Sunday, January 27, 2013

Finding Health Insurance as a PostAcademic: The Basics

Soooooo ... health insurance. The thing that few people understand, everyone hates, and no one wants to have to buy. Let's talk about it!! :)

When you leave academia, you will unfortunately be leaving your university-provided health insurance behind. And unless you're one of the lucky people who lands a job with health benefits before you officially separate from your university, you will probably be facing a period of time where you won't have any health insurance coverage ... unless, of course, you take the time to find and buy some on your own.

You could always try to just take your chances by remaining uninsured ... but I really don't recommend it. Even a crappy insurance plan will save you money compared to what someone without insurance would pay if you developed a significant medical problem.

Now, finding and buying health insurance can be super-scary and intimidating ... but it's manageable. You are smart and accomplished, and you can tackle this problem like any other that you've faced in your academic life. In fact, what you need to do is to do some research about what kind of health insurance coverage is available to you. And you DO know how to do research, don't you???? :)

If you're planning to leave academia, you'll want to start doing this research as soon as possible. Even if you don't need to buy a policy for a few months or more, it will make things easier if you find out ahead of time (1) what you can qualify for and (2) how much it is likely to cost you. Then, when it's time to actually pull the trigger and buy some, you will be prepared.

So here's a starter guide to finding health insurance after you leave academia. As you read, please feel free to leave a comment or email me at leavingacademia(at)gmail(dot)com if anything is unclear or if you have any questions.


First things first - once you know you are officially leaving, you should check with your university to see if you will be able to keep your current coverage for a set period of time under the federally-mandated COBRA provisions.

The COBRA legislation allows people who are losing their group health insurance (which is what you have through a university) to keep their coverage for a set period of time if they pay their premiums on their own. When I initially left my graduate program in 2011, I was able to keep my health insurance for six months under COBRA before I had to buy an individual health plan.

On one hand, your university benefits are quite possibly better than anything you will be able to buy on your own ... so you might want to take the opportunity to keep them a little longer. On the other hand, though, the premiums may be too expensive for you. But you won't know unless you check, so contact your insurance company or someone in the university benefits office to check.


Once your COBRA benefits run out - or if you decide not to take advantage of them - it's time to find brand new health insurance, unrelated to what you had in academia.

This is where things can get a little rough. This may very well be the first time you've had to seek out and buy a plan on your own, rather than having one provided for you by your parents or the university. So let's talk about how health insurance works and how you can go about finding yourself a plan.

In the U.S. today, there are four primary ways that you can get health insurance coverage if you are not eligible for Medicare. You can (a) get group coverage through your or a family member’s employer, (b) purchase a regular individual health plan for yourself or your family, (c) purchase one of the “preexisting condition health plans” that are now offered under the provisions of the Affordable Care Act (or “Obamacare), or (d) see if you or your family qualifies for Medicaid coverage.


If you fall into the first category described above – (a) people who have access to a group health plan through a new job or a partner's or (if you’re under age 26) parent’s employer, then great! Chances are good that whatever coverage you will be able to get this way will be better (and possibly cheaper) than anything you will get through the other three categories. You should immediately touch base with HR and figure out when and how to enroll yourself on the plan.

Unfortunately, however, many of you who will be leaving academia will not have immediate access to a new group health plan and will need to find other coverage. That’s where the other three categories of coverage come in.


If you don’t have access to a group health plan but you’re reasonably healthy and have enough money to pay a premium every month, you can try (b) applying for individual health coverage in your state. In this post (ed. Note: linked post forthcoming), you can find a list of the 2-3 largest providers of individual health coverage in your state, with links to the application pages for each.

If you apply for individual health coverage, you will need to answer a lengthy questionnaire about your recent health history, doctors that you’ve seen, medications you take, etc. It can feel invasive and stressful, but unfortunately, it’s what you need to do to buy individual coverage.

Once you fill out the application, you will hear back from the insurance company in about a week or so with a response to your application. They will either offer you coverage (invariably for a higher premium than what you are originally quoted on the website), or deny you coverage if they deem that you have a preexisting condition.*

If they offer you coverage, you can either accept their offer or call to speak with someone about other plan options that they might be willing to sell you, which might be more affordable (for example, you may be able to find a plan with a cheaper premium but higher deductible). But it’s important to understand that once they offer you coverage, it is not in effect until you pay your first premium. You can always decline the coverage they offer, or change to a different plan, or look elsewhere. But don’t be scared to fill out the application – you’re not buying anything at that point.

If you’re going this route, I would recommend filling out applications for more than one insurance company. The plans and premiums will vary between companies, and it certainly can’t hurt to check out a few different options from different companies.


Now, if you do find that you’re declined coverage because of a preexisting health condition, you do have options. Under the Affordable Care Act, each state must now offer (c) coverage to people with preexisting conditions under either a state or federal plan. You (the policyholder) will pay the premium, but they cannot deny you coverage for health reasons.

In my experience researching these plans, both the premiums and coverages are pretty solid. If you can qualify for these policies, don’t hesitate to apply.

The one important catch with these plans, however – and it’s a big one - is that you must be uninsured for six months before you can buy into them.

Is this ideal? No, of course not. But if you have health problems, this may be your only option for coverage … so make sure to have your application and premium check ready to go after six months. A state-by-state list of where to go to apply for the state preexisting condition plans can be found in this post.


And finally … if none of these options work for you or your family, you can go here to find a state-by-state list of (d) eligibility requirements for Medicaid. Medicaid is government-run health coverage, funded primarily at the state level, which provides coverage for low-income Americans.

It is far easier for people under age 18 and pregnant women to qualify for coverage than healthy adults, but the eligibility requirements vary by state. So if you think you might qualify, spend a few minutes checking out the eligibility requirements.

And if you have children under 18 who don’t otherwise have coverage, make sure to check out the eligibility requirements for kids. Like I said above - it's far easier to get coverage for children than adults. Even if you can't find coverage for yourself, you can probably find some for your minor children.


So, start here to look for coverage. You may also want to look into whether you might have access to health care discounts through groups or organizations that you belong to. Some discipline-specific academic organizations offer discounts on health coverage to their members without institutional affiliations, and people with military or union connections can sometimes have access to health insurance coverage through those groups.

But if all else fails, this post will give you a place to start to find some health insurance coverage.


Now that you know what kind of coverage you can qualify for and where to go to apply, you’re done with Step 1 in this process. Step 2 will involve figuring out what the best policy you can afford will be, in terms of the benefits that each plan offers.

Stay tuned … we’ll have a post up soon that will help with that.


(*Preexisting condition denials should be rendered obsolete in 2014 through the Affordable Care Act. However, right now they can still occur, so you should be prepared for the possibility that they'll be an issue for you.)

1 comment:

  1. [...] described in the original post about health insurance on this site, people who have preexisting conditions that make it impossible [...]


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