Message Font: Serif | Sans-Serif
 
No. of Recommendations: 0
Hello fellow retirees and others,

I have an odd insurance situation. My wife and I are separating physically, but not legally, if you get the distinction. She's still working, I'm not. I am moving to Indiana. She is staying in CA. She has group coverage at work, and I'm covered under that for California doctors etc. It won't cover anything in Indiana except emergencies. I've been looking at insurance coverage and I can probably get a high deductible high copay policy for about $100/month. But, doing the mental math, I'm not sure I need to do it. My regular doctor has reminded me that there's nothing really left to test. We know I have fibromyalgia, peripheral neuropathy, and IBS. At this point, I'll just need a doctor in Indiana for maintenance meds, flu shots, and the occasional cold. Emergencies will be covered by the wife's group plan. If it were something really serious and I could make it to CA, treatment wouldn't be a problem.

I'm really considering just leaving my insurance as it is. Would I really benefit from paying that $1200+/yr for premiums, considering my situation? IOW, I think it boils down to: will I be paying more than $1200 premium, plus $2500 deductible, plus 50% copay if I just pay the doctors cash for my health maintenance?

Things could change, of course, but at this point, it doesn't seem to make any financial, or other, sense to get lawyers involved in our affairs.

Hedge - discovering that there's just too much nonsense involved in getting disabled
Print the post Back To Top
No. of Recommendations: 2
I'm no expert but one thing I remember from my working days. When two insurance companies are involved, things get complicated. If you purchase your own insurance and are still on your wife's policy, her carrier will become secondary to yours. Talk this over with an insurance agent you trust, but I think you might be needlessly complicating things by getting your own policy.

You don't say how long this situation is expected to last. That could be a factor in the decision too.
Print the post Back To Top
No. of Recommendations: 1
She has group coverage at work, and I'm covered under that for California doctors etc. It won't cover anything in Indiana except emergencies.

You should also check the fine print on your wife's coverage. If there are geographic residency requirements, except for "temporary" absences, and the insurance company gets wind of your relocation you could run into trouble despite your legal marital status.

Phil
Print the post Back To Top
No. of Recommendations: 0
I've been looking at insurance coverage and I can probably get a high deductible high copay policy for about $100/month. But, doing the mental math, I'm not sure I need to do it. My regular doctor has reminded me that there's nothing really left to test. We know I have fibromyalgia, peripheral neuropathy, and IBS.

Not to rain on your parade, but...
...are you certain that you would qualify for an individual plan?
Insurers are quick to not accept anyone with chronic and/or recurring conditions.

My DD was born with atrial and ventricular defects ("hole in the heart").
The atrial defects self-repaired by her 4th year. Her ventricular defect has closed +/- 60% and is likely to be closed by her teens.

However, when I converted from an employer's group coverage to an individual plan, she could not qualify. They are rejecting coverage since her defect has not been surgically corrected. Her cardiologist has no expectation that she'd ever need surgery. She is disqualified for not having something done that she doesn't require.

Speaking to her cardiologist, this is a routine paradox which he not ever seen anyone overcome by challenging the insurers.

What she does qualify for is a HIPAA plan, where if she's rejected by insurers, they have to convert her to a plan. It's more expensive than my son's and my premiums combined and has 2-1/2 times higher deductible.

Even if you're not going to do it now, you may want to go through the application process to see if you'd qualify. Then you'll at least know if you need to pursue alternatives and could be working on those while you're still under your wife's plan.

Also check her plan, I seem to recall that you'd still qualify for coverage under COBRA should you decide to later divorce. It's been over 4 yrs since I waded through that morass and my recall is fuzzy.
Print the post Back To Top
No. of Recommendations: 0
Hi SisypheanFool,

Yeah, it's a morass, and TBH, I'm not truly sure I could qualify. I've just been going by the online estimators. COBRA conversions are hopelessly expensive, so I haven't even bothered looking at that. I have filled out a couple of applications to see what they come back with. But, it really doesn't matter, I guess. What is, is, and I'm not going to spend time worrying about it.

thanks for the input,

Hedge
Print the post Back To Top
No. of Recommendations: 0
Hi Phil,

She works for a small insurance company, which provides the health coverage. They've already given us an internal statement on what we can expect.

Hedge
Print the post Back To Top
No. of Recommendations: 1
Based on what you say, a few of questions come to mind:

#1 Do you reasonably expect to spend over $4,000 in non emergency stuff each year? If not, I don't see how you can justify additional insurance if the coverage from your wife really does cover you.

#2 Check the fine print -- there are issues for dependents (usually we think of college students here, but you are one here) insurance and out of state. Like college students, be careful what you do in terms of voter registration, where socical security, etc. checks are sent. You want to keep a legal residence with your wife. Keeping your voting, banking, state income tax, etc. there goes a long ways.

#3 If you plan on trips back to CA, you could schedule medical visits during those trips would would reduce your out of California medical costs further.

Gordon
Atlanta


Print the post Back To Top
No. of Recommendations: 0
Hi Gordon,

Your thinking on #1 obviously matches mine. And Hal's (I think it was Hal) comments on insurability are right on the money. I just spoke to a rep, and he told me that my chances of getting insurance through any of his carries was pretty much nil.

I'm not sure how I can effectively manage the issues you put forth in #2. I'll have to look into it.

As to #3: yeah, I was thinking that any non-life threatening issues could be taken care of by a trip back to CA.

I've still got to file for SS disability. I think my chances are very good for that; in which case, things will be pretty good for me.

Hedge
Print the post Back To Top
No. of Recommendations: 0
Not to rain on your parade, but...
...are you certain that you would qualify for an individual plan?
Insurers are quick to not accept anyone with chronic and/or recurring conditions.


Well, at least my leg's not the only thing wet. :o) Yeah, you were right, and I should have realised that from the start. I just got a call from an insurance rep, and after a short conversation, it's clear that I'm not going to be getting personal health insurance. Ah, well. I've been without insurance before. :o)

Well, maybe someone out there in Fool-land who's a little shyer than I am, about posting, is getting some benefit out of my experiences on the way to a (hopefully) successful retirement.

Hedge
Print the post Back To Top
Advertisement