Insurance Question

[SawyerAshton]

I've been meaning to ask this question.

I teach elementary school. There is a very good chance that I will be offered a spot at a different school for next year. This would mean that I would have to change insurance carriers.

I have not been officially diagnosed yet.

My question is: Has anyone had a similar experience? Will I be fighting preexisting condition clauses? Should I just stay at my current job until things settle down.

 

[lowone]

While my experience with this was not a chronic condition....

A few years ago I crashed my bicycle and hurt myself. Dislocated 6 ribs, and damaged my right knee. My gp was able to reset 5 of the ribs, and thought to wait on the other. Knee kept hurting (so painful after walking a flight of stairs I couldn't sleep at night) so I went back and was referred to a specialist. I got X-rays and they showed nothing. Then an MRI, the MRI showed a square chunk of cartilage that flipped over so I had a pit on one side of the knee cap and a doubled thickness chunk on the other. They scheduled me for surgery after the new year as well as sent me to start physical theropy.

Well that new year the university I work for switched insurance providers. The new insurance company's fraud department called me up after the surgery . It took an hour of explaining and they went away for about a month. Then they called up again searching for someone else to pay for the surgery. I explained it again and that was that.

(surgery was awesome, it fixed the problem as well as 2 other undiscovered problems. I was able to start running again, something I had not been able to do in years from other knee pain)

Now that I am diagnosed with crohn's this is something I am fearing. I think it's only a matter of time tell another change happens. I also feel a bit trapped as before my recent flare and diagnoses I was searching for a new job, which I think might be impossible now. Cause seeing costs of things like the colonoscopy and lialda, there is no way I could afford it without insurance. So I guess I very much share your concerns and fear regarding this!

 

[akpatti]

From what I am to understand if it is a group plan they can not exclude your pre-existing condition, but can make you wait 6 months before covering if you did not have coverage going into it...that being said sounds like you won't be going without coverage so it should pick up from the start. At least that has been my experience with group plans. When in doubt call the insurance company you may be switched to and ask them what there policy is on pre-existing conditions on group plans. I have never had a problem with them by asking their policy guidelines, my problem has always been in network or out because of where I live

 

[LindaS]

Sawyer, I'm not sure when the portion of Obama Care goes into effect where insurers can't deny coverage due to a pre-existing condition. I think it might be some time next year. If that is the case, then you needn't worry about it. Also, if it is a large group policy, then usually they don't deny for pre-existing conditions.

 

[Miss Underestimated]

It should be covered with no problem, since this is a group plan.

 

[chrisnsteph1022]

I've switched group plans 3-4 times since my diagnosis and never had a problem with pre-existing clauses. As long as there's no lapse in coverage, they cannot deny a condition.

 

[scoutfinch]

You should be fine. I don't know the specifics of your situation (e.g. how long you've had your current coverage, whether you will have a waiting period under your new plan, whether your new plan even has a pre-existing condition clause, etc) but HIPAA regulations would likely cover you. Read more at the Dept of Labor site: http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html