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Healthcare Insurance
Under age 65
The most costly benefit most of us purchase is health insurance.
If you are under 65, and not yet eligible for Medicare, you are
faced with qualifying and paying for an individual health policy.
Individual health policies differ from "group" policies
that are supplied through your employer because you must qualify
and be approved by the insurance company. The application includes
medical questions about you, and your medical records may be reviewed
as part of the application and approval process.
Gemini works with a variety of insurance companies. Each company
has developed their own approval criteria. It is not unusual for
one company to decline an application while another will approve
the application. Some companies will issue a policy, but with an
exclusion rider for a particular condition, for example, a bad back.
A policy issued with an exclusion rider will cover everything provided
for in the policy except the excluded body part or condition.
Policies also may be issued with an exclusion for a pre-existing
medical condition. Typically, the exclusion has a time limit of
six or twelve months. Be sure and ask the Gemini representative
to explain the pre-existing limitation clause in detail to you.
Policies vary in cost based upon your age, where you live, smoking
status, gender, and a variety of other factors.
The Gemini individual health representatives will shop the market
for you with multiple insurance companies. Since each company has
differing policies with regard to medical conditions, it is important
to use a consultant that knows the market and can shop around for
you. You may apply for an individual policy at any time.
65 and Over
If you are age 65, you may qualify for Medicare. In the Denver metropolitan
area, FPPA has a
policy issued by PacifiCare. This program is known as Secure Horizons
Medicare+ Choice Group Retiree Plan. This plan is an enhancement
to Medicare by which PacifiCare is totally responsible to cover
your health care costs plus provide additional programs to get you
healthy and keep you healthy. PacifiCare has a network of contracting
Primary Care Physicians, health care professionals, and medical
providers. It also includes prescription drugs and vision care.
Premiums are deducted from your monthly pension check.
Contact FPPA’s Payroll Specialist for general information
and an enrollment application.
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