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insurance questions - 10/21/2011 1:32:23 PM   
defiantbadgirl


Posts: 2988
Joined: 11/14/2005
Status: offline 		What is the best way to obtain free accurate information about health insurance laws on preexisting conditions? I have temporary state funded insurance due to cancer that does not cover post treatment monitoring for recurrence. Once treatment ends, my Sir who recently became my husband is going to add me to the policy he carries at his job. Can they refuse to let him add me? Can they refuse to cover monitoring of my preexisting condition and if so for how long? Does the federal insurance portability law provide protection from preexisting condition denials if there's no lapse in coverage between the time my state insurance ends and coverage under my husband's insurance begins or does that only apply to insurance through employment or workers themselves and not their family members (my last employer didn't have health insurance for employees)? I don't know if asking his insurance company is a good idea as they might lie or omit important info to protect their bottom line. Who can I go to for free accurate non biased information?


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RE: insurance questions - 10/21/2011 1:34:15 PM   
mnottertail


Posts: 60698
Joined: 11/3/2004
Status: offline 		call the insurance commissioner of your state it is generally an 800 number for outstate, or a local if you are in or near the capitol.

they will lay the poop on ya.

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RE: insurance questions - 10/21/2011 1:44:49 PM   
MasterG2kTR


Posts: 6677
Joined: 8/7/2004
From: Wisconsin
Status: offline 		In many states marriage is considered a "Major Event" (similar to having a baby) which creates an automatic open enrollment which means the insurer must accept you under the group policy. However, there is usually a limited window of time which this can be done after the marriage takes place. How long has it been?

I also agree with mnottertail, to contact your state's insurance commissioner with any questions.

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RE: insurance questions - 10/21/2011 2:31:28 PM   
defiantbadgirl


Posts: 2988
Joined: 11/14/2005
Status: offline 		We were married Aug. 3 of this year. He planned to add me immediately because at that time, my state coverage was going to end Aug. 30. Then we found out the cancer was worse than they thought. I was given the option of continuing my state coverage and cautioned that if he added me to his insurance I would be ineligible for state coverage. He's a college student that works at Walmart and I'm not working right now due to treatments (my FMLA just ended so I'm now unemployed). With his wage being our only income, we can't afford the co-pays and additional 20% of the treatment costs so we decided he would add me later. His yearly open enrollment is now and ends November 4. If there are time limits on adding a spouse after marriage....if he adds me, the state drops me, and his insurance can claim a preexisting condition......yikes. I plan to contact the insurance commissioner next week. I'm glad there's someone I can contact.

< Message edited by defiantbadgirl -- 10/21/2011 2:34:40 PM >

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Only in the United States is the health of the people secondary to making money. If this is what "capitalism" is about, I'll take socialism any day of the week.


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RE: insurance questions - 10/21/2011 3:15:43 PM   
windchymes


Posts: 9410
Joined: 4/18/2005
Status: offline 		Most insurance companies have a website that you can access, though he'll have to make an account to log into the site, no biggie. The addy should be on the card, as well as the ID number and group number.

Or if he was given a handbook by HR that spells out the terms of the plan his company subscribed to, there's a good chance it can tell you if there is a pre-existing condition clause or not.

Or, there should be an 800 number on the card that you can call to get specific information by talking to a customer service rep personally.

Or, you could talk to the insurance administrator in his company's HR department. They should be able to answer your specific questions about the plan they carry.



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RE: insurance questions - 10/21/2011 3:17:19 PM   
LafayetteLady


Posts: 7683
Joined: 5/2/2007
From: Northern New Jersey
Status: offline 		You have no profile, so I don't know what state you are in. However, check with the hospital that has been providing care and find out if they offer charity care. Also, if there is a teaching hospital in reasonable distance, chances are they offer charity care. Since there is income, you may not qualify for 100% free coverage, and there may be a co-pay, but the co-pay would be varied based on your income.

For prescriptions, there are various programs that will lower the cost. You can also contact the pharmaceutical company and apply to get your medication for free.

Good luck.

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RE: insurance questions - 10/21/2011 4:26:24 PM   
littlewonder


Posts: 15659
Status: offline 		His work should have given him a handbook with what is and isn't covered and all the in-betweens. The last place I worked for did just that and the insurance didn't cover pre-existing cancer but they offered an additional coverage for that through Aflac and an extra $30 was taken out per paycheck. It would cover the treatments, money lost due to having to miss work, prescriptions, etc...




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RE: insurance questions - 10/21/2011 5:31:10 PM   
Aylee


Posts: 24103
Joined: 10/14/2007
Status: offline 		You may also be able to talk to his HR department for some answers.

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RE: insurance questions - 10/21/2011 6:52:22 PM   
barelynangel


Posts: 6233
Status: offline 		Actually, your presumption the insurance company is going to lie or omit information is a "sky is falling" concept. Their policy isn't going to change because you inquire regarding their policy on adding a spouse and pre-existing conditions and how the insurance company handle you being added.  What you can do is have them do a full analysis of your situation and give you the bottom line of what they will cover, what they won't -- and how much it will cost you. 

It makes no sense for them to lie or omit information.  There is a policy, they have documentation, your husband as its part of HIS policy can ask for this documentation.  IF you think they are doing something wrong after they have giving you the information you seek, go have a consult with an attorney and go over what they have said, AND your husband's policy  -- they are usually free.

Don't freak out before you have a reason to freak out.  TALK to the company that has the policy instead of talking to 2380321032103281839281 people who don't know the specifics of the policy you are requesting information regarding.  That's just borrowing trouble.  

angel


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RE: insurance questions - 10/21/2011 8:23:17 PM   
LafayetteLady


Posts: 7683
Joined: 5/2/2007
From: Northern New Jersey
Status: offline 		I really don't mean to make matters worse for you, but I just read that Walmart is reducing insurance availability to part timers and raising the employee's share.

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RE: insurance questions - 10/21/2011 8:27:46 PM   
littlewonder


Posts: 15659
Status: offline 		yup. My daugter's boyfriend works at walmart part time and he's already been through that.



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