Insurance question for Canadians

[Tesscorm]

Is a pre-existing condition a problem with insurance coverage in Canada? My son is currently covered under my employer plan but my plan will no longer cover him once he finishes school.

So, once he finishes school and, assuming he finds a job right away, would there be an issue with coverage given that he would have a pre-existing condition when the (new) coverage begins?

And, can anyone tell me if there may be an issue if I were to change jobs now and then adding him to the insurance coverage at a new company (he'll still be in school for, at least, two more years so would still need to include him in my coverage if I were to change jobs)?

Thanks

 

[FrozenGirl]

Nope. I'm in alberta and coverage is coverage. Job plans tend to be by major insurance companies (Blue cross, sunlife etc). They generally don't ask. If he gets coverage on his own just watch for restrictions on what they will cover (with and without pre auth) and off label use coverage. I got my own Blue cross plan after diagnosis with no problems. My Remiacade coordinator applied for me so I'm not 100 percent on the process but I never filled out medical details. If you add him on with a family (dependant) plan same deal. Most plans go up to age 26 as long as he is in school. My mother had only dental through work but when I was diagnosed she added prescription coverage ( luckily I was diagnosed late nov and her plan choice was in Jan).

 

[hawkeye]

I did not have any issues with employer's health insurance when I started working with a pre-existing condition with any of the 3 companies I have worked for and that was with different insurance providers.

 

[Lam123]

No issues at all. No questions asked.

 

[Tesscorm]

Great to hear no one's had any issues!

Appreciate all your replies.

 

[Tesscorm]

Another question re 'new' insurance...

Prior to my son starting remicade, we had to get pre-approval. If I change jobs (as he's still covered under my insurance), would his remicade need to be reapproved with the new insurance plan - whether it happens to be with the same insurance company or not? Would past approval carry forward with a new plan?

Thanks

 

[SupportiveMom]

When D was on Remicade the Bio Advance coordinator said it might need approval with a new provider but it happens quickly because it's already an administered drug. she had said she would handle that if it came up. Maybe contact your coordinator?

 

[FrozenGirl]

It would likely need to be reapproved. I got 3 different insurance approvals from all my plans. It should be pretty quick ( my last approval, I was on Remicade already took a little over a week)

 

[Lady Organic]

My GI explained to me that everyone in Canada can have access to Biologics: companies have compassionate plans for people who have bad private coverage and who cant be enrolled with public government insurance plans. So there is nothing to worry about regarding that issue. GIs know how to fill the papers so that everyone can have access without spending much money. I even called Humira to clarify all of that and they clearly explained to me that no one is left aside.

If your son is an independant worker and doesnt have insurance through his job, or if he is still a student, he will be automatically covered with the government public insurance plan. It is a law in canada to have a drug insurance, everyone must have one, private or public.

 

[lgpcarter]

Yes, you will likely have to get re-approved, but I have found with Remicade they are pretty quick about it, especially if the GI is quick and faxes stuff right away.

I am getting Stelara on compassionate release from Janssen right now because my insurance denied it. It's off-label use for Crohn's, only approved in Canada for psoriasis at the moment. I have Manulife through my job.

I have also had to go the Ontario Trillium Drug Benefit program route before after I finished school and before I had a job with coverage, so I can answer questions about that if you have any.

 

[Tesscorm]

Thanks all!

Was just a bit worried about what might happen if I left my job. Good to know there are a number of options.

I may be back to you for more info!

Thanks again.