Thursday, February 14, 2013

Till death do us part

As many but not all of you know, last week Laura and I got married. This was an unforeseen event, as our plan was—and still is—to have a wedding at the end of next month. But on Tuesday of last week we drove to the courthouse, met up with our two witnesses Nick and Bobby, and paid the J.P. to make everything official ahead of schedule.

Usually when a couple gets married in a rush at a courthouse, there's a fetus involved. That was evidently the case for one of the other couples at the courthouse that day, but not for us. Why else do couples get married in a rush? For legal residence? To piss off a parent? Or maybe just out of impulse? In our case, it's because of health insurance.

A few weeks ago I developed a medical condition that I thought might need moderately expensive medical treatment to fix. We're not talking a break-the-bank amount of money, but rather an amount for which it's worth looking into possible loopholes to exploit. Of course, not being the responsible type who buys individual coverage for himself after quitting his job, I learned the hard way what it means to have a preexisting condition and what that means for getting insurance to pay for preexisting-condition stuff. The short answer is: it's probably easier to buy homeowners insurance for a house that's already on fire than it is to get coverage for a preexisting medical condition. Several hours of detailed research on different health insurance plans revealed to me that health insurance companies have spent a lot of money employing people to think about preexisting conditions and ways irresponsible people like me might exploit the insurance companies. Hence we have health insurance companies that everyone hates.

Anyway, in doing all that research, I learned some interesting facts relating to health insurance and preexisting conditions. Here are some quick points worth knowing.

  • Every health insurance company describes preexisting conditions and the subsequent exclusions differently for individual coverage. But they all reduce to the same effect: if you show symptoms of a problem in the months (or years) prior to buying coverage, that preexisting condition won't be covered.

  • However, if you've been covered under a plan within the last two months, you're probably OK. Having prior coverage shows that you're not an irresponsible jerk looking to save money after you got sick. Instead, you're a responsible person whose coverage happened to lapse for a short time.

  • The two previous facts are about individual health insurance plans. Since the passage of HIPAA in the 1990s, group health insurance plans can't exclude persons because of a preexisting condition—if that person hasn't in the last 12 months gone to a doctor for that condition. This is why chronically sick people need a job with a group health plan (or else they need a spouse with a job with a group health plan)—it's the only way to get insurance once you're sick.

  • Starting Jan 1, 2014, ObamaCare—a term now endorsed by the President himself—will force all health insurance companies not to exclude preexisting conditions for individual insurance plans.

  • Meanwhile, until that provision of ObamaCare takes effect, there's a government-provided plan called Preexisting Condition Insurance Plan that provides exclusion-free individual health insurance to people with preexisting conditions. But you must have been without coverage for at least six months to qualify.

  • Thus, if you've been without insurance for more than two months (i.e., more than the amount of time insurance companies are OK with your benefits having lapsed) but for less than six months (i.e., less than the amount of time that qualifies you to go on government PCIP), you're currently in preexisting condition no man's land and probably won't find coverage for your condition.

I was in no man's land, but I had a way out—marriage. Now newly married, I'm eligible to go on my wife's health insurance plan—should I elect to do so. But that health problem I mentioned at the beginning of this post has mostly cleared up, and I think I'll instead go with the cheaper option of buying individual coverage. So if ever Laura is asked why she married me, she can answer with the honest truth: she was tricked into it.

7 comments:

Unknown said...

The health insurance junk is so confusing and frustrating, it makes my head swim! (Sounds like for now, you are okay in the department, so I'm glad.) BUT, that's not going to stop me from saying CONGRATULATIONS! So happy you have tied the knot. What a surprise! May your marriage be long and happy.

(Sorry for the multiple parentheses:)

Unknown said...

PS--Bring Laura to Houston next time so we can meet her!

Craig Brandenburg said...

Lindsey— Don't let the health insurance industry drive you crazy—because they won't cover all mental health expenses!

Bobby and the Presidents said...

I heard y'all had an incredible wedding photographer -- post pics!

Craig Brandenburg said...

Bobby et al.— Yes, we had a great wedding photographer. As for posting those pictures, Laura's in charge of that, and she should post pics eventually. I recommend hounding her until she does so—but don't tell her I said that.

calc said...

Good job, and Congratulations!

(albeit a bit late). :-)

Craig Brandenburg said...

calc— Thanks!