View Full Version : Medical Insurance For My Husband???


cupid0214
06-17-2009, 05:28 PM
My Husband was recently released to a HWH. If he needed medical attention would he still be covered under the Federal Prison since his BOP release date is 7/20 and technically he is still in their custody? Also, I would like to add him to my insurance but my employer is telling me that his release is not a life qualifying event. Is this true? :confused: Sure feels like one! I would hate to have him have to wait until open enrollment, that's 6 mths away. Thanks for your help...

bellisq
06-17-2009, 06:48 PM
Your employer is way too much in your business and sounds like a jerk. Is it a small business? Is there an employee manual? I would suggest you read it. Why isn't it legitimate that you were separated and aren't any more? Why does the employer have to know your husband's BOP status?

I know you have to be very careful with what information you give the insurance company, because if they decide you have been inaccurate they can cancel you and not pay benefits. I think you need a lot more information before revisit this issue. I think a big issue is who is paying for your husband's coverage? If it is you, why does your employer care?

I believe your husband is required to pay his own medical expenses while in Halfway house. It seems to boil down to the definition of "life qualifying event". I would suggest you look for advice and help from a friendly insurance broker who can help you find the right language to go back to your employer. You could also try an anonymous call to the State insurance commission to see what information they can offer. Good luck, sounds like you will need it.

cupid0214
06-17-2009, 06:53 PM
I work for a hospital with over 5000 employees. The benefit specialist said it had something to do with section 125 from the IRS, blah blah blah. Apparently, it is not up to the employer?? It's so confusing and yes I will need some luck.

Zelda50
06-17-2009, 07:01 PM
The other issue to look into right away is the language in the insurance policy. Believe it or not, some health insurance companies (like Blue Cross) include a clause that, even if the person is an enrolled member, they will not cover health care costs if that person is in the custody of law enforcement and that includes jail or prison. Technically, in the halfway house, he's still in BOP custody, I think - so it's a catch-22 because then, technically, the BOP should be paying the medical costs but apparently is not. So you have to be careful what you tell the insurance company, if they have that clause - if you don't tell him he's in a halfway house and he just goes to the doctor, the insurance company won't know his BOP status. Get a copy of the actual insurance policy.

As for when your husband can enrolled, I know with my employer-paid insurance, there is only an open enrollment yearly and, if he were not covered already and he were released from prison, we would have to wait until that open enrollment date. That's why I include him on my health insurance now, even though he's still inside and cannot use it. Ever hopeful he'll be released and then it will be available immediately!! You've asked a good question because this will alert others that, if your spouse's release date is coming up, be sure to add him/her during your employer's open enrollment in advance. Z.

cupid0214
06-17-2009, 07:05 PM
Thanks for the responses, what really upsets me is that I was going to put him on the insurance last November during open enrollment but decided to ask first to avoid paying the premium when he wasn't even out yet. So I asked and they told me as long as I had a paper saying he was released or whatever, now they act like we never had that conversation...Ugh!

bellisq
06-17-2009, 07:24 PM
This stuff is a pain, to be sure. If you didn't put anything in writing, then you are still in a position to get your needs met, especially if there is more than one benefits specialist. I'm thinking the IRS stuff is bull and you have a lot of research to do, and it will be like reading Greek. Go find some help, either through friends or church who can lead you to an expert (you may even need more than one helper because there are several issues here) or start with the library. You need to find out the paramaters of the "life qualifying event" first and see if there is any way to fit in there.

Did you make notes on your conversation last year? So much has gotten worse since then, but the notes could help you prove your point. But realistically, who would remember that type of conversation from 7 months ago with all the people they deal with? Too bad they didn't give you the reference for their advice, but they could have simply been incompentent or wrong. There are some options for uninsured through the state, which you should also check out. Might not be as good as you have or as cheap but something is better than nothing, if that ends up to be the situation.

AllThrtl
06-17-2009, 08:53 PM
From what I understand, while he is in HWH or HC, he is still considered to be in BOP custody. Because of that, the BOP is still responsible for a standard level of healthcare.

Federal laws come into play here. I'm no insurance specialist, but I had to deal with it as an employer. Typically, "life qualifing event" refers to death, marriage or birth. A lot of it has to do with how your premiums are paid. If premiums are paid with pre-tax dollars, you will only be allowed to add or subract dependents during open enrollment. This is IRS law and not easy to work around and gets VERY complicated. I highly doubt you will be able to add him to your insurance until open enrollment. Your only hope is if you can convince the plans administrator to let you add him. That's a big IF. You might be able to work the angle that he couldn't be covered while he was incarcerrated and now he's not. I wouldn't hold my breath...

Most plans that premiums are paid with after taxed dollars, you are able to cancel a dependent at any time. However, nearly all group plans require you to wait until open enrollment to add unless it is due to marriage or birth.

This is VERY common, I think it sucks, but that's the way it works. If you dislike this, wait until Socialized health care comes along. Then the same feds get to decide when or if you really need treatment....Lord help us all!!!

cupid0214
06-18-2009, 07:50 PM
Update! I conquered a small battle and they let me put him on my insurance :yay: My boss (she's so wonderful) bent the Director of Human Resources ear and in the end they said okay. So I'm not quite sure if being released from prison qualifies as a "Life Qualifying Event" or I was just lucky. I also had the HWH case manager email me a letter explaining that while in the HWH they are responsible for their medical coverage. I wasn't sure about that either yesterday. I'm just glad things worked out but just a heads up to inquire about your loved ones healthcare coverage before they are released so that you can be prepared.

AllThrtl
06-18-2009, 08:17 PM
Congrats...

I looked at a couple different plans today, it is feasible to consider getting out of prison a life event. If a qualified dependent looses coverage because of a change of employment status, it is considered a life qualifying event. It just takes a plan administrator whose willing to work with you...

cls614
06-18-2009, 08:37 PM
hi

would anyone know if my husband can receive social security at the halfway house if he qualify's for it?by that i mean he would qualify if not for being in a halfway house,because he will still be controlled by the bop.
thanks

bellisq
06-19-2009, 08:11 AM
You should start a new thread for this question but the answer is no.

bellisq
06-19-2009, 08:15 AM
Update! I conquered a small battle and they let me put him on my insurance :yay: My boss (she's so wonderful) bent the Director of Human Resources ear and in the end they said okay. So I'm not quite sure if being released from prison qualifies as a "Life Qualifying Event" or I was just lucky. I also had the HWH case manager email me a letter explaining that while in the HWH they are responsible for their medical coverage. I wasn't sure about that either yesterday. I'm just glad things worked out but just a heads up to inquire about your loved ones healthcare coverage before they are released so that you can be prepared.

Good for you, especially on getting the HWH to cooperate and the HR person to go in your favor. Even with all the gobblegook, it's still humans who make the decisions and it was politics that got the system to bend. I hope you never have to use it.

Zelda50
06-19-2009, 07:22 PM
Congrats on getting him put on the insurance! Good for you for being persistent and good for your boss for giving you that support. This is the 2nd "good news" positive post I've read here today - kinda nice! Z