Insurance Advice Needed, Please

One of the hallmarks of the Patient Protection and Affordable Care Act signed into law in March 2010 is the elimination of pre-existing condition requirements imposed by health plans.

Effective September 2010, children (below age 19) with pre-existing conditions may not be denied access to their parents' health plan and insurance companies will no longer be allowed to insure a child, but exclude treatments for that child's pre-existing condition.

If you had at least a full year of health coverage at your previous job and you enrolled in your new health plan without a break of 63 days or more, your new health plan cannot subject you to the pre-existing condition exclusion.

For example: Greg L. decided to change jobs for better promotion opportunities. He worked with a recruiter and found a new job, which he started four weeks after resigning from his previous position. His new job offered similar health insurance and he enrolled in a family point-of-service plan. Although Greg is in good health, his wife has type 2 diabetes and one of his children has asthma.

Greg had worked for his previous company for two years and had no health insurance coverage for four weeks (less than 63 days). In spite of pre-existing health conditions in his family, Greg’s health plan was not able to impose a pre-existing condition exclusion period.

http://healthinsurance.about.com/od/healthinsurancebasics/a/preexisting_conditions_overview.htm

Thanks so much BeatUC!

Hopefully, we will be able to take advantage of that act when either one of us finds a job with group health insurance. In the meantime, private insurance is not totally affected by the act and they will not have to accept adults with pre-existing conditions until January, 2014. Children cannot be excluded, but they also cannot receive major medical without an adult on the policy. They can get a limited medical plan, but I don't think that will cover enough for a child with multiple conditions.

I guess what we are going to have do is purchase coverage for myself with UC excluded in order to get decent coverage for our children and hope for no major flare-up. I am exclusively on Asacol now so that is not very expensive. My husband can always do the COBRA even though it is 600/month just for him alone and will eat up our savings a lot faster.

I heard that some professional organizations and unions offer group health insurance to members. I am searching them out, but so far no luck.

I appreciate your response!

madabs

My couple of suggestions:

-apply to all insurance companies at once not one at a time. There is a question "Have you ever been turned down for insurance" that you must answer truthfully. If you apply all at once you can say "No".

-There are some insurers that will exclude your condition for a period of time, which means you will be responsible for those expenses until the exclusion period is up (6 months, 1 year, 18 months). Every insurer is different and some will not offer coverage at all. It's just a process of finding what who offers the best policy for your family.

-I think Dr.A's idea is valid. Have your policy separate from theirs so your child is covered by your wife's plan until you get on a group plan or the Healthcare act of 2014 arrives unreversed.

I never had any luck with professional organizations for group coverage, hope you have better.