.

    Mark has said the company has a plan that pretty much hits anyone in a fair amount, some with medical conditions as me, basal cell.

    I have talked to these people a few times, problem setting a time to get paper work sent.

    So far Humana sounds fine, but alot of the doctors in my area i hear don't like dealing with Humana...?

    Pamela

  10. #35
    Senior Member Underestimated's Avatar
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    Default Re: health insurance worries

    To be on disability, you can make up to what you're getting paid in disability per month. If they sign you up to recieve $800, you can make $800 on top of what you're getting. The more you claim on taxes now, the more your monthly payments will be. Once you go on disability, you'll be paying taxes on what you get from Social Security. If you want to know what your monthly will be, even if you don't want to file, call the 800# for SSA. Ask what your benefits would be if you decided to file today.

  11. #36
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    Default Re: health insurance worries

    Quote Originally Posted by Melonie
    If you want to seriously explore the possibility of setting up a 'medical fund', I'm pretty sure that there's a way to do this via forming an LLC/corporation where every dollar you contribute to the 'medical fund' is a tax write-off even if the contributions are much greater than the actual medical expenditures in a given year. I'm also pretty sure that, as long as it is kept separate, that the 'medical fund' money can be invested and collect tax free interest and dividends until the time comes when it needs to be spent. I've never explored the details of this i.e. the legal requirements for an LLC/corporation with one 'employee' setting up 'self-insurance' coverage for that employee, but I'm pretty sure that it can be made to work. Legal/accounting experts ?
    While state laws vary, this almost certainly will not work for IRS purposes. There are two basic ways that business entities are taxed: pass-through taxation and separate-entity taxation. You pretty much get to pick what you want for something like what you've described (one owner and not in a separately regulated industry like banking).

    Pass-through tax (a/k/a Subchapter K or S business associations) means that all income and all deductions are allocated to shareholders in proportion to how much they own of the business. If you've got one owner/shareholder, you've done nothing to affect how much tax you owe.

    Separate entity taxation (a/k/a Subchapter C business associations) means that the company will pay a corporate tax of up to 34% on taxable income. Any profits distributed to the shareholder/owner are generally dividends or capital gains, generally taxable at max 15%. This means a double tax, so it's not preferred. But it has some advantages like deductions for dividends it receives from other corporations (allowing you tax deferred income from investments). But the dividend deductions are only up to 90%, not 100%. Any services that the corporation provides on your behalf (like paying for medical expenses) will be considered a constructive dividend that you'd have to pay taxes on.

    The main problem with doing this is that the IRS will probably not consider this type of scheme to be a "business purpose" (paying for your own medical expenses would probably not be considered a business purpose). You'd need to have some kind of a significant profit motive. But payment of your medical expenses will always be a constructive dividend that you'll have to pay a 15% tax on.

    The best solution I've heard of, if you're generally healthy, is to create a medical savings account, which allows you to contribute money that you can deduct from your income for the year. Then, carry catastrophic illness coverage to take care of the stuff that your MSA can't take care of (usually a pretty low premium, like <$100/mo). If you can save up $1,000 in your MSA and carry catastrophic coverage for everything above that, it's cheaper than paying a premium for regular private insurance. Then, once you get your MSA up to, say, $1,000, you may decide that's enough and you won't have a monthly expense after that except for your catastrophic illness premium. Of course, all of this is well and good if you're generally healthy and don't have regular medical expenses or a true pre-existing condition that requires care. For that, I don't have a great suggestion.

    Greg

  12. #37
    Featured Member evan_essence's Avatar
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    Default Re: health insurance worries

    If you lose your status as a dependent child under your parents' group plan, you're eligible for COBRA. It's more expensive than before, but may be less expensive than an individual plan or no plan for people with chronic conditions.

    See http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html

    Also, under HIPAA, if you have been covered prior to taking a new job where group insurance is available, that prior coverage may reduce or eliminate the period that the new plan can exclude you from coverage of a pre-existing condition. Right now, if you leave your parents' group plan and went immediately to work for a company with a group plan, there might be a brief waiting period for coverage to start, but there would be no pre-existing condition exclusion since you were coming in from a situation where you had been covered for more than the previous 12 months.

    Having COBRA or individual coverage prior to a new job would meet this provision as well. If you took a job a year from now, and had COBRA from now until then, you wouldn't have a pre-existing coverage problem with the new job's group plan either.

    See http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

    Whatever you do, you sound like you have a condition that needs to be factored into your future financially. Even if it's a large savings stash and possibly some high-deductible plan that covers only catastrophes. Check with your state's department of insurance to see if the state has organized some sort of high risk insurance for people who can't get coverage any other way. And the suggestion about applying to drug companies for cheap or free medicine is also a good one if you're not covered and are income eligible. Each company is different, as I understand it, and your doctor has to participate in filling out some of the paperwork to submit for you to qualify.

    It's a major bummer but good luck.

    -Ev

  13. #38
    God/dess Bunny's Avatar
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    Default Re: health insurance worries

    Check with your state's department of insurance to see if the state has organized some sort of high risk insurance for people who can't get coverage any other way.

    I think florida has something like this IF you make about diddly squat as an income. If you make a livable wage and have a pre-existing condition you are SOL.

  14. #39
    God/dess Bunny's Avatar
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    Default Re: health insurance worries

    My mom told me last week that she called the FL Dept. of Health and August definitely is open enrollement month in Florida so in the Month of August they cannot refuse you. Might be only with certain companies but I know Blue Cross and a bunch of others were listed on the website.

  15. #40
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    Default Re: health insurance worries

    Quote Originally Posted by tampadancer
    you know... thats an idea

    i generally have serious attacks every 3-5 years. twice i have been hospitalized and the bill was about 10-12k each time. I did not need to go to the hospital this past time. $500 an month is 6k a year - and assuming i need hospitalized every five years - i would have 30k in the bank to cover it....
    As a couple of posters have briefly mentioned, an HSA-structured policy sounds like it would work best in your situation. I went to at the beginning of the year, and have been very pleased. See the link below for a brief explanation.

    How Do Health Savings Accounts Work?

  16. #41
    God/dess Bunny's Avatar
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    Default Re: health insurance worries

    HSA's are good but they probably won't approve her. I have hormone problems and migraines and havne't had many hospital bills and have been denied (even after an appeal with a lenghty explanation) from Humana.

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