HealingWell
Search Close Search
☰

Pre-Existing Condition Insurance ?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 12/11/2008 1:07 PM (GMT 0)
Was searching and could not find answer from previous postings. If or when I leave my current job and take another job will I have problem with my health care covergae where the new insurance company would deny my coverage of treatment due to having prostate cancer and saying it was a pre-existing condition?  Thanks!!

LIVESTRONG!

Posted 12/11/2008 1:19 PM (GMT 0)
I have the same question, actually.
Posted 12/11/2008 1:37 PM (GMT 0)
SHU93, glabers,

In the middle of having adjuvant radiation therapy I switched insurance plans (my wife's group ins. plans) and the only problem was I had to pay the yearly minimum again. I may be wrong but if it's a group plan I believe they cannot exclude you.

Ken
Posted 12/11/2008 2:31 PM (GMT 0)
I think the new company's insurance has to take you the way you are. But aren't you past most of the expenses?
Posted 12/11/2008 3:56 PM (GMT 0)
even if the switch is because of a new job entirely, and not the same job & just a new insurer?
Posted 12/11/2008 4:17 PM (GMT 0)
I'm not a HR specialist or attorney, but my recollection from dealilng with some of this issue at work is that if you're absorbed into a group health care policy you cannot be rejected - coverage must be extended to all group (work unit) members equally. However, some policies may require a certain period of time to pass before you're allowed to make a claim for benefits as the result of treatment for a pre-existing condition. It's unlikely you'll be denied reimbursement/coverage for prescription medication, such as Viagra or Cialis, etc., even though the medication is related to something pre-existing, and the chances are probably very slim that you'd need more prostate cancer-related surgery within, say, the year following your new employment. You're probably sensitive to this already, but I'll suggest it's best not to disclose pre-existing health issues to a potential employer during the interview/initial evaluation process.
Posted 12/11/2008 5:50 PM (GMT 0)
Good point Mavica about the disclosure part...and I don't think a perspective employer can ask the question anyway...although they may. I would think that it depends on the insurance and the company...many companies now are self insured up to a specific limit to reduce the insurance cost before the actual insurance kicks in. If that is the case then the company can dictate pre-existing conditions as well as the time limit before coverage can commence. So theres the rub...by asking the questions of the employer you are in return disclosing your medical condition. Catch 22.
Posted 12/11/2008 6:24 PM (GMT 0)
You can ask the question after you've recieved a written offer of employment (which is binding) but before you accept the position. That way the information can't predjudice the hiring decision, and you can decide based on how good the coverage is.
Posted 12/11/2008 6:28 PM (GMT 0)
A pre-existing condition is a medical condition diagnosed or treated before joining a new plan. In the past, health care given for a pre-existing condition often has not been covered for someone who joins a new plan until after a waiting period. However, a new law. called the Health Insurance Portability and Accountability Act. changes the rules. Under the law, most of which goes into effect on July 1, 1997, a pre-existing condition will be covered without a waiting period when you join a new group plan if you have been insured the previous 12 months. This means that if you remain insured for 12 months or more, you will be able to go from one job to another, and your pre-existing condition will be covered. without additional waiting periods. even if you have a chronic illness. Continued here: http://www.healthinsuranceadvice.org/conditions.html
Posted 12/11/2008 7:03 PM (GMT 0)
Thanks Steve...isn't the internet wonderful...ask a question and an answer is there somewhere.
Posted 12/11/2008 11:20 PM (GMT 0)
Thanks!! Its a relief!!
Posted 12/11/2008 11:45 PM (GMT 0)
Concerning insurance. You must have continuous insurance coverage from one job to the next. If you are out of work for a time, Cobra is in effect. You must not allow your coverage to laps more than 63 days or you will lose your pre-existing coverage. also, depending on the state, your coverage may be limited. In Indiana, there are very few group policies that allow treatment for erectile dysfunction. If you are a small business owner like me, there is no coverage available at all of an individual medical policy at any price. Please get out your policy are read the exclusions before you contact a physician if possible.
Posted 12/12/2008 12:43 AM (GMT 0)
SHU93, You shouldn't have an issue. Take a look at

http://www.dol.gov/ebsa/newsroom/fshipaa.htm


The Health Insurance Portability and Accountability Act (HIPAA) lays out the rules governing pre-existing rules. As ART66 stated above, you eed to have continious coverage, with no laps greater than 63 days. A wait period imposed by a new plan is not considered in that 63 day gap however. When you leave your current job, your insurance carrier will give you a certificate of prior coverage (HIPAA certificate) that will serve as proof of prior coverage. If your new plan tries to impose a wait period, due to a pre-existing condition, you can present that HIPAA certificate. They must offset the pre-existing wait period by the number of months of prior creditable coverage you had, as per the HIPAA certificate.

✚ New Topic ✚ Reply