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The High Price of COBRA Insurance and Preexisting Conditions

Posted on: April 26th, 2012 by Cobra Insurance Guide

No family ever predicts that a serious medical condition will hit their family, but sometimes it happens. Families suddenly find themselves facing decisions they never expected and many times facing health insurance bills they can’t fathom. Making this situation all the more complicated is that many times in the face of serious illness, people are forced to quit their job to care for their loved ones, and that’s when COBRA insurance comes into play. For some people COBRA insurance can be an incredible option in this situation, but for others, it can quickly become more expensive than they could ever imagine. To help understand this better, let’s look at two different families in similar situations, but apt to make very different decisions.

Our first family recently found out their son had cancer and will need almost around the clock care during his treatment. His mother is happy to provide that and preparing to quit her job in order to take care of her son. Her husband is self employed and does not have health insurance. Previously the entire family used her health insurance. Unfortunately, her company recently needed to cut costs and drastically changed their health insurance plan. The HMO has a deductible of $30,000 per family per year and the premiums have skyrocketed. While she was employed, her employer continued to cover 80% of the cost. After quitting her job and looking at her COBRA election form, she learns that health insurance for her family will cost over $7500 monthly due to the lackluster health insurance plan and her son’s condition. That is over $90,000 annually plus the $30,000 deductible which they will definitely use given her son’s condition. In all, her family will spend $120,000 this year on health insurance, a number they can’t afford.

Our second family also recently found out that their oldest daughter has a serious stomach condition and will need weekly medical care. She also will need constant care at home for at least the first 6 months. Facing the same decision, the family decides that they will stay at home to care for their daughter and use COBRA insurance coverage for the 18 months. Luckily for this family, the health insurance plan they are using is very good. Even with COBRA insurance they will spend $1500 monthly for their health insurance with no deductibles and minimum co-pays. Given their child’s preexisting condition, they know this is the best rate they can get.

So what can the first family do? It wasn’t there choice for the insurance plan to change and there is no way to afford $120,000 in medical care. Right now, they have a few options to cut their costs. First, they can consider only ensuring their son with COBRA and moving the rest of the family to an individual plan. This will cut some of the costs, but probably not drastically enough. Secondly, they can look to put their son on a pre-existing condition plan, or PCIP, and look for the lowest rates available. They will not be cheap but they will likely be less than COBRA insurance. Finally, they can explore government and state insurance plans and see what their options are. Depending on the state there may be options that can help cover the costs. Another option, finding part time work with health insurance. Starbucks for example offers health insurance to it’s part time employees.

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