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University Health Insurance Policies
Aug 21, 2007

I was fairly recently laid off, and my severence-paid coverage expired a month ago. I've enrolled in my former employer's COBRA plan, and I've applied to a graduate school.

I looked at the health plan the university offers, and noticed that it only pays a maximum of $750/year for prescriptions. Not really surprising, given the low cost of the plan, but that does not even cover a month of what I'm on currently.

Obviously, I'm going to stay on my COBRA for as long as I need it.

But before COBRA expires, if I enroll in the University plan -- and end up having to pay out of pocket for prescriptions when COBRA coverage does expire.... will I have any "pre-existing conditions" issues later down the line if and when I get an employer plan that would pay for my prescriptions (like I have now). Or would the university's coverage be adequate to avert that?

Response from Ms. Franzoi

Under a federal law, HIPAA, if you qualify for coverage under a group plan or an individual policy and you have not had a break in coverage that is 63 days or more, even if the new plan has a pre-existing condition clause, the clause can't be greater than 12 months and the plan must recognize your prior periods of coverage towards that pre-existing condition exclusion period. Therefore, the prexisting exclusion won't apply to a person who gets coverage within 63 days of his COBRA coverage ending. It might be best for you to review your options once COBRA ends, i.e., an individual HIPAA policy v. the university plan. Although the HIPAA policy will be more expensive, it could provide better benefits. Any insurance company that sells individual policies in your area must offer HIPAA policies.



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