Good chance I will lose coverage this year- prexisting conditions concerns

[laidoffin08]

I was laid off from my employer in October and currently remain covered under their group health plan under COBRA. However, there is probably a 50% chance that my former employer is going to go out of business this year, which would mean I would lose coverage entirely.

During my time off I would like to get a full physical as well as a heart CT scan to get a calcium score. I am a 38 y.o. healthy male but I have some low HDL issues and would like to know what my current risk of a heart attack is so I can take appropriate measures. I would also like to start treating my low HDL with medication to get it up to normal range. It's been several years since I've had a check-up and I want to start becoming more proactive about my health.

My question is, if something shows up during the physical or CT scan (for example, the scan finds a blocked artery) and later on I lose my COBRA coverage, will I be completely barred from coverage for whatever condition is revealed when I try to find new insurance? Or, if I can pick up new insurance within 63 days (HIPAA rule), does this become a non-issue? There is a possibility that if I lose my current coverage I can get on the group health plan of my father's company.

Or, am I better off just postponing any tests until I find a new job with group coverage?

[Amir Mostafaie]

Below is a useful link for commonly asked questions about HIPAA rights;

http://www.dol.gov/ebsa/publications/yhphipaa.html

Sincerely,

Amir Mostafaie

[laidoffin08]

Also, I forgot to mention I am currently a resident of Virginia.

[Amir Mostafaie]

Dear laidoffin08,

I’ll have to answer you in parts because there are a few separate issues in question.
First is your “portability or insurability”;
While you are HIPAA eligible, you will be considered guaranteed insurable, in other words you will be able to find health insurance coverage through Anthem BCBS of VA and during this period and all your pre-existing conditions will be covered.

The other question is “what is the cost to you”?
Keep in mind that health insurance coverage for HIPAA eligible individuals that have already been diagnosed with a condition like “a blocked artery”, is going to be more expensive that another person who doesn’t have the same health issue (or at least there isn’t reasonable cause to believe that he/she has the condition). So as you are insurable, you may pay a higher price for a HIPAA plan.

As I am not suggesting in any shape or form that you should delay any treatment or tests for anything, it is beneficial to enroll in an Individual plan while you still qualify, because once you are diagnosed, you may not be able to qualify for the Individual health plans.

If/when you get on a group plan through another job or your father’s group plan, either one should cover you with no exclusions on your pre-ex conditions as long as you maintain continuous coverage.

Let me know if you need any further clarifications.

Sincerely,

Amir Mostafaie