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  • Pre-existing condition?

    I have an insurance question and wasn't sure where else to post it. My hubby is starting to look for a new job. Our health insurance is completely through him since I work from home independently.

    Since being diagnosed with IC (again), we've had the same insurance. Is it considered a pre-existing and what does that do for us if we switch to another insurance?

    Another concern is that my hubby was just diagnosed with early stage diabetes. Because he's young, we think making some dietary changes and stuff will keep it from going full blown. However, looking at his papers from the doctor, it looks like they are writing that he is diabetic. So I'm wondering how that will impact an insurance change as well.

    Any thoughts or suggestions for resources?
    ~ Stacey

  • #2
    Stacey,
    As long as you have insurance the whole time or do not have a lapse of insurance more than 63 days and can proof it the new insurance can not consider it a pre exsisting condition. If you do have a lapse more than 63 days then they make you fill out forms proving that you haven't been treated for it for a certain amount of time or they will exclude it for a year or whatever their policy is. I've had endo when I got my new job and I ran into the pre exsisting condition issue because I went more than 63 days w/o insurance. I hadn't been treated in anyway for the endo though in over 6 months which was their requirement so I didn't have a pre exsisting condition. The kids have issues that could be considering pre exsisting but they had insurance from the state the whole time so I just provided that documentation and it was fine. Hope this helps.
    Christine



    I have been diagnoised for 6 1/2 years now. I have taken a long break from the ICN but really miss helping out my fellow IC patients and want to get back into posting.
    1st hydro 4/07 showed no visible signs of IC but tons of mast cells in all my biopsy samples which did prove IC.
    2nd hydro 4/13/09 showed dark purple glomerulations and I had a capacity of 450 cc's. This hydro proved that my IC had progressed.
    I have tried every oral medication as well as rescue instills and DMSO.

    I have been lucky enough to see Dr Hanno, the top IC specialist in PA who has told me due to the fact that I have not responded to any "standard" treatments that I have a severe, end stage case of IC with a horrible quality of life (didn't have to tell me that last part!)

    Proud wifey of Shane, mommy to Griffin, and step-mom to Logan and Gage
    Also proud mom to the best Bullmastiff on earth, Claus

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    • #3
      Thanks. That does help. I've been wondering about it and worrying about it. I can be pretty good at doing that!
      ~ Stacey

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      • #4
        I'm glad it helped. I went through it myself with my new job and I work for a third party adminstrator that adminsters benefits so I know something about it.
        Christine



        I have been diagnoised for 6 1/2 years now. I have taken a long break from the ICN but really miss helping out my fellow IC patients and want to get back into posting.
        1st hydro 4/07 showed no visible signs of IC but tons of mast cells in all my biopsy samples which did prove IC.
        2nd hydro 4/13/09 showed dark purple glomerulations and I had a capacity of 450 cc's. This hydro proved that my IC had progressed.
        I have tried every oral medication as well as rescue instills and DMSO.

        I have been lucky enough to see Dr Hanno, the top IC specialist in PA who has told me due to the fact that I have not responded to any "standard" treatments that I have a severe, end stage case of IC with a horrible quality of life (didn't have to tell me that last part!)

        Proud wifey of Shane, mommy to Griffin, and step-mom to Logan and Gage
        Also proud mom to the best Bullmastiff on earth, Claus

        Comment


        • #5
          Group health plans, such as through employment will usually cover pre-existing conditions. Private insurance plans usually do not. A health plan should be a major requirement for your husband in his job search.

          Donna
          Stay safe


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          • #6
            Hey,

            Griffsmommy's advice was good, but I would look into the amount of days allowed in your state and what your insurance companies policies are on that. Our insurance did NOT have the 63 day rule so we paid Cobra out of pocket for the 1 month in between plans. It was only 1 month for us, and worth it in the long run.

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            • #7
              I think that we will end up paying to keep insurance in between when the two companies allow us insurance. It is definintely a priority for his job search. We did check a few years ago to see if independent insurance is cheaper, but since I'm still young enough to have children (27), then my rates were incredibly high.
              ~ Stacey

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              • #8
                I am the benefits administrator for my company and as long as you do not let your insurance lapse then pre-existing conditions are covered. It is worth going on COBRA until the new insurance kicks in.

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                • #9
                  I know this post is a few months old, but it looks like my hubby is going to leave his job. I checked with the insurance company about the cost to us to do Cobra, but they can't tell us. They said we need to talk with his employer, but he isn't ready to tell them he's leaving. However, it's something that we need to plan for financially. Can anyone give me an idea of what Cobra might cost us in between jobs? Is it a certain portion of insurance being paid by his company or what?
                  ~ Stacey

                  Comment


                  • #10
                    The cost of COBRA depends on the type of insurance your husband has and how many employees are in the company. Generally the company will charge you the full cost of the insurance but they could add on an administative fee as well (at least that is how they do it in NY). If your husband currently contributes to the cost of his benefits then you can probably figure out how much they will cost.

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                    • #11
                      Stacey,
                      It does depend on what the full cost of the insurance is. His employer is picking up a portion of it and you guys are paying a portion. They would charge the full amount for Cobra. I know it was over a thousand amount for me and my son to have Cobra from my last job and that was an HMO. I couldn't afford that and didn't get it. Wishing you luck.
                      Christine



                      I have been diagnoised for 6 1/2 years now. I have taken a long break from the ICN but really miss helping out my fellow IC patients and want to get back into posting.
                      1st hydro 4/07 showed no visible signs of IC but tons of mast cells in all my biopsy samples which did prove IC.
                      2nd hydro 4/13/09 showed dark purple glomerulations and I had a capacity of 450 cc's. This hydro proved that my IC had progressed.
                      I have tried every oral medication as well as rescue instills and DMSO.

                      I have been lucky enough to see Dr Hanno, the top IC specialist in PA who has told me due to the fact that I have not responded to any "standard" treatments that I have a severe, end stage case of IC with a horrible quality of life (didn't have to tell me that last part!)

                      Proud wifey of Shane, mommy to Griffin, and step-mom to Logan and Gage
                      Also proud mom to the best Bullmastiff on earth, Claus

                      Comment


                      • #12
                        I know with our insurance with the state - you have to wait 3 months before they take you but there is no pre-exsisting conditions; they will take you whether you have an illness or not. But you still have the 3 months that you are without so you have to have the COBRA and with my group it is very expensive. You just have to look into it and see what is out there -- good luck.

                        Comment


                        • #13
                          We're working on figuring out the Cobra costs. It's a bit difficult since we're in a situation where we'd rather not let his current employer know he's thinking about leaving.

                          I think we might also talk with our other insurance agent who does our house and cars, etc. We had talked with him about health insurance a couple of years ago. Basically, his rates were reasonable until we added in pregnancy coverage. But if we only need it for a few months, I think we could skip the pregnancy coverage option.

                          Times like these I wish I had an employer who offered insurance and we wouldn't have to worry so much. I love my work as a self-employed person, but no benefits stinks sometimes!
                          ~ Stacey

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