I have pretty good Cobra Insurance  (Health Net PPO, eligibility expires 12/17), however, I am concerned with the current political climate, Obama Care may go away

***Here’s where I’m keeping up on the status. donaldcare.healthreformquotes.com

and when I am no longer eligible for Cobra, it might be difficult to get insurance due to pre-existing condition or other medical related risk factors becoming a factor as they were in the past. To protect against that, I would like to get a Blue Cross PPO now

***Click here to get proposals, benefits, subsidy calculation etc.

In the past we had HIPAA for those who lost COBRA.  There was also MR. MIP – High Risk Pools.

and just continue it until my Cobra expires.

***Losing COBRA gives you a Special Enrollment Period

So therefore, I would have two health plans. My current Cobra group plan and an individual/family Blue Cross PPO plan.

The questions I have are:

  1. Can I have two health plans (I’m not trying to commit fraud, I understand I cannot get paid more than the bill).
    1. Dual Coverage & Co-ordination Rules
    2. Let’s see if the question is asked on the paper application  –  I’m looking at doing this direct, no Covered CA no subsidies.  For subsidies, the answer would definately be NO.  
      1. Question G 2 asks about other coverage and if you plan to cancel it.  So yes, you would have to disclose other coverage.   I doubt they would write you.  If it’s that important to you I could email them and ask.  I could also check the ACA rules and see if the ACA law says you can buy coverage, even if you have other coverage.
  2. Do I need to tell Blue Cross?
    1. Yes, since they ask.
  3. Can I pick and choose who I want to use, if Blue Cross
    1. Please get a quote proposals, benefits, subsidy calculation.   I don’t think Blue Cross has a PPO in your area.  Try Blue Shield.
  4. has a doctor I like or pays more benefits for a particular procedure, can I only use them.
    1. These questions are quite complex and I think I’m going to have to charge a research fee for them.  Under ACA, I practically have to work for free.  See our page on Dual Coverage, see also the rules in the current evidence of coverage, if we can even get you an extra policy, that we do NOT recommend that you purchase!
  5. The same for Health Net PPO, use them if they are more beneficial for the procedure I have. – Please answer for Blue Cross, I have already got Health Net’s comment.
    1. Verbal comments are worthless!!!
    2. See the rules on dual coverage, basically the 2nd company pays up to 100% of what the first one didn’t.  It may well be that there is NO co-ordination of benefits clause on two INDIVIDUAL policies.  Thus, you could collect more than 100%, which is why I don’t think you will get a policy issued, if you plan to keep the first one.
    3. Note too, that I won’t give an answer, unless I can show it too you in writing or the law.   I don’t want to have to pay the claim out of my pocket.
  6. My intent it to cancel my Health Net policy down the road
    1. I think you should keep it, till you really want to move and it expires.  There is also Cal COBRA, which gives you another 18 months of coverage.
  7. but I have had it for 15 years and am leery just to let it go.
  8. Also, I go to doctors who do not take insurance. Can I go to doctors who do not take insurance and not let Blue Cross know I am having a procedure done?
    1. If you have a PPO, you could still turn in the claim.  When  a MD says they don’t take insurance, that just means they don’t agree to the negotiated rate, they still will cash the check.
  9. Usually the bills are below the deductible or I don’t want to wait for an approval – like an MRI)
    1. The question is beyond my pay grade.


Ok this might be an unusual question, also the extra money for premium payments is not material to me right now.

Leave a Reply

Your email address will not be published.

wp-puzzle.com logo