Q. I just left my job and am trying to decide if I should continue my health insurance benefits under the COBRA law. I have preexisting medical conditions. I am starting a new job and wonder if the new company (insurance carrier) can refuse to insure me?
A. It is always best to continue coverage when you change jobs. The first reason of course, is that you will have coverage should you need any medical visit, test, or procedures during that time. The second reason is that it safeguards you from the possibility of having a waiting period under your new carrier for any preexisting conditions. The new company can not refuse to you insure you (NJ), however, depending on the size of the company you will be working for, and how long a gap you have in coverage, you could have a waiting period for the preexisting conditions. You can go from one small group plan (less than 50 employees) to another small group plan and have a gap of up to 63 days without insurance and they must cover preexisting conditions. You must be able to prove that you were insured for at least 6 months and the gap is not greater than 63 days. If you get employment with a very large company, it will depend on how their group contract is written. Usually, you will be okay but you cannot take a chance on that; you must know exactly what that employer’s policy is. It is always best to be safe and not have a gap in coverage at all. If you purchase an individual policy (not through an employer), you can only have a gap of up to 30 days; otherwise, you will have a one-year waiting period for preexisting conditions.
Q. My son graduated college two weeks ago and I just learned that his health insurance ended the day he graduated college. Can they really do that?
A. Yes. Most health insurance plans terminate on the day of graduation. Some plans will go to the last day of the month in which you graduate and some will go to the 23rd birthday. It is your responsibility to know the limits of your coverage. You will find this in your Benefits Handbook. As for coverage for your son, depending on the size of the company the insured parent worked for, you may be able to continue him under the COBRA law. ( more than 20 employees). Otherwise, you should purchase an individual plan for him until he, hopefully, finds employment that offers coverage.
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Q. My doctor said I have the beginning of arthritis in many of my joints. Should I purchase long term care insurance now or will I be turned down?
A. It is best to purchase long term care insurance when you are still in good health so the sooner you apply, the better. If the discomfort from the arthritis can be controlled with over the counter medication, you probably will not be turned down. No insurance agent can guarantee that a policy will be issued. Long-term care insurance is medically underwritten which means the insurance company will contact your physician for your medical records. Based on the Underwriter’s review of your records, the policy can be issued as applied for or they may come back with a counter-offer, such as reducing the length of time you will be covered or increasing the elimination period.
Irene Card & Betsy Chandler share the responsibilities of running Medical Insurance
Claims, Inc. a health insurance services company. If you have questions relative to this
column or other related topics, we invite you to call (973) 492-2828, browse our
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