Small crimp in my health care gaming strategy

Posted: August 7, 2010 in Health

After reading a story on TechCrunch about the new government health care website healthcare.gov I paid it a visit and checked out the page that discusses the Pre-existing Condition Insurance Plan. There are three conditions to quality for the plan:

  • You must be a citizen or national of the United States or lawfully present in the United States.
  • You must have been uninsured for at least the last six months before you apply.
  • You must have had a problem getting insurance due to a pre-existing condition.

It is that last bullet that puts a small crimp in my strategy for gaming the new law. If you read my original post you recall that the approach was to not buy health insurance and instead pay the penalty because it is on average only one-fourth the cost of insurance. But then if you anticipate needing insurance you buy it because you cannot be denied for pre-existing conditions under the Affordable Care Act. The requirement that “you must have had a problem getting insurance due to a pre-existing condition” adds a small complication to the tactic. You are going to have to first apply for insurance and get denied, then go and apply for the pre-existing condition insurance.

Details of the pre-existing condition plan are at http://www.healthcare.gov/law/provisions/preexisting/index.html You can get a cost estimate by state at the site. For example, a 50 year subscriber in San Francisco would expect to pay $575 premium with a $1,500 deductible and $2,500 total out of pocket.

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