Updated 5/27/11
The purpose of this document is to provide resource information for individuals looking for individual health insurance options.
The scope has been limited to the 5 key states:
- California
- Oregon
- New Mexico
- Arizona
- Massachusetts
Key questions and issues
- Are you currently undergoing any ongoing treatment or treatment that may
be disrupted as a result of the change in health plans? - Are you taking any prescription medications?
- Are you taking any specialty drugs?
- Are you receiving treatment from either an inpatient or outpatient facility?
If yes, are these facilities participating in the plans you may be considering?
- If you are not currently undergoing any treatment, is there treatment
planned for the future? (pending outpatient surgery etc.) - What is important to you: choice in Providers (primary care/specialist), copays, lifetime maximums, monthly premium, drug coverage, out-of-pocket maximums?
Plan & Coverage Features
Individual Plans – A type of insurance plan for individuals and their dependents who are not eligible for coverage through an employer group (group coverage).
Ensure you understand the plan benefits and limitations
- What are the exclusions? i.e. transplants may be excluded
- What are the plan limitations? i.e. benefit maximums or plan maximums
- Are you required to access care via in-network providers only?
- What is coverage when out of the area?
- Are there any pre-existing coverage exclusions or limitations?
- Are there any coverage wait periods?
The Intel Retiree Organization is a volunteer organization that does not
endorse any business nor accept paid advertising. Information on our
website or in our newsletter is provided as a service to Intel retirees and
readers should not act on the basis of any information on the website
without first obtaining advice relevant to their specific situation from Intel
or from appropriate professional advisors.
Government Programs
- Medicare is the name given to a health insurance program administered by the United States government, covering people who are either age 65 and over, or who meet other special criteria. http://www.cms.hhs.gov/
- Medicaid – a program of medical aid designed for those unable to afford regular medical service and financed by the state and federal governments Note: Medicaid waiver programs are managed by each individual state and do not transfer across state lines. If you move you will have to reapply and meet the new state’s eligibility guidelines. http://www.cms.hhs.gov/home/medicaid.asp
- Military Coverage – As a member of the military community, one of the most important benefits you’ve earned is comprehensive health care coverage. TRICARE is the Department of Defense’s health care program for members of the uniformed services, their families and survivors. TRICARE also offers health care programs for retired service members, including TRICARE Pharmacy, TRICARE Dental (United Concordia), and TRICARE for Life. http://www.military.com/benefits/tricare
- CAL COBRA – CA law may provide an extension of COBRA continuation coverage up to a total of 36 months for participants covered by a CA HMO. Intel’s self insured plans which include Plan Name are not subject to Cal COBRA.
Key Points to Consider
As you explore obtaining individual health insurance it is important to be aware of the following key points:
- Companies selling individual health insurance typically require a review of your medical history that could result in a higher premium or you could be denied coverage entirely.
- If you are denied coverage, you can contact the health insurance company who denied your coverage directly for information or contact your local health insurance agent to assist you in selecting and enrolling in a health insurance plan.
- There may also be state programs that can help provide coverage if you are denied, if you have dependent children or if you met income/resource guidelines.
- Review each state’s resources and use them as appropriate to act as a guide.