Question:
Can you still keep insurance on your own if husbands group is up 4 renewel?

I have bcbs fl ppo I am approved for surgery but they are giving me a hard time they verified that I dont have a pre-existing condition but they are still saying I have to wait unil Aug.1,2003 that is when I have 1 yr. w/ them the problem is that my husbands employer is up for renewel then and they might be changing insurance again would I be able to keep policy on my own w/ them if I made direct payments to them my husbands employer was only covering him and he has to pay each week for me they dont pay any percent for me.If anyone has an answer I appreciate it thank you..    — marie M. (posted on May 30, 2003)

May 29, 2003
NO... If your husband's company changes insurance.. you go along too.. EVEN tho you are 'paying' for yourself you are still being covered under the group plan.
   — star .

May 29, 2003
Sure - however, you would have to convert the policy to an individual one, possibly under COBRA. But you would have to pay for the entire premium yourself -- plus they usually charge you an additional 2% fee.
   — Nannette

May 30, 2003
I have to agree with Helen - your husband is part of a group plan, and just because you pay the premiums yourself (I am betting the rates are discounted, even though it may not seem like it) you probably won't be able to conitinue to pay for that plan yourself. If it is a plan designed specifically for his company, the policy may, in fact, cease to exist if the company drops it.
   — koogy

May 30, 2003
The first poster is right--if the group plan changes, then you have to go along with the group. COBRA will not help you because the employer switching plans is not a "qualifying event". You may be able to convert to a personal policy, but it will be at considerably higher rates thaan you pay now because there is no group discount. I chagned insurance companies after having been approved by one, and had no trouble getting approved under the new one. Also, pre-existing condition credit MUST be given to you for the period of time you were covered under the previous plan (one of the good provisions of HIPAA), so the new plan cannot make you wait yet another year under them.
   — Vespa R.

May 30, 2003
I agree with all the other posters. Only one more comment to add. Even if you went out and got your "own" policy directly from BCBS it is very possible that WLS might not be covered. BCBS has sooooooo many different plans and I'm not sure if the ones offered to the individual public include WLS coverage. My BCBS policy does but again it's part of a group plan. I still think you need to be working with HR to see if there was anything in writing that indicated pre-existing conditions would be excluded. We have the opportunity to change plans every October and if we change to a different plan there are no pre-existing condition clauses. This should have been spelled out in the insurance booklet you would have gotten. If it isn't then park your butt at the closest regional office until at least a customer service supervisor will talk to you. Better yet make an appointment to see the vice president of that branch and present your case and ask to have it reviewed and quickly since time is of the essence. I suspect your rights under the policy are being violated because they are hoping the company changes plans and then they won't have to pay. The just hope that people won't be savvy enough to push the issue and call them on it. <p>When I wanted BCBS to cover the cost of Redux they told me there was no coverage. When I pointed them to the page in the exclusions section that said weight loss treatment was covered for the MO as long as medical necessity was met, they said OH. My request was approved and even extended for an additional 6 months. So be absolutely sure that your policy indicates what they are saying is right before giving up.
   — zoedogcbr

May 30, 2003
Hi,thank you for all your help I am the original poster to this question I have been trying for days to speak w/ a supervisor at ins. comp. and the reps. keep telling me I have to have 1 call me back but they never do I have been in contact w/1 rep. who seems to understand my problem and she says she is going to try to help me w/ it and get medical review to change the date on approval I called yesterday and they said her inquiry is still pending I am so afraid they will have another excuse what can I do if I cant speak to supervisor ?Thank you for everyones help...PS. I even filed aa complaint w/ my states ins. commisioners office and the lady from their keeps asking them for an answer but they dont have a straight answer from them niether but I dont feel as though she is pushing it though she is still working on it also..
   — marie M.