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Pre-existing Conditions and Health Insurance

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Crohn's Disease
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Posted 11/7/2008 6:25 PM (GMT 0)
I am considering a job change...the one I am at now is way too stressful!  sad

My main concern is, with having Crohn's, does anyone know if it can be considered a pre-existing condition?  A friend of mine said that insurances cannot do that anymore but I was wondering if anyone here has heard differently?

Thanks so much!

Posted 11/7/2008 7:09 PM (GMT 0)
They can do that if you go without insurance for 90 days. At least that's the way it is here where I live. DH has switched jobs in the past and we had to wait the 90 days before the insurance kicked in, which was fine. Scary though I know!
Posted 11/7/2008 7:49 PM (GMT 0)
The only type of insurance I was able to get was through the state (welfare basically) and I had to fight like hell to get it. Any other insurance company I tried would not cover anything that had to do with my crohns, dr's visits, meds, hospital stays ect until I had that insurance for 1 year, then they would cover it...because it is a pre-existing condition.  My employer doesnt offer medical benifits until 2 years of employment, but once I get it I will be fully covered under them.  I guess it just depends on what insurance your employer offers. But having Crohns is a pre-existing condition, at least thats what every insurance company has told me.

Posted 11/7/2008 7:51 PM (GMT 0)
If you're in the US they can't do that. You get a certificate from your current employer verifying that you've had continuous coverage, and the new employer's insurance can't invoke a pre-existing condition clause. Some places do still have a 30, 60 or 90 day wait for all employees, though. They just have to treat everyone the same as long as you have continuous coverage.

It's a federal law.
Posted 11/7/2008 8:07 PM (GMT 0)
I couldn't imagine not being covered. I live in Canada and we just buy life insurance. Also the gevernment gives assitance to those who don't make enough money for medical. I don't have to pay for any meds unless its something crazy that the government won't cover. I don't ever have to worry about hospital stays either. I think I am very lucky and hope your situations get better with your employers and all :)
Posted 11/7/2008 8:13 PM (GMT 0)
What Judilyn said. I had to provide proof that I had insurance on the previous job in order for the preexisting clause to be waived on the new job.
Posted 11/7/2008 8:15 PM (GMT 0)
Hi Chronic . . . my relatives live in Canada and they say that they still have to buy supplement medical insurance to help cover their medical expenses. Not sure if that is based on income? They are just average folks. But they do have to wait a l-o-n-g time for things like radiation and surgery. They were on a list and had to wait until their turn came up. Then they had to make a three hour drive, each way, to get radiation treatment, every day. It also seems that it depends where, in Canada, you live. Because some Canadians on the Lupus forum sound like they have really good health care. I sure agree, though, that things are way too expensive here. Blessings!
Posted 11/7/2008 8:37 PM (GMT 0)
It is a pre-existing condition, but group insurance through your employer can't refuse you for it.

Posted 11/7/2008 9:41 PM (GMT 0)

AlwaysRosie said...
Hi Chronic . . . my relatives live in Canada and they say that they still have to buy supplement medical insurance to help cover their medical expenses. Not sure if that is based on income? They are just average folks. But they do have to wait a l-o-n-g time for things like radiation and surgery. They were on a list and had to wait until their turn came up. Then they had to make a three hour drive, each way, to get radiation treatment, every day.

It also seems that it depends where, in Canada, you live. Because some Canadians on the Lupus forum sound like they have really good health care.

I sure agree, though, that things are way too expensive here.

Blessings!

In Canada, you only need med. insurance for prescriptions and semi-private or private hospital rooms and some rare blood tests. Everything else is 100% covered by govt. No paperwork or waiting involved on our part, we just show up with our provincial health card and get treated. It's sooooooooo awesome.

My relative just had thyroid cancer and had surgery within three weeks of diagnosis. She also started radiation without waiting.

Another relative just had non-life threatening cancer and had surgery within 3 weeks also.

There may or may not be a wait, but they won't make a serious life-threatening illness wait, and if they do they can get sued if seomthing happens to the patient.

Chronically ill, if you just bought life insurance for yourself, I hope your insurer told you that if you die or get sick from ANYTHING that can be related to crohn's or its medications, you WILL NOT be covered. I know because I have people in my family who are insurance agents and I've looked very heavily into getting life insurance for myself.


Post Edited (Roni) : 11/7/2008 2:53:10 PM (GMT-7)

Posted 11/7/2008 9:51 PM (GMT 0)
If there is a probationary period before benefits kick in at your next job, make sure to pay for COBRA in between so that there is no GAP in insurance or you will be denied for crohn's. 30 days is the max of a gap you can have. Been there, done it all.....
Posted 11/7/2008 9:58 PM (GMT 0)
Some added insurance in Canada also covers things like dental, physio, chiro, massage, acupuncture, eyeglasses and so on. My coverage is for 70% of those expenses up to an annual limit - usually something like $200 for most things, but more for some dental stuff. That insurance costs more than the premiums on the regular health care plan - last I recall it was about $130/mo.
Posted 11/7/2008 10:28 PM (GMT 0)
I don't know if this still applies, but when my husband changed jobs, we signed up for COBRA, but didn't have to pay for it if we didn't use it. Since it was only for 30 days until the new company's insurance kicked in, I was able to avoid going to the doctor and I pre-filled all my Rx's. It would have been cheaper in the long run than having a gap in coverage, but we ended up not having to pay for it at all. But this was years ago, so my info is old.
Posted 11/8/2008 12:57 AM (GMT 0)
Zanne is right. The amount of months you can gap varies by state I think but the usual is 90 days. You have 90 days to elect your COBRA. If you do elect COBRA you have to pay for it from the day you left your job and it covers you retroactively. So, if you will be covered under the new plan in less than 90 days don't pay for the COBRA unless you wind up needing it. If you need one $200 med it might be cheaper to pay out of pocket than a $600 COBRA payment. But like others said, don't gap because that is when you can be flagged with a pre-existing condition. Some states make it illegal for group insurers to have pre-existing condition clauses. If that is the case then you do not have to worry. Hope that helps!
Posted 11/9/2008 1:41 AM (GMT 0)
My only tip here, Indigo, is to make sure that you have a statement of "Credible Coverage" from your current insurance. Take that statement, and make 50 copies of it!!! I'm serious. Going into a group plan with crohn's more than likely means that they're required to cover you if you follow allow the rules listed in the other posts. The thing is... that doesn't mean they won't fight you every step of the way. I had Healthlink for a couple years through my employer. They covered me, but I had to prove "credible coverage" every 3 months or so. Healthlink would just mysteriously "lose" my paperwork, and tell me that a Remicade treatment wasn't covered because it was pre-existing or some other line of nonsense. I must have faxed my Credible/Continual Coverage sheets to them 25 times. Not exaggerating. EVERY time I had a claim over a couple hundred dollars I'd have to go through the same dog and pony show.

So... get your statement... and make LOTS of copies!!! And keep good notes (i.e. names and id numbers of insurance personnel that you speak with). Good luck!
Posted 11/10/2008 8:46 PM (GMT 0)
Thanks everyone!

Yikes! It just scares me. I guess I will wait and see what happens...I never worried or cared a whole lot about health insurance until I got sick.
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