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"In terms of the premium for individuals who are not qualified beneficiaries, the IRS indicated that no portion of the premium attributable to these individuals is eligible for the subsidy. For example, some plans provide domestic partner coverage. In these cases, plans need to determine the incremental cost of providing this coverage. That portion of the premium is not eligible for the credit. Note that, for this purpose, it does not matter how state law characterizes these individuals. For example, if a state law provides that domestic partners are to be treated as “spouses,” that does not mean that the domestic partner is treated that way for federal law purposes."Now get to pay $340/month additional for the privilege of not being considered having been without insurance.
Question: Suppose I chose not to pay COBRA premiums for a few months while unemployed. During that time nothing new happens. Then I get insurance again. Does my failure to pay for nothing mean that drugs for depression etc will never be covered by insurance again, since there was a lapse and I was diagnosed before the lapse?
I can has real fucking country with national health plan yet?
2009-07-02 06:39 pm (UTC)
2009-07-02 06:49 pm (UTC)
Maybe I should make myself too unlazy to look.
2009-07-02 06:53 pm (UTC)
In Washington:
(a) unless you receive treatment, or are told to receive treatment, in the either 3 or 6 months preceeding your start date for your hypothetical new insurance, it's not pre-existing. 3 months for big (>50 people) plans, 6 months for small plans.
(b) if it *is* pre-existing, your new insurance is allowed (but not required) to refuse to pay for it for either three or nine months (3 months for >50 people, 9 months for <50 people), after which time they have to pay for it
clearer?
2009-07-02 06:59 pm (UTC)
2009-07-02 06:43 pm (UTC)
5. If I get health insurance through my employer, is there a federal law that limits how my plan will exclude my pre-existing condition?Yes. The Health insurance Portability and Accountability Act (HIPAA) of 1996, limits the pre-existing conditions that health insurance plans can exclude from coverage.The only pre-existing conditions your insurance plan may exclude are for those you received or someone recommended you receive medical advice, diagnosis, care, or treatment during the six months prior to your enrollment date. Your enrollment date is your first day of coverage, or if there is a waiting period, it’s the first day of your waiting period (typically, your date of hire).If you had a medical condition in the past, but you have not received any medical advice, diagnosis, care, or treatment for it within the six months prior to enrolling in the plan, your old condition is not considered a pre-existing condition. As a result, an exclusion does not apply.Washington state law shortened this six-month period to three months for employers with more than 50 employees, and those who offer coverage through an insurance company or an HMO.6. Legally, what is the limit on the group insurance pre-existing condition exclusion?For self-funded employers, the federal Health Insurance Portability and Accountability Act (HIPAA) permits health plans to require a 12-month pre-existing condition exclusion period.For large groups (more than 50 eligible employees), state regulated health insurers may require a three-month pre-existing condition exclusion period. For small groups (2-50 eligible employees), state regulated health insurers may require a nine-month pre-existing condition exclusion period
http://www.oic.wa.gov/publications/heal
2009-07-02 06:51 pm (UTC)
2009-07-02 07:26 pm (UTC)
Sooo, I think it may depend on how your insurance had things listed. Popcap didn't differentiate DP vs Spouse coverage, once we put in the form that said "no, really, we're DP", so I think maybe it's just a question of whether the COBRA management company and the insurance manager (generally someone at the employer) communicate certain facts, and if the COBRA people Know.
2009-07-03 04:26 am (UTC)
2009-07-13 09:47 pm (UTC)
On the other hand, if you choose not to pay then you're not covered, and expecting coverage is just begging for someone to take care of you when you weren't able to. We usually call this charity. In the meantime, it's economics.
Case Study: Both me and the husband were heading into unemployment and I had a baby incubating and a hernia...If I had missed Cobra payments, when I started paying again they would had covered delivery, but in the case of C-section, not the work done to fix the hernia, because the baby is more protected by society than I am. Go figure.