Does it ever make sense to switch health insurance plans?

[jess_g]

If you have a child with a pre exsisting condition and you know that other plans that you could get through your employer cover more things that the child needs, would you switch during open enrollment? We have been with the same company for years, but everytime around open enrollment I always wonder if we should switch. Any great words of wisdom on this issue? Are medical expenses could be very expensive without the right insurance so we don't want to loose what we have but its hard working within the limits of an HMO sometimes.

Jessica.

ETA: Now I am realy embarrassed. I ment to post this in the lounge. I think I am too chicken to switch right now anyway. -Jessica.

[wellyes]

No great words of wisdom, but I've switched insurance carriers a few times over the past few years and it's really no big deal. All it means is you have to make a few phones calls in January to inform doctors / practitioners of your new coverage. If there's a reason to switch, I wouldn't (don't) hesitate to do so.

[lmr1101]

I would just be VERY careful right now -- considering long term coverage. With Health Care Refrom still so "unfinished" nearly every major insurance carrier has stopped selling individual plans for children... at least in AZ. (They have done this because the HCR bill says insurance carriers cannot deny children under 19 due to pre-existing condidtions -- so it's easier, for the carrier, to just not sell any coverage then be forced to cover the children with pre-existing conditions.)

Right now, joining a group plan may provide great coverage for your child, I would just consider if you may need to find an individual plan down the road. Group plans won't deny children, but individual plans can and I wouldn't want you to be stuck later if you no longer work for that group.

Just fyi, I'm an insurance broker in AZ so there may be different state rules where you live but out here that is now how it works :(

As for moving plans, that is fairly easy and if you decide to move you should be able to make an easy transition.

Good luck, and again my experience is only for AZ, but this industry is changing so much right now it's pretty scary.

[vball4all]

Its nice to have folks like lmr1101 on here with some experience.

I'm just a regular mom ;) I've had no problem switching insurance companies at my work during open enrollment...and switching to my husband's during open enrollment. I have also added my husband (and kids) during an "event". In the past, we've mainly made sure that there are no gaps in coverage...not even one day (this was a clerical error one time, and it took a long time to straighten it out). We don't have any "existing conditions" - so I don't know if that makes a difference (adult or child)...I don't think our insurance differentiates (at work). We have not looked at independent policies outside of our employers. Do your employers have a HR/Benefits person to talk to?

I agree with lmr1101 that the upcoming healthcare changes seem scarey...I'm sure it will benefit a few, but, it just makes me nervous.

Good luck - i hate thinking about insurance!

[Tinkerbell313]

We have switched insurances and insurance companies during open enrollment. I personally have a pre-exisiting condition. Our prior insurance companies have always provided us with a certificate of prior coverage (this is very common) and we just provided it to the new insurance company. As long as there have been no gaps in insurance coverage there is no denial of claims. We have done this in three different states.

Certificates of prior coverage can be printed off of our insurance companies website.

I have done this with US Healthcare, Aetna, BC/BS, Optima (may have a different name now), and one other insurance which I cant remember.

[applebutter]

I'm also a broker, in WA state. I'm surprised no one's mentioned HIPAA. As long as your DS has had continuous coverage, he won't have any issues with pre-existing conditions.

If you lost your job, and were unable to move DS to your spouse's plan, DS could continue on COBRA for 18 months. In WA state, one can move to an individual plan without having to satisfy a health questionnaire, so one can't be denied.

The only reason I would keep my son on an individual plan is if the benefits were richer than I could get from a group plan, and my child had serious health concerns and needed the rich benefits; or, if the rates were better than those through my group plan.