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Missy

VR.org Supporter
Supporting Member
Joined
Jun 12, 2001
Messages
448
Location
New Mexico
My husband and I do not have enough life insurance and I am wondering if it is hard to get when one has heart problems like us.

We have been fixed so to speak and realize that we are getting older and need to act if we are going to. I was asked the other day by my credit card company if I wanted insurance and sounded like a really good deal so I said okay and answered the questions and was turned down immediately no need to proceed she said.

So we started thinking that maybe we need to try to get some life insurance.
Does anyone know the best companies that will insure ?

I had to drop my health insurance as it just kept getting higher and higher. We only have so much money. It really makes it difficult. And with a pre existing condition I just know about finding insurance even if it was affordable.

One other time there was a discussion on here about insurance and what is considered affordable.

My standards have changed some since we are older and prices of everything are so high.

we make too much money for the state income level insurance.

Can anyone help.
 
I'm in a very similar position. I called an insurance sales guy who basically tried to sell me a product that covered only emergency room visits. It was something like 600 a month for just me. What he thinks I don't know is that they have to treat me if I'm dying anyway because of their Hippocratic oath and whatnot.

I called some other sales guys too. After they questioned me about my health it was just like "yeahhhh, let me give you a call back." Oh, ok, right? I'll never talk to them again.

So the one of few options for me right now is a mini-medical thing through my wife's work. It has a yearly maximum of 25,000. I'll run that up after what, two MRI's? :rolleyes:

My only suggestion to you Missy is find a job (if you can work) that provides decent benefits. The benefits should be your main criteria. Honestly, I've looked in to it and even Walmart has ok benefits now. it's like 80/20 with a decent yearly maximum. Enough to get through a surgery.

This is an area that I'm not strong in at all. I've been covered through GM insurance all my life, and I'm just now getting removed from it. I need to look in to COBRA, but I have no idea how it works. COBRA is supposed to be some kind of law that allows you to keep your same medical coverage at the group rate even if you lose your job or something.

I'd love to hear other members' input on the subject because this is definitely a huge hurdle in my life as well.
 
Hang on to what you have. Getting a new policy or even trying to add to your existing will be next to impossible without paying far more then you already are. I'll let those that have done it explain it. I've been along for the ride, but haven't done it myself.
 
Missy: As we all have seen, health insurance is much more expensive than life insurance. However, it is also much more difficult to get by without health insurance than to get by without life insurance. I was looking into this a few years ago, and believe that New Mexico has health insurance options for people who are otherwise uninsurable. I don't know how long you have been without health insurance, but that can be a very important question.

After some period of time, any health insurance you get may exclude coverage for heart related issues. I realize this may not matter if you flat out can't afford it-but you are looking at a pretty "sticky" situation. Ross is right about trying to hang on to what you have-if at all possible.

When I was elected to our local school board, I was given certain options concerning life & health insurance. In my case I didn't need to take advantage of those opportunities, but I tucked them away in the back of my mind.
 
Missy, I've never been able to get life insurance other than a small policy that an employer may have been offering at the time. As for health insurance, I've never been without it since I have had heart issues from birth and knew that I would always have problems. The only way I can get it is through a group plan when I was working and now I'm on my husbands. If you don't have any health insurance now, I would think it will be almost impossible to get one that you could afford (even if you can find someone to take you) unless you go to work somewhere where they have a group plan and have to take you. However, unless you have had continuous coverage, they can enforce a pre-existing clause and not cover your heart or other health issues. Good luck trying to sort this out.

Kim
 
Wow, this is a sobering subject if not a sad one; One that is fueling this political season and yet sadly nothing good will come of it at the end of the day-I fear.

I can't imagine having gone through all this without Insurance. If you, or a spouse, are employed and take out Company Healthcare; can one be denied due to pre-existing conditions? It is my thought that they must insure both you and your dependents irregardless (am I wrong?).

My wife and I (long on our jobs) compared policies and went with her's as the better offer however; my employer did offer a supplemental policy (AFLAC), which I took out. We both have only the life insurance offered by each employer with an additional supplemental. Collectively, that is roughly one years salary plus $15,000.00 for each of us. We pay premiums only on the supplemental and that's just a couple dollars per paycheck. Fortunately, the only real debt we have is our house payment with only 11 years remaining. We each have enough in our 401k's to cover that should anything happen to one of us. I had looked into an independent life insurance policy and the premiums were outrageous. The money is better spent in a 401K.

During this years "open enrollment" (October), I want to add the Healthcare savings plan. I've been reading up on this and it sounds pretty good. The money put in this account is pre-tax with the company matching contributions by 20%. This seems to work like a separate checking account for medical expenses which if used thusly remains tax exempt.

You would be surprised at the benefits offered through employers. In younger years; I disregarded them but find myself sifting through them carefully now. Middle-aged and beyond, you find yourself needing these benefits more and more.

I've long been aware of these credit card insurance "deals". What a scam! At the first clap of thunder; they drop you like a hot potato and run. You would think these too would be Government regulated.

It's hell being middle-aged and middle income.
 
Missy, I would follow Dennis' suggestion and look into possible state health insurance programs. The other alternative is to go to work for a larger company who has group medical insurance that does not require "health questions". You would probably still have to satisfy a pre-existing condition clause for a period of time. You would probably also have group term life insurance which you could convert to an individual policy if you left the employer. You might also ask the agent who handles you auto or home insurance for help. They often know of "extra risk" companies that specialise in higher risk situations. However, it will be more costly than any standard risk policy.

AaronJ, COBRA is a federally mandated program that does allow you to keep group health insurance coverage for a period of time. If you have been a qualified dependent under your parents plan and you lose that status, you can continue the group plan for a stipulated time (18 or 36 mos depending on the reason you lost your eligibility). You mention that your current plan is GM. If that is General Motors, their plan might actually have "continuation" benefits better than COBRA. However, you need to act within time limits or you will lose the COBRA option.
 
It's a very difficult situation, isn't it Missy. I can't get life insurance on myself. And health insurance can be very expensive. I'm sorry I have no answer, just empathy.

Others mentioned COBRA so in regard to that, when our COBRA plan expired, 18 months I think it was for us, this was our next option: http://valvereplacement.com/forums/showthread.php?t=19246&highlight=hipaa

And, I think I also may have been on a waiting list for some type of state major risk plan -- vague memory of that. With either that or the hipaa plan, I had to prove that other health insurance plans denied me membership.

And as was mentioned, pay close heed to those time limits and act within them.
 
Hi Missy....

Hi Missy....

Missy -- I agree with the others who recommended Health Insurance over Life Insurance -- no comparison. You NEED health insurance and you're lucky enough to reside in a state that has a high risk pool.

See: http://www.nmmip.com/ and see if you qualify. It does list "open heart surgery" and "artificial heart valve" as approved criteria for insurance.

We have the same insurance available to us in Texas and I've been on it for some years. It's administered here by BCBS and the premium is dependant upon four things: Amount of deductible you choose, your age, smoker or non-smoker, and your zip code.

Oops, I just saw where the New Mexico pool has "income guidelines" however: also stated is "INCOME ALONE DOES NOT DETERMINE POOL ELIGIBILITY" - the Texas risk pool doesn't have income requirements, only health requirements..

Yes Alistar -- the Healthcare Savings Account is a great thing...and the money rolls over from year to year (if not used) until you reach age 65 and contributions end. After that the money rolls over until the account is exhausted. Tax free anything is good...!

Good luck..!
 
What about AARP's health insurance through United Healthcare?

I have not investigated it yet, but probably will.
I am debating whether to take a buyout at work (26 weeks pay + taking a lump sum on pension; deadline to decide is 9/4, with last day of work 9/12). I could get insurance for 3 months at current premium rates, then would be on my own. I would continue on with insurance through my husband's employer, should I do so.

The insurance problem may keep me at work.
 
To Catwoman, I believe the AARP insurance thru United Health is a Medicare Supplement. For this you must be on Medicare and normally age 65+. I have not paid a lot of attention to what AARP has available, if any, for pre-65 folks. Any pre-65 coverage they may offer is probably NOT a true major medical coverage. You should be OK being on your husbands group policy although the coverage probably will not be exactly the same. I assume you are currently listed as a dependant on your husbands policy. If, and when, your husband retires in a few years, you should be able to carry his COBRA coverage until you reach 65 and go on Medicare.
 
One other thing to consider. It may well be different from state to state, but before I could be insured through our state's high risk pool, I had to be (1) uninsurable at any cost OR (2) exhaust the period of COBRA offered. Just during the last month of our COBRA eligibility, my husband got a job that offers great health care coverage. But the contract his business has is only guaranteed through March of next year, and I am very concerned how much the COBRA would cost for each of us should we have to do that again. When the insurance company dropped my healthy 19-year-old son, it would have cost us over $600 per month to continue coverage for him through COBRA. (My 33-year-old daughter pays $150 for her individual health insurance each month). So I'm concerned.

Group health insurance is almost a necessity, even though there is an initial waiting period for pre-existing conditions, UNLESS you have non-interruption of insurance coverage, which includes COBRA. (Catastrophic health insurance only does NOT meet the requirement of "non-interruption" of coverage).
 
See: http://www.txhealthpool.com/index.html

See: http://www.txhealthpool.com/index.html

Marsha & Karen -- I qualified for the Texas High Risk Pool by the highlighted words below:

Eligibility
You are eligible (for Health Pool coverage) if you are under age 65 and you have been for at least 30 days and remain a legal resident of Texas and a United States citizen, or a legal permanent resident of the United States for at least 3 continuous years, and if you provide the Health Pool's administrator evidence of one of the following:

1. Notice of rejection or refusal by an insurance company to issue substantially similar individual health benefit plan coverage due to health reasons;

2. A certification from an agent or salaried representative of an Insurance Company, on the Pool's Application form, that states the agent or representative is unable to obtain substantially similar individual health benefit plan coverage for you with any state-licensed Insurance Company, which the agent or representative represents, because you will be declined for coverage, as a result of your medical condition, under the underwriting guidelines of the Insurance Company.

3. An offer by an Insurance Company to issue substantially similar individual health benefit plan coverage that excludes a medical condition or conditions;

4. The individual has been diagnosed with one of the Qualifying Medical/Health Conditions. see: http://www.txhealthpool.com/eligibil.html#Qualifying Medical Conditions

5. You are also eligible (for Health Pool coverage) if you are under age 65 (or over 64 and not eligible for Medicare), you are a legal resident of Texas, and if you have maintained health benefit plan coverage for at least 18 months preceding application for coverage to the Health Pool, with no gap in coverage greater than 63 days, and your last health benefit plan coverage was provided: 1) by another state?s high risk pool; or 2) through employment, with a U.S. employer. (United States citizenship or 3-year legal permanent residency is not required for this HIPAA eligibility category only.)

Dependents are also eligible for Health Pool coverage. If the eligible individual is a child, family members of the child who have been for at least 30 days and remain legal residents of Texas and United States citizens and who reside with the child are also eligible for Health Pool coverage


**For full details, see the Texas Health Insurance Risk Pool website above**
 
dick0236 said:
To Karen. Normally, a young, healthy male can purchase medical insurance thru BC/BS, Aetna, State Farm etc., at a cost far less than exercising his COBRA option.
Click to expand...

Dick, I'm sorry I didn't make that post very clear. That was kind of my point in stating what my daughter's insurance costs her. My son was dropped from our policy because he was not a student on his 19th birthday. He is now on a mission for our church, and his health insurance is covered by the church. When he returns, we WILL buy him an individual policy like you mentioned, or have him insured through the college he will be attending.

Shezagirlie, It's been a while since I researched the Utah HIP stipulations. But I remembered that MY stumbling blocks would have been (1) IF an insurance company would cover me NO MATTER the cost or (2) having a lapse in my insurance coverage of more than 60 days or so, like you mentioned.

My husband lost his job in August 2006, and I posted then about the options (or lack of options) we had for insurance. I was very relieved when he got the job he has now, in December 2007 - just a month or two before COBRA was exhausted.

Now I worry that our COBRA will be even harder to afford because of the high premium the company is paying for our current insurance. This situation is a little stickier because he is working in Washington DC (living in Alexandria) and I am in Utah. I'm afraid he's tiring of the arrangement, even if the contract is renewed. But my understanding is that, if a company will insure me - even for say $2,000 a month - that would make me ineligible for Utah HIP. (Whether or not I could afford $2,000 a month). So my other option would be that I would HAVE TO afford COBRA for as long as it's offered, usually 18 months...

I am soooo glad that for so many years I was able to tell doctors and insurance companies that "the surgeon said he fixed the problem, and I can forget I ever had surgery!" For many years, ignorance WAS bliss! :eek:
 
I know this thread is really US-based but I would like to comment on private health insurance in the UK.

I have been insured through BUPA since about 1975 first through my husband's company policy then when we separated I have paid the premiums myself first for my children and myself, then when they graduated from university, just for me.

When I became ill they paid, no problem, then when I needed my OHS they paid, again no problem. For the next few years they paid for my cardiology checks, ECG, echos etc. Then this year after paying my annual subscription of over £2,000 I telephoned for an authorisation number for my regular checks, an echo and to see the cardiologist only to be told they are not covered. As I had not been told this before they covered it this one last time, then I would need to go on the public health system.

When I read my handbook from them I also discovered that if I required additional care when having a procedure, so something like bridging before and after a surgical procedure then this won't be covered, just the procedure itself.

I discussed this with my cardiologist and with my GP, the result is that I have now written to BUPA to tell them to refund the unused portion of my premium. From now own I will use our public medical system.

All I can say is that I am grateful that we have an excellent free public medical system, barring GP visits which need to be paid for but were never covered by BUPA anyway.

So any Brits with BUPA, read your handbook.
 
sue943 said:
All I can say is that I am grateful that we have an excellent free public medical system, barring GP visits which need to be paid for but were never covered by BUPA anyway.
Click to expand...

Yes, you are fortunate indeed. Here stateside we have upwards of 50 million people without health insurance. As you know, it's a major social policy issue. On a personal level, uncertainty about coverage adds stress to an already stressful situation for many people like myself facing issues like valve replacement surgery.
Jim
 
Just wish to clarify one thing, I am not in the UK so do not come under the NHS per se.

Locally we have our own medical system and are only sent to the UK for treatment which cannot be supplied locally, such as OHS, in this situation our local health scheme will pay the NHS to carry out the treatment.

Our health system will even pay for private air ambulances to get us to the UK in an emergency and will pay our airfares for non-emergencies.
 
As I read it, the New Mexico high risk pool doesn't base pool eligibility on income - but there is a premium discount for people who qualify by income.

In addition, here's a link to the federal Centers for Medicare and Medicaid Services (CMS) [the federal agency that administers HIPAA].

http://www.cms.hhs.gov/healthinsreformforconsume/

This is a discussion (with attached PDF informational documents) concerning HIPAA group insurance market reforms. The general rule is that employer-based health insurance can't discriminate against you based on health status (meaning they can't turn you down if you apply timely). There are exceptions to the prohibition but at least it's the general rule in the employer market. (You may be subject to a pre-existing condition exclusion, which can be offset by prior recent insurance - but not all products have a pre-ex.) The point of this is that, as discussed in some earlier posts, you may be able to get coverage without being rejected for your health condition if you (or your spouse) gets a job that provides health insurance.

Good luck!
 
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