health insurance soon lost now what?

B

bobsledder

New member
I am from Illinois and my wife is an employee at a hospital. 17 months ago she started having complex migraine headaches. They cause some loss of eyesight weakness on one side and she has difficulty speaking. These episodes she has had regular migraines intermittently over time and now she has had 3 of these major episodes. It takes 4-6 days in the hospital and lots of meds to get her past the worst of the symptoms. Then recuperation at home is about 2 weeks. She has worked limited hours and no longer qualifies for health insurance. She has been COBRA on her company provided health insurance and even though it is very expensive it is worth it as her Dr Appointments and medications just to survive are massive. There looks to be no way she will ever be able to go back to any full time employment.
Now the question: WHAT do we do when she no longer qualifies for COBRA. I am a partner in a small family business and have my own insurance thank goodness. I am concerned that one of these episodes with hospital care would put us into financial ruin and also cause the other family members to suffer financially also. I have heard of some kind of state run high risk insurance pool. Anybody know about this?

Any helpful related info will be greatly appreciated.
Bob
 
E

ezra

Well-known member
why not put her on the payroll of the fam biz she can work so called full time for 100bucks a week and put her on your company plan
 
P

polarisrider1

New member
ezra said:
why not put her on the payroll of the fam biz she can work so called full time for 100bucks a week and put her on your company plan
Click to expand...

That is how I do it. Heck wife gets all (most) the money anyways, may as well make her a title for it and put her on your insurance. Just got to get around the pre-exsisting illness clause. Most group Insurances can't turn her down if made an employee, but can if you just add her to your own policy.
 
xsledder

xsledder

Active member
bobsledder said:
I am from Illinois and my wife is an employee at a hospital. 17 months ago she started having complex migraine headaches. They cause some loss of eyesight weakness on one side and she has difficulty speaking. These episodes she has had regular migraines intermittently over time and now she has had 3 of these major episodes. It takes 4-6 days in the hospital and lots of meds to get her past the worst of the symptoms. Then recuperation at home is about 2 weeks. She has worked limited hours and no longer qualifies for health insurance. She has been COBRA on her company provided health insurance and even though it is very expensive it is worth it as her Dr Appointments and medications just to survive are massive. There looks to be no way she will ever be able to go back to any full time employment.
Now the question: WHAT do we do when she no longer qualifies for COBRA. I am a partner in a small family business and have my own insurance thank goodness. I am concerned that one of these episodes with hospital care would put us into financial ruin and also cause the other family members to suffer financially also. I have heard of some kind of state run high risk insurance pool. Anybody know about this?

Any helpful related info will be greatly appreciated.
Bob
Click to expand...

How many people are on your businesses plan? Does your plan cover only employees or does it cover employees, spouses, and children? If covers only employees, then modifiy the group plan to include spouses and children but you will get a big kick in costs. To offset the costs, increase the employee contribution.

In Illinois, she can't be declined from the group for pre-existing conditions. This was in place before Obamacare. Also, pre-Obamacare, the most the policy could increase was 67% per-year (but it increased 67% every year) in Illinois.

So you can modify your group plan and add her without making her anything in the company, but it will be expensive. You need to talk it out with your insurance rep and business partner.
 
T

tealracing16

Member
Also if she lost her medical insurance she may qualify to enter onto your plan. Like having a baby or a marriage is a "qualifying event." Definitely talk to your ins manager about getting her onto your plan.
 
N

nic

New member
If your plan has the option to cover spouses- she can definitely be added to your coverage as the loss of her coverage is considered a 'qualifying event'. I work for a benefits administration company, so this is a fact. However- I'm guessing adding her to your plan isn't an option or else you would have done that.
As someone said- your company can update it's plan to cover dependents, but your partner would have to agree to all that comes with it (higher costs, etc)
But you mention that it's not likely she will be likely to return to full time employment. This is the direct definition of disability. If she can no longer work- the state needs to determine her to be fully and permanently disabled. AT that point, she is elig for social security, and medicare.
 
Z

zrgrl

New member
There is insurance by the state of Illinois called CHIP http://www.chip.state.il.us/default.htm

I had looked into this when the job I was going to go full time didn't have benefits but luckily didn't have to go that route and found a job with benefits.

The CHIP program is for people that are not able to pick up insurance by other providers such as people who (like me) have pre exisiting conditions.
 
C

catalac

Active member
Bobsledder, be sure to let us know what happens with this because this is very interesting to hear.
Good luck with this, I hope it works out good for you.
 
W

windingtrailgal

Active member
Bob, X2 to what zrgirl says. Look into assistance from the state. We pay through the nose in this state for a lot of people who have not put into the system all that you and your wife have. Have your wife talk to the administrative people at her hospital that know how to jump through the hoops to get assistance for the patients who use her hospital. They should be able to help her out as to the ins and outs and may give her contact info so her file doesn't end up at the bottom of some pile. Illinois, so graciously, is much better than a lot of states in regards to assisting people in these situtations.

Good luck - thoughts and prayers to you and your wife. I'm sorry to read that she is going through this!
 
saber1

saber1

Active member
I thought that insurance companies could not refuse you anymore for preexisting conditions
or did that not take affect yet?
 
B

bobsledder

New member
Thanks all!

Thanks for everyone’s input. We have until November to figure this out so it will be a slow process. Windingtrailgal thanks for the link. I have been swamped at work and my wife has had another bad episode so there isn’t much energy left to deal with this.
The neurologist says the season change is most likely one of her “triggers”
Thanks Again
Bob
 
You must log in or register to reply here.
Top