Totally confused about Florida health insurance! (Jacksonville: buying, living, price)

[AstridMonster]

Hi. My husband and I looking to move from Connecticut to Jacksonville. CT is super expensive, and we can't afford to live here anymore. The only thing we foresee being a problem is health insurance.

In CT insurance companies can't exclude or charge you more for pre-existing conditions, but it seems in Florida they can. I noticed this seems to be common on individual plans in FL, but can group plans through your employer also have exclusions? Do your health plans cover prescriptions? I seemed to find lots of info on individual drug plans.

The last and most important questions is regarding mental health coverage. In CT you have to cover (my husband has bi-polar disorder), which without insurance can be really expensive (prescriptions w/o insurance are almost 3,000 a month). I heard that many employers have "counseling plans" that you pay for separately directly to the employer.

All of this is really confusing, can anyone explain to me? CT is easy, everyone is covered through their employer. The last thing we want to do is get to FL only to find out it will cost us more then staying in CT because of insurance costs.

Thanks.

[jcs2000]

Bingo. Now you understand one reason CT cost of living is higher--someone has to pay for all these insurance mandates. If you are getting a job through an employer, generally pre-existing conditions, will be covered. The amount of mental health benefits will vary by the policy selected by your employer. If buying an individual policy, you will have to pay to cover both the pre-existing condition as well as mental health benefit. It may be difficult, however, to find an affordable policy. My recommendation would be get a job in JAX first and then see if the benefits will be enough to offset higher insurance costs. You could also consider moving to MA to be covered by the government exchange, but again that is a very pricey place to live.

[AstridMonster]

Thanks! I have some call backs on jobs already, so hopefully I can get in under a group plan. I think that an individual plan would be too costly for us if we would have to cover pre-existing conditions.

[kdubose]

You will definitely save ALOT of money if you can get in with coverage on a group policy through an employer. With individual plans, you will have to be underwritten and they will pull your prescription history and med records and for every little thing that is not "ideal" you will have a rate up percentage over the standard rate.

With your husband having bi-polar, I can guarantee that they will rate him up for that. It is usually somewhere between a 20-35% rate up depending on the company. So for example if you have a 40 year old male with a standard rate of $250 a month and he has bipolar disorder with a rate increase of 30%... then he will be charged $325 a month instead.

There are also so many other factors that are taken into consideration for rate increases... smoking, height/weight ratio, any meds that could suggest a problem (hypertension, high cholesterol, depression).

If the rate ups end up equaling over 100% then you will be declined and cannot get insurance through that company... and chances are if you are declined with one company then you will most likely be declined with all you apply to.

Individual plans that you have to be underwritten for are hard to get approved at a standard rate unless you are in tip top health and body shape.

Each company has different plans and within those different plans are covered benefits. One may cover mental health whereas another may not.. you really have to break down the plan options to find the one that will cover exactly what you need it to. Its the same with prescription drug coverage, some companies actually have this as a separate plan from your medical coverage because they will give you different prescription plans to choose from. 1 may have generic only coverage (which is always the cheapest) but another may cover brand names and generics at the 3 tier costs... just fyi that your prescription drug plan will also be rated up if you are so (un)lucky to get a rate up.!