Those with pre-existing health conditions often find it difficult to obtain health insurance coverage. With Kaiser Permanente, you have several options depending on whether you live in California or Georgia.

California Residents

California residents with serious pre-existing health conditions who own their own business should apply for a group health insurance plan. Group medical plans are issued automatically in California without health questionnaires and without concern for pre-existing conditions. The key here is that you must qualify for small business coverage. To qualify you must have at least two people; husband-wife businesses often qualify, especially if the couple files taxes jointly. If you do not own your own business, you may be able to get Individual and Family coverage. However, these plans do go through medical review and those with serious pre-existing health conditions are often denied. The only automatic denial stated by Kaiser underwriters is current pregnancy, but those with serious health conditions such as cancer, HIV, heart problems, obesity, etc. are often denied. If denied, your only chance of getting healthcare coverage may be to find employment (for you or your spouse) that offers a group medical plan or to apply for Medicare or Medical.

Georgia Residents

Georgia residents with serious pre-existing health conditions who own their own business should apply for a group health insurance plan. Your group health plan may be rated  up, meaning you will pay more, but you will not be denied. Kaiser Georgia does have the option to deny coverage on Individual and Family plans. However, if the pre-existing conditions are not too serious, you may simply be rated up and offered Individual and Family coverage at a higher price.

Posted: May 29th, 2008 under Kaiser Permanente.
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Kaiser Permanente offers many advantages for people living in the Atlanta, Georgia area. Kaiser is the only carrier in the area that covers maternity in the first 12 months. Lab work and radiology is covered 100% before the deductible for all the (non-HSA) plans. Also, all these plans cover doctor visits, specialty visits and prescription drugs with a copayment before the deductible is met. Kaiser members in Georgia also have access to a large network of non-Kaiser facilities and doctors. Those who wish to keep their family doctor, even though this physician is not a Kaiser doctor, can often remain with their doctor on a Kaiser Permanente healthcare plan.

Posted: May 29th, 2008 under Georgia Individual.
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Any of the regular HMO plans will work for maternity. These plans include the Premier Plan, Plan 500, Plan 1000, Plan 2000, Plan 3000, and Plan 5000. All these plans offer the same coverage for maternity. Maternity charges are $1,000 for ob/gyn/midwife services (prenatal, postnatal and delivery). There is a $2,000 charge for hospital delivery. Other charges may apply especially if there are complications with the birth. Whichever of these plans you choose, you’re looking at a minimum of a $3,000 to have a baby. Click Individual and Family Health Insurance Quote and choose the plan that is right for you and your family. If you qualify for group coverage, you may want to consider that because the Georgia group plans have richer maternity coverage.

Posted: May 16th, 2008 under Georgia Individual.
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On all (non HSA) Kaiser Georgia health insurance plans, the primary care doctor visits are not subject to the deductible. Therefore, you will have a set rate of $30 for all Primary Care office visits. Prescriptions, however, are subject to a $200 RX deductible before they become a set rate of $15 for generic and $35 for the brand names. For hospitalization and other services, you will need to accumulate the amount of you deductible first, and then the plan will cover 70% of the remaining bill. You will be responsible for 30% of the remaining bill up to your out of pocket maximum.                                            

Posted: May 16th, 2008 under Georgia Individual.
Comments: none

On all (non HSA) Kaiser

Georgia health insurance plans, the primary care doctor visits are not subject to the deductible. Therefore, you will have a set rate of $30 for all Primary Care office visits. Prescriptions, however, are subject to a $200 RX deductible before they become a set rate of $15 for generic and $35 for the brand names. For hospitalization and other services, you will need to accumulate the amount of you deductible first, and then the plan will cover 70% of the remaining bill. You will be responsible for 30% of the remaining bill up to your out of pocket maximum.                                            

Posted: May 16th, 2008 under Georgia Individual.
Comments: none

If you are not yet enrolled with Kaiser Permanente, now is the time to make the move. Rates are going up after June 1^st, 2008 for new groups. I recommend applying by May 27th to make sure your group gets in before the deadline. If you apply now, you can lock in the current lower rates for one year. Groups that hesitate will face serious rate increases of 2% to 17%.  

The $0/$1500 Deductible Plan with HSA is one of the plans being hit the hardest by these rate increases. Kaiser Permanente priced this plan very aggressively in 2007, yet still they were surprised at how popular it became, and they were caught off guard by the utilization of the plan. Businesses often funded the $1500 deductible without putting money into Health Savings Accounts. In this way, many members on this plan were given 100% coverage. Thus they had no deterrent from utilizing their coverage and ended up costing the Kaiser Health Plan more than expected. A Kaiser Permanente sales representative commented, “Members don’t have enough skin in the game.” The ultimate result is higher costs on this plan in the second half of 2008.  

Despite the increased costs, the $0/$1500 Deductible Plan with HSA is expected to continue to be one of the most popular

California small business health insurance plans. A

Northern California insurance broker commented, “The 17% increase won’t slow me down a bit from selling this plan.”

Posted: May 15th, 2008 under California Group.
Comments: none

The deadline to apply for Kaiser health insurance for Individuals and Families in California is the 23^rd of the month. However, underwriters get incredibly busy this time of the month, so I don’t recommend waiting until the last day. Those who apply on or around the deadline usually face delayed processing and may not find out about their approval until days beyond their effective date. Underwriting may take two to three weeks to notify you of your status after you apply. This may mean you end up paying for a certain amount of days of healthcare coverage that you never get the opportunity to use. The sooner you apply the more smoothly and quickly your application will go through underwriting and the sooner you will be notified of your approval status.

Posted: May 13th, 2008 under California Individual.
Comments: none