Once you have an ongoing health issue that is covered by your insurance

[Longhorn]

are you still covered if you quit working?

I know that I am eligible for my health insurance as long as I teach one class per long semester (I'm an adjunct professor at a community college.) But if I'm not able to keep teaching when my treatments begin, won't I still be covered? Does my coverage depend on continuing to pay the premiums? And finally, is the only reason COBRA is more expensive is because the employer no longer contributes? In my case, my employer doesn't contribute at all so I assume my payments wouldn't go up.

I appreciate your help! :hi:

[Mojorabbit]

1. I don't know

but when I was diagnosed with Ms I worked for another two years before I had to retire due to illness. I lost my health insurance and could not afford the cobra payments. I was without health insurance till medicare kicked in. (2 years)

[Longhorn]

2. Did you have any medical bills during those two years that your insurance paid for?

Or did you have to pay out of pocket?

:hug:

[SharonAnn]

3. You will only be covered as long as you are paying your premiums.

That's what I understand. Also, if the cost of your treatments exceeds the "Limits" of your policy, then your coverage also stops.

Once you no longer can pay your premiums, you will need to look for alternate coverage. That could be Medicaid if your income level is low enough and there are slots open in your state for your category, or Medicare Disability which I believe has a long waiting period (2 years?) for review and approval.

Of course, if we had Unviersal Coverage, those things wouldn't be an issues.

[Longhorn]

5. Thanks!

Do you know if only the medical condition itself would be covered after the COBRA runs out? So then if I broke my leg, for example, we'd have to pay for it out of pocket? I don't think we would qualify for Medicaid and I'm several years away from Medicare.

[dajoki]

16. If your illness...

is expected to last for a year you should apply for SSD right now, you are entitled!! Then, once approved, Medicare will kick in. Get a good lawyer who specializes in SSD!!

[Longhorn]

17. Thanks for the advice!

I've checked and my cancer qualifies. I haven't quit work yet but I will get started on this if I have to.

[dajoki]

18. Yes, I think it does also...

but don't waste time because of the backlog. Also a good lawyer may be able to get your case resolved a lot faster. Above all, DO NOT ATTEMPT to handle this by yourself!! Good Luck and I'll pray that you get well!!:pals:

[Tess49]

4. Since you pay your entire premium yourself, your Cobra will be

what you pay now, plus a small administration fee. Your coverage continues under Cobra without a break in benefits as long as you make the premium payment. Cobra lasts 18 months.

[Longhorn]

7. Thanks! That's good to know! nt

[MiniMe]

6. If your insurance remains the same, they will cover you

For COBRA, the reason it is usually more expensive is because the employer usually charges you the entire premium, they can also charge you a small service charge I think, but I have never seen it be more than about $10 a month. Yes, if you don't pay the premiums you will lose your insurance. COBRA can be purchased for up to 18 months after you leave your job, after that you have an option to convert it to an individual policy which will most likely be significantly more expensive. If you are without insurance at any point, it is very likely that any future insurance policies will have a 1 years exclusion rider where you won't be covered.

I have been on COBRA, and that is how it worked for me, I'm not sure if anything has changed.

[Longhorn]

8. Oh, good, I didn't know about the option to get an individual policy.

We'll certainly make sure we keep the insurance in place, no matter what!

Thanks! :hi:

[Ms. Toad]

11. The conversion to an individual policy is under HIPPA

Once you have coverage and a pre-existing condition, it is important to maintain creditable coverage (generally a group health plan, Medicare, Medicaid, public service-sponsored health plan, state high-risk pool - or a COBRA/HIPPA extension of one of these). As long as you are have been continuously covered (no gap longer than 63 days for a period of a year preceding the new insurance), all new group insurance policies have to cover pre-existing condition. Once there is a gap, new group insurers can refuse to cover pre-existing conditions for 12-18 months.

The premiums may be extremely high under HIPPA - BUT if you maintain health insurance continuously you can never be cut off from access to coverage for pre-existing conditions (critical for folks with chronic illnesses who previously were denied coverage - or were covered only for their non-chronic illnesses).

[MiniMe]

12. Thanks Ms. Toad

I knew it was something like that, but I didn't know all the details and I didn't want to give her information that wasn't true. Thanks for jumping in.

[petersjo02]

9. You're entitled to stay on your employer's COBRA

or 18 months after you quit working. I did this when I retired at age 62. At 63-1/2, when I left the COBRA coverage, then I had to find private insurance to cover me for the next 18 months until I was eligible for Medicare. Once you're on Medicare and a Medicare supplement at age 65, you're covered no matter what happens. Because I've had multiple health problems, no one would insure me from 63-1/2 until 65. I finally got coverage trough a state-run program that offers insurance to high risk people who have no other options. It was/is unbelievably expensive and was essentially catastrophic-only coverage, but I had no choice. In order to be eligible for Medicare supplement policies, you must have been covered by health insurance up to within 60 days of your 65th birthday, so going without altogether for those 18 months until Medicare kicks isn't an option.

[Longhorn]

10. The stress of serious medical problems is difficult enough.

We shouldn't have to stress about how we're going to pay for it and if we have this stress when we have insurance, I can't imagine what it would be like for someone who has none. :cry:

Hang in there and good luck! :hug:

[Blue-Jay]

13. They are more likely to die

A recent study of people with cancer indicated uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling health care obstacles.

http://www.cnn.com/2007/HEALTH/conditions/12/20/cancer.uninsured.ap/index.html

[peacebuzzard]

14. Hi Longhorn. I am going through this right now.

I recently have been diagnosed with a serious chronic illness after feeling lousy for a long time and was away from work and on a med leave for 9 months.

Back to your questions, when you leave work, I believe your premiums will go up because you will no longer be on the group plan which is considerably less than an individual COBRA premium. Probably as long as you have sick leave or vacation your premiums may remain on the group plan or if you are on an approved FMLA. You will need to check with your Human Resource Dept or Benefits Dept to find out the particulars. If it becomes a long term treatment, your premiums may shock you.

I am struggling right now because my disability benefits from the group disability policy have been cut off. The insurance company is denying further payments for absolutely distorted reasons and I am now in the process of having an attorney help me. I will probably have to seek the long drawn out process of SS appeal (it has been denied twice now) to get insurance from the Medicare/medicaid or whatever. I can no longer afford my COBRA payments ...it costs over 400 a month and my disability income has been cut off. Fortunately my sister will be helping me out but I have to move cross country to where she lives and basically just lock the door to my home. I am fortunate to have mortgage insurance, I hope I have a better experience with that insurance company. I will be ok but I just wish I could stay in my own comfort zone, but such is life, you roll with the punches I guess......I am still in denial over all this. My best to you with your research into all of this.

The health care system in this country is a mafia in my opinion. I hope you have all the good answers and success with your treatments.

[Longhorn]

15. I'm sorry about the upheaval in your life this has caused.

I hope the move and transition goes as smoothly as possible! Thanks for thinking of me at a time like this. :hug:

[peacebuzzard]

19. I hope all goes well for you too.

I am luckier than most, since I have a sis who is willing to help out. I have lived by myself for so long and when something catastrophic happens it is crucial to have something/someone to fall back on, esp. if the insurance you thought you had disappears.