"Don’t Hang Up!"

The nice lady called about 4:30 on a Tuesday afternoon (and no, the sky was NOT “dark and gloomy.” Sheesh). She was calling, she said, to find out about health insurance for herself and her family.

She’s self-employed, and her husband wants to quit his job to come work with (for?) her, but they’re loathe to give up his benefits.

It’s then that she literally begged me “please, don’t hang up.”

As one would expect, I was a bit puzzled by this. Why would I hang up on her? Well, "because everyone else has” once she disclosed that she’s a Type I diabetic. I simply responded “well, you just weren’t talking to the right agent.”

One of the first things one learns in this business – and then most of us promptly forget – is to ask a lot of questions. Which I proceeded to do. It turns out that she’s actually on several meds, including self-administered insulin injections, and she has some other problems, as well. She and her husband desperately wanted to be in a position for him to quit his job, but were faced with job-lock due to her condition.

Sometimes, things seem hopeless, because you’re too close to the problem, and because you just don’t know about alternatives. It’s an agent’s job to inform prospects and clients about these options.

Turns out, there are several guaranteed issue plans that may be of value to her, and she’s eligible for COBRA, which offers an avenue to longer term coverage, as well. In fact, the COBRA option may be her best bet:

By electing COBRA continuation, and keeping it for the full 18 months (for which she is eligible at this point), she fulfills the critical test for a HIPAA guaranteed issue plan. Assuming she’s still uninsurable at the end of COBRA (which, let’s face it, she will be), she can then transition to another plan, one which will continue to cover all her pre-existing health problems. None of this is cheap, of course, but I submit that it’s still less expensive than going “bare.”

In this case, procrastination is “a good thing.”

Oh, and since her husband is quite healthy, it’s no problem setting him up with his own major medical plan. Problem(s) solved.

ADDENDUM: This is an example of why it’s so important to work with a local, independent agent, as opposed to one of those online services. The anonymous person at the other end of the 800# or email has products and knowledge geared toward the “normal” case. Throw any curveballs (such as diabetes, or thyroid conditions, etc) at such a service, and the most likely response is “Sorry, can’t help you.” Granted, they are unlikely to hang up on you, as apparently happened to this woman. But they’re not going to be much help, either. A knowledgeable pro will know about guaranteed issue plans, HIPAA and COBRA issues, and even non-insurance alternatives.

‘Nuff said.