Individual Health Plans:

 

Question:  I have preexisting conditions and have been turned down by several Insurance companies.  They say that I am not insurable.  What can I do?

 

Answer:  The Risk Pool is specifically designed for persons who are not able to purchase an individual health plan.  This is a guaranteed issue policy.  The risk pool plan will cover your preexisting conditions if you have proof of prior coverage with no more than a 63 day lapse in coverage.  Please go to our instant health quote and view the pricing.

 

Question: What if I can not afford the Risk Pool? Is there any other option?

 

Answer: Yes there is other coverage. We do offer a Guarantee Issue policy that provides limited benefits for doctor, hospital and drug care. Go to the Guarantee Issue health button for plans and pricing.  

 

Question: Does my Doctor Co-pay count towards my Deductible?

 

Answer: Your Doctor Co-pay is a separate benefit and is not applied toward your Deductible.

 

Group Health Insurance Plans:

 

Question:  I am about to complete my COBRA and have cancer, what do I do if I can not qualify for individual medical because of my medical condition? 

 

Answer:  Your best Option is the Risk Pool of Texas.  The risk pool will give you full take over for your preexisting conditions, if you apply and are issued before you have a 63 day lapse of coverage.  DO NOT: allow a gap in coverage, Apply for the risk pool before your COBRA runs out.

 

Question:  I just changed jobs and can not afford COBRA.  I have a preexisting condition.  The waiting period for my new job is 90 days.  Will this condition be excluded under my new plan because I have exceeded the 63 day clause?

 

Answer:  No.  HIPAA does not allow an employers waiting period to count against the 63 day clause.  You could enter the waiting period with no insurance for 62 days (two 31 day Months) and start a 90 waiting period that states the first of the month following 90 days of employment.  You would qualify for 100% take over.  PLEASE NOTE: any medical expense you incurred during the 62 days and waiting period will have to be paid by you.  

 

Medicare Health Insurance Plans:

 

Question: I live in a rural area and cannot afford a Medigap plan.  I make to much money to qualify for Medicaid, what can I do that may be affordable. 

 

Answer:  You may consider Government Part C plan.  The part C option that may work for you in a rural area would be a PFFS plan. (Private Fee for Service Plan).  Before you sign up for one of these plans ask your Physician if he will participate.