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  #1  
Old 06-28-2009, 11:55 PM
actuarialStudent1234 actuarialStudent1234 is offline
 
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Default Question about insurance after COBRA!

I have a question about health insurance. Not sure if it fits in this forum, but thought I would give it a shot!

I have a family friend that had an ok job - not great, but it paid the bills, and he was able to take care of himself. He is single, so not much responsiblity. Unfortunately, recently, he developed brain lymphoma, which is a type of cancer that is considered terminal. He has been hospitalized for the last couple of weeks, and is on STD at work. Sadly, in a few weeks, he will be terminated since he has not been able to go back to work, in which case COBRA kicks in for 6 months. His family is wondering a lot about what happens after that, and they came to me as an actuary, assuming I would know the answer (I work for a life insurance company, but that's besides the point). So I thought I would post here and see what the "experts" thought about this, and what options were available to him:

Some of the questions were:
1) After COBRA, can he just continue with the insurance company that he has, but pay the full premiums, OR
2) Does he have to shop for new insurance? And will this be a problem, since he is technically uninsurable?

I have no idea how it works, so any help would be appreciated.

Thanks!
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Old 06-29-2009, 01:06 AM
Not Mike Not Mike is offline
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He should have 18 months of COBRA, not 6 months. Actually, potentially even 29 months of COBRA coverage.... see here if this applies:

http://www.cms.hhs.gov/COBRAContinua...ofCoverage.asp

After that, he may qualify for Medicare if receiving Social Security disability payments (but I'm not sure if his condition will qualify or not). Certainly something to look into if he's currently on STD and moving to LTD.

If he can't get Medicare, he is lacking options. While it sounds crazy, I guess marriage is an option (and covered under spouse's insurance).
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Old 06-29-2009, 10:02 AM
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Medicaid may also be an option depending on what state he lives in.
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Old 06-29-2009, 10:31 AM
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Also check to see if the state has a risk pool. These are set up to cover those who no longer are eligible for COBRA AND exhausted their benefits. List the state, and someone can find a link.
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Old 06-29-2009, 10:39 AM
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Don't some states have individual HIPAA policies with no pre-existing condition exclusions

Sounds like he may qualify for HIPAA coverage
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Old 06-29-2009, 02:25 PM
actuarialStudent1234 actuarialStudent1234 is offline
 
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Quote:
Originally Posted by G.O.A.T. View Post
Also check to see if the state has a risk pool. These are set up to cover those who no longer are eligible for COBRA AND exhausted their benefits. List the state, and someone can find a link.
He lives in California
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Old 06-29-2009, 02:38 PM
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Um, "terminal"?
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Old 06-29-2009, 02:44 PM
actuarialStudent1234 actuarialStudent1234 is offline
 
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Quote:
Originally Posted by Dr T Non-Fan View Post
Um, "terminal"?
That is what the doctors said. Of course, no one ever knows! And they definately do not need the extra stress of finances.
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Old 06-29-2009, 02:46 PM
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Quote:
Originally Posted by actuarialStudent1234 View Post
That is what the doctors said. Of course, no one ever knows! And they definately do not need the extra stress of finances.
You're not making the options easy.
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Old 06-29-2009, 03:15 PM
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COBRA coverage isn't exactly cheap, but in a situation like this, it's almost certainly worth it. What about life insurance policies that could be tapped for accelerated death benefits?
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