Question:
Looking for individual policy that doesn't offer HMO or PPO, just 80/20 plan

In Jan. 2000 I will be eligible for HIPAA (Health Insurance Portability & Accountability Act.) To be eligible for this you have to be coming off of a group policy that no longer offers group coverage, for example, company is going out of business therefore no Cobra election is possible. You also have to have continuous coverage for the past 18 months and you have 60 days to obain coverage after the loss of insurance. YOU CAN NOT BE DENIED BY ANY CARRIER, ALL PRE-EXISTING CONDITIONS MUST BE COVERED, BUT YOU DEFINETLY PAY THEIR HIGHER PRICE. You are usually only offered their lowest coverage, exp. HMO Plan. I may want to go out of state and don't want to be told which doctor I HAVE to use for this surgery. Does anyone know of a carrier that offers only 80/20 plans that covers this surgery. These 80/20 plans are usually (at least I think) not state specific. Any help would be appreciated, I need to make the decision soon. Also, no Insurance Agent will help find the coverage (or at least willingly) because they don't get a commission on HIPAA policies, therefore, I also need a phone number for the insurance company.    — [Anonymous] (posted on November 11, 1999)


November 11, 1999
State Farm Insurance has a basic hospital and surgical policy that is neither HMO nor PPO but 80/20, and bariatric surgery is not listed in their exclusions, so you might want to check them out. Also you are right, you can see any doctor in any state you wish and you can have major surgery as soon as your policy is approved or have it covered immediately if it is an emergency. I don't know which state you are in, nor do I have an 800 # for them, but I'm sure you can take it from here and find the number in your phone book. Good Luck :0)
   — dandjon

November 12, 1999
Try UNICARE insurance. I got it for my son and it is 80/20 and it is about $40-50 a month
   — Jen L.

November 4, 2000
State Farm does NOT cover bariatric surgery, I just tried to get insurance with them. I was honest with them up front and asked and they told me they don't cover it. Also they most likely won't insure you if your height and weight isn't proportioned, or so I was told.
   — Laura S.




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