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A friend is moving from New Jersey to Pennsylvania this year.

I was told by a...
A friend is moving from New Jersey to Pennsylvania this year. I was told by a rep at his health insurance company that he would have to get new insurance because the New Jersey health insurance coverage is different than the PA coverage. It's very important that we know before he moves because he was diagnosed with Early Onset Alzheimers. Can someone get us a definitive answer on this?
Hi insurance is with United Health Care (New Jersey)
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Answered in 5 minutes by:
4/26/2013
Tina
Tina, Lawyer
Category: Legal
Satisfied Customers: 33,167
Experience: JD, BBA Over 25 years legal and business experience.
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Hello and welcome. My name is XXXXX XXXXX my goal is to provide you with excellent service today. I am sorry to hear of your friend's difficult situation. Before I can give you an accurate answer to your question, please provide the following additional information:Is your friend insured through the state of NJ's high risk insurance program or some other government-sponsored plan or does this involve a private policy? It is not through an employer?I look forward to assisting you as soon as I have received this information. Thank you.
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Customer reply replied 4 years ago

Hi insurance is through his former employer and it is a regular policy. Not a high risk or government policy.


 


His former employer wanted to spare him having to pay a high premium to a Cobra plan and offered to extend his participation in his group plan as long as my frind pays the premium.

I see. Thank you very much for that additional information, Gloria.Since it is an employer-sponsored plan, it would typically be necessary to review the terms of the plan. It, like other private plans, can be limited to coverage in a single state. There are national private plans as well, so it is impossible for me to say with any certainty as to which type of plan your friend has.What I can say, is that if your friend determines that the policy only covers in-state services, then he will need to obtain a new policy in PA. His plan administrator or customer service should be able to answer this question for him.I am looking now for plans available in PA that your friend may apply for and will post it here once I obtain that information for you.
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Hello again, Gloria.Unfortunately, PA has suspended applications for its federally-sponsored high risk health insurance program, so your friend could not gain coverage through the state I'm afraid. Since he does have a pre-existing condition, I would expect him to be denied coverage for other plans unfortunately, unless he qualifies for Medicaid once he is a resident of the state.Therefore, if his employer-sponsored plan is not a national plan, he should not move to PA if at all possible, or continue to maintain residency in NJ.Here is a link to the PA high risk plan, which indicates enrollment has been suspended:http://www.pafaircare.com/I hope this helps clarify the situation for you and your friend. Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!Tina

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Customer reply replied 4 years ago

Hi Tina
Thanks for the suggestion to review the actual plan the company offers to
get a clearer answer. I failed to mention that my friend will qualify for
Medicare in March of 2014. How will this effect his coverage?
He needs to move to Philadelphia because his Alzheimers will cuse him to
need the help of famui;y (who are in Philadelphia.
Any further suggestions you may offer will be appreciated.

Hello again, Gloria.

You are very welcome. He may not need the full coverage through the former employer once he qualifies for Medicare coverage. Instead, he would typically look for a supplemental insurance plan for coverage. Such policies do not usually prevent an individual from obtaining coverage due to pre-existing conditions, although it may be quite expensive.

With Medicare coverage, many of your friends expenses will be covered, so he could use what he is paying on the policy now to purchase a supplemental policy.

Here is a link which provides information on obtaining supplemental policies in PA:

http://www.mysenioradvisorsgroup.com/MedicareSupplementInsuranceQuotes-PA.html
Tina
Tina, Lawyer
Category: Legal
Satisfied Customers: 33,167
Experience: JD, BBA Over 25 years legal and business experience.
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Hello again Gloria,
I wanted to thank you for using JustAnswer, and to inquire whether my answer was helpful in clarifying your understanding of the law even though it may not have resulted in the outcome you were hoping it would.
Is there anything else I can assist you with?
If you do not require further legal information at this time, please feel free to bookmark my profile so you can request me when you do have another question. Here is a link to my profile: http://www.justanswer.com/law/expert-tina/
Thank you very much and all the best to you.
Tina
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