Have you been denied coverage in California?

If it's on your mind and it has to do with multiple sclerosis in any way, post it here.

Have you been denied coverage in California?

Postby surfbird » Wed Feb 09, 2011 10:28 am

I really want to quit my job and am afraid I will be denied coverage through my next employer because of MS.

Has this happened to anyone, or has anyone successfully obtained coverage through an employer after you were diagnosed and treated for MS?

What do those of you that have been denied do for medical coverage? My employment situation is getting worse by the day but I feel stuck here because I need insurance...
User avatar
surfbird
Family Member
 
Posts: 61
Joined: Sun Aug 29, 2010 2:00 pm
Location: Charleston

Advertisement

Postby scorpion » Wed Feb 09, 2011 10:46 am

I am not sure but since Congress passed the new health care bill isn;t it illegal to deny coverage based on a pre-existing condition?
User avatar
scorpion
Family Elder
 
Posts: 1323
Joined: Wed Nov 05, 2008 3:00 pm

Postby surfbird » Wed Feb 09, 2011 10:48 am

I thought so, but my call to BlueCross said otherwise. They told me that because I take a maintenance medication and see a doctor for regular check-ups, it is a disqualifying pre-existing condition and no insurer will give me coverage. I think the reforms don't officially kick in until 2012, and then 2014.
User avatar
surfbird
Family Member
 
Posts: 61
Joined: Sun Aug 29, 2010 2:00 pm
Location: Charleston

Postby CCSVIhusband » Wed Feb 09, 2011 10:52 am

If at all, because the law is "unconstitutional" until otherwise proven by the Supreme Court at this point.

It gets one more saying ... and otherwise this whole shabang may have been just a giant waste of 3 years.
User avatar
CCSVIhusband
Family Elder
 
Posts: 474
Joined: Sun Jun 27, 2010 2:00 pm
Location: Pittsburgh, PA USA

Postby patientx » Wed Feb 09, 2011 11:35 am

Surfbird:

Regulations vary by state, but in general you cannot be denied coverage under a group plan (like you would get through an employer) for a pre-existing condition. This was part of the federal HIPAA that was passed during the late 90's. (Now, for individual plans, it's a different story, though the new health care law was supposed to address that.)

The caveat is that you have to be able to show proof of continuous coverage. If you're jumping from one employer to the next, this usually isn't a problem. But, if you get laid off or something, that's why it is a good idea to continue COBRA coverage for as long as possible (I know this can be very expensive). If there is a gap in coverage, there's some sort of grace period before the new plan has to cover the pre-existing condition. This is one of the things that varies by state, but the grace period length is usually based on how long you went without coverage.

This might make your head swim, but here's some info on the HIPAA:
http://www.dol.gov/ebsa/publications/yhphipaa.html#2

I don't know if or how the current legislation affects this, but most of those regulations don't go immediately into effect anyway.
User avatar
patientx
Family Elder
 
Posts: 1068
Joined: Wed Sep 10, 2008 2:00 pm

Postby surfbird » Wed Feb 09, 2011 11:46 am

Thanks patientx! That info was very helpful; I think this means I'd be in the clear. I would definitely go on Cobra between jobs, despite the expense. This is a little weight off my shoulders. Thank you for the link & info :D
User avatar
surfbird
Family Member
 
Posts: 61
Joined: Sun Aug 29, 2010 2:00 pm
Location: Charleston

Postby brave » Wed Feb 09, 2011 1:46 pm

Surfbird
I live in CA, was diagnosed with MS, 12 years a go and since then, have changed company 4 times.
Never been denied to obtain insurance through my employer. just make sure to stay insured between jobs to be qualified for HIPAA later if needed.

brave
User avatar
brave
Family Member
 
Posts: 61
Joined: Tue Feb 24, 2009 3:00 pm

Postby patientx » Thu Feb 10, 2011 7:00 am

No problem, Surfbird. I'm not a lawyer or anything, but I've considered trying to change jobs (not easy in this economy), and I've had the same concerns about insurance as you. So, I did a fair amount of online reading on this, trying to stick with sites that didn't look like BS, like .gov sites.

One other thing that I've thought about - if I actually did get an offer at another company, I think I would try to find out ahead of accepting that (a) their insurance wouldn't give me any grief about covering the MS, and (b) what exactly their coverage was (what medicines, how much are co-pays, etc.) It seems insurance companies vary pretty widely in coverage. This might not be a deal breaker, but at least there wouldn't be any price shock. Of course, I wouldn't bring any of this up before getting an offer.

Just something else you might want to consider.
User avatar
patientx
Family Elder
 
Posts: 1068
Joined: Wed Sep 10, 2008 2:00 pm

Postby ikulo » Thu Feb 10, 2011 10:41 am

Thanks for posting this question, I've been curious about people's experiences with insurance. I have a follow up question though.

I was told by my neuro that the smaller the employer, the more difficult it is for that employer to bring in someone with a preexisting condition. His explanation was that a small company has less employees to spread the costs around. If I joined a small company (lets say under 10 people), their premiums would raise so much that they wouldn't be able to afford it. Can anyone verify this?
User avatar
ikulo
Family Elder
 
Posts: 444
Joined: Tue Aug 04, 2009 2:00 pm
Location: colorado


Return to General Discussion

 


  • Related topics
    Replies
    Views
    Last post

Who is online

Users browsing this forum: Kronk


Contact us | Terms of Service