Individual PPO to employer
Jul 16, 2007
My question wasn't understood. So let me be a little more specific.
I have an individual PPO plan through Blue Cross that I've had for over five years, because my employer is small and has no health plan.
Last year I tested HIV+ and have since started treatment.
What is my situation should I move my employment to a new company who provides a group plan?
Should I plan on staying with the individual plan forever irregardless of what a new employer may provide?
Response from Ms. Franzoi
I cannot advise you regarding whether or not you should leave your current employer to work for an employer who offers a group health plan. That is a decision only you can make based on employment opportunity, benefits, compensation, etc. However, here are some factors to consider.
a) Analyze the cost to you of your individual BC PPO plan - monthly premium, out-of-pocket expenses, etc. Evaluate the benefits it provides you. Are there annual or lifetime maximums? How are prescription drugs covered? Etc.
b) Depending on what employer you might look at for new employement, the health plan offered there could be more valuable than what you have - lower monthly cost to you, possibly a lower deductible and/or a lower co-pay, more generous prescription drug benefits, etc. Group plans, especially large group plans, typically offer better benefits at a lower cost than an individual plan.
c) If you were to get a new job with group health benefits, continuing your individual plan would be costly. Once you are covered under a group health plan, if you were to lose coverage you would be eligible for COBRA (assuming the new employer is large enough to be required to offer COBRA) and at the end of COBRA, a HIPAA policy.
d) If your current employer is small, do you have disability benefits? If not, that would be a consideration if you were to become employed by a larger companny with a full spectrum of benefit programs.
I hope this is helpful.
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