You are confused. Under HIPAA, the company can only look back six months to exclude you from coverage in the group plan for pre existing conditions or can cover you for everything but the pre existing conditions if its group plan allows that. The exclusion can be for a period of up to 12 months, but at the end of the exclusion period the company can look back over the last six months and exclude you again if "medical advice, diagnosis, care, or treatment was recommended or received during the 6 months". In this manner, you could be excluded forever from the group plan.
Frequently Asked Questions about Portability of Health Coverage and HIPAA
Nonetheless, a six month look back period is much shorter than insurance companies would like, however, people who go to work everyday are likely to be healthier than those who cannot make it to work, and as people become sicker, they are more likely to lose their jobs and their health insurance. Insurance companies would prefer a five year look back period to a six month look back period, and a five year look back period would produce lower group rates than a six month look back period does, but the higher group rates the six month look back period produces is somewhat mitigated by the fact that sick people tend to drop out of coverage, but that will not happen under any of the plans now being considered. That means group rates as well as individual rates are going to increase because of the exclusion of a look back period and because the plan will have to continue to pay the costs of people who become too sick to work and would have previously dropped out.
In principle, the shorter the look back period is, the higher the risk to the insurance company and the higher the group premiums are; the higher the drop out rate for sick people, the lower the risk to the insurance company and the lower the group premiums are. Therefore, insuring everyone at standard rates, no look back period, and requiring insurance companies to continue paying health care costs even after some one can no longer work or even pay his/her premiums will raise the cost of health insurance for everyone whether he/she is insured by a group plan or an individual policy. There are no free lunches to be had here.
I have no idea why you think I am opposed to health co-ops. I like the concept and have no problem with the experiment, but since we have had health co-ops and other non profits for decades I see not reason to think these new ones will have any more effect on health care/insurance costs than the ones we already have have had.
yes, i was confusing you with someone else...
ok, what you say does make sense...
but i will say, not one company's insurance in my or my husbands 25-30 year work history, did not cover preexisting conditions from the day the work insurance policy began.
so right now they are at a 6 mo. looking back period but will be going to no months looking back period?
wonder how much higher the costs will go?
According to the estimates from the guy from the University of Michigan, they will go up between 10% and 15% just for the coverage of pre existing conditions. Costing an employee with a family of four another $520 to $780 a year.
Insured might pay more under Obama plan - Health care reform- msnbc.com
Capping out of pocket expenses will cause them to go even higher and requiring insurance companies to continue coverage even after the person becomes too ill to work and pay premiums will cause them to go even higher.
The higher premiums go, the more likely some who now have insurance will be forced to drop it and the fewer who will be enabled to buy with the money available for subsidies. I just don't think it is possible to significantly increase access without at the same time taking steps to significantly lower health care and health insurance costs and nothing that will significantly lower health care and health insurance costs on an ongoing basis in included in any of the plans now under consideration.
sheesh...for a blue cross/bs Anthem individual insurance policy, covering my husband and i, who are both approaching our 50's, with no preexisting conditions and no prescription drugs that we have been prescribed that we have to take regularly, and both non smokers, covering 80% of medical costs, with a $2000 dollar deductible on some things, before they pay a dime, is $2100 a month, $25,000 a year for the 2 of us, here in maine....I CAN NOT IMAGINE it getting any higher than THAT? individual policies on the free market is where the problem lies...the group policy with an employer is 1/3 this amount...why is that?