Any good individual medical insurance plans in TX?

[peejay 327]

I added my (then 18 years old) stepdaughter to my employer's group medical insurance plan after I married her mom in 2004. Unfortunately she dropped out of college at age 19 and was no longer eligible to be on my employer's group family medical insurance plan. I was able to continue her medical coverage by paying an extra $233.41 per month through C.O.B.R.A. (Consolidated Omnibus Budget Reconciliation Act health benefit provisions of 1986) that allowed group coverage to be extended for another 36 months at extra cost. Unfortunately the 36 months has passed and my employer's group plan is no longer required by law to extend her group medical coverage. Her group medical insurance will end on January 31st. The insurance carrier declined to offer her an individual plan coverage.

My stepdaughter's employer does not offer any group medical insurance plan or benefits. She gets a paycheck and nothing more.

We applied for a high deductible individual plan through Blue Cross Blue Shield of Texas and the application was denied yesterday. They refused to even cover her and denied the application while pocketing the $30 application fee. It took BCBS-TX nearly a month to decide not to cover her and now we face the prospect of no medical insurance for her after January 31st.

My 22 year old stepdaughter is in relatively good health, but is successfully treated for epilepsy through medication. I can't believe they would deny her coverage just because of that. #######?

Does anyone know of any reputable individual medical insurance plans offered in Texas?

Edited January 19, 2008 by peejay

[Dr. Obvious 49]

It is possible that if she was denied once, she would more than likely be denied again. Individual plans are only for people who have no medical history, under 40, healthier than horses, ie, people who would never use it. I have no idea what your state (Texas?) offers for health coverage or what her income would be considered as, but that may really be an option if she cannot get employer coverage. Some states have plans not exactly tied to Medicaid so the income limits are higher.

[peejay 327]

It is possible that if she was denied once, she would more than likely be denied again. Individual plans are only for people who have no medical history, under 40, healthier than horses, ie, people who would never use it. I have no idea what your state (Texas?) offers for health coverage or what her income would be considered as, but that may really be an option if she cannot get employer coverage. Some states have plans not exactly tied to Medicaid so the income limits are higher.

In Harris County (Houston) the county hospital district offers offers a government subsidized HMO type plan in which participating patients must go to only county operated clinics for basic care and pay on a means tested basis. Legal immigrants are accepted in the Gold Card program. IMO it appears to be bare bones indigent care and very limited. I don't know the details of the coverage or the maximum liability. I'm not even sure if she qualifies, but she probably does because her income is so low.

I will get quotes and apply at Humana, Aetna, Unicare, and some other carriers before I resort to the county system. Surely someone would underwrite a bare bones high deductible emergency hospitalization plan with a total out of pocket of $8000 max.

I could keep her on my employer's plan until she is 24 years old if she would just go to college as a full time student. The problem is that she won't attend classes even when I pay 100% for books and tuition. Her mom and I tried to send her to college, but she cut classes and flunked out. What a waste. Very frustrating for me. It is a big liability for sponsors of immigrants that signed an I-864. One accident can ruin you if the government chooses to go after you.

The private, profit driven system is not the answer for American healthcare. The way things are now is not acceptable IMO. It is a profit driven rip off for necessary services that are not a frivilous luxury.

These people are setting themselves up for eventual socialized medicine. Their chickens will eventually come to roost and they will richly deserve it IMO.

[Collie 122]

I empathise with your step- daughter as I too have epilepsy and before I had insurance through my work, we were paying $210 for my medication every 30 days as opposed to $15 now.

There is a plan by Aetna called the vital savings plan Vital Savings by Aetna. Its isn't insurance but it offers discounts and may be worth looking into?