questions about changing insurance companies

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tall girl
Regular Member


Date Joined Apr 2009
Total Posts : 68
   Posted 5/4/2009 8:47 AM (GMT -7)   
Hello All,
 My husband is in the Marine Corp so we have Tricare (insurance). It pays 100% for everything from doc. app. to lab work to meds. My husband's contract is up in August and he has decidied to get out. We will be going back to civilian life and no more awesome insurance. Has anyone changed insurance companies since being dxed? Do most insurance companies consider it a pre existing condition? Will I be covered? I spoke with my HR friend (benefits cordinator) at the company I work for and she said as long as there is not more than a 30 day gap in coverage I will be fine. Is she correct? Any body had experience with this? Thanks
25/ Female DXed Crohn's 1/09
Many diet restictions
Entecort, Pentasa, Zantac, Fish Oil
Still confused and sometimes angry/frustrated
However I am learning to laugh at all this more often


inflamed
Veteran Member


Date Joined Nov 2005
Total Posts : 1340
   Posted 5/4/2009 8:52 AM (GMT -7)   
Yes, you get a certificate of portability (I think that is what it is called). If you are switching straight to another work plan you are fine. I switched from my husband's to my work plan and back to my husband's without a problem. We actually did the forms so there was a 15 day overlap with each to be safe, but it was fine.

No plan will be as good as the one you have now. Depending on employer benefits consider a FSA or medical savings account to cushion the extras you will now be paying.
Hoping to stay in remission after the birth of a healthy baby girl. On Pentasa during my pregnancy, went med-free 2 months to nurse (stupid), but back on Pentasa and still nursing.


B&K'smom
Regular Member


Date Joined May 2009
Total Posts : 31
   Posted 5/4/2009 9:02 AM (GMT -7)   
I am 20 years old and Dx with CD. I know that if i wanted to switch to a private insurance company, they would not cover me. I was to high of a risk(and this was before I had surgery and multiple problems) I looked at several different companies with the same reply. My husbands insurance is so expensive (170 a week (for just us not including the kids) with a 5000 deductable) But I ended up having to switch from my Dads to my husbands. There was no other choice, b/c that was the only way we could get around pre-exsisting. Good luck!!

dt19&99
Regular Member


Date Joined Apr 2009
Total Posts : 174
   Posted 5/4/2009 9:37 AM (GMT -7)   
My younger brother had a pre existing condition and a gap in his insurance so he had to wait 12 months for anything to be covered with that condition...

Anybody had any experiences with gaps like that? I was without insurance for about 6 months 2 years ago, but went 4 or 5 years without seeing a doctor... Hoping that doesn't come back to bite me in the ass.

Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 5/4/2009 2:16 PM (GMT -7)   
The last time my husband changed jobs there was a waiting period before any of us were covered. Only 30 days, but my kids were young (ie, you never know what kind of trouble they could get into) and I have CD). We signed up for COBRA. We didn't have to pay for it, unless we used it, still better than having a gap of insurance or having to pay for an unexpected surgery or broken arm. I prefilled all my prescriptions and hoped I could wait out the 30 days without any doctors appointments. Just make sure that you don't have any gaps of insurance. That is the sticky wicket so to speak. If there is a gap then they can deny coverage, and that is why you need to sign up for COBRA if the new insurance doesn't cover you right away. Or at least that is my understanding. There are a couple of insurance people on the board so hopefully they will see your post and give you all the up to date info.
Suzanne

CD 20 years officially, 30 unofficially. 3 resections '93, '95 '97
Managing with strict low residue diet, keeping symptoms to a minimum. All test show small amount of ulceration, still have occasional blockages. But still have a great time with my 2 daughters and husband!


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


tall girl
Regular Member


Date Joined Apr 2009
Total Posts : 68
   Posted 5/4/2009 2:51 PM (GMT -7)   
Thanks Zanne and everyone else- That's kinda what my hr friend told me too. My new job will start June 1 and I am covered with the military insurance intill September 1 so hopefully there will not be a gap. Can you explain more about Cobra....I have heard of it but am not sure where to get more info incase I need it. You don't pay unless you use it?
25/ Female DXed Crohn's 1/09
Many diet restictions
Entecort, Pentasa, Zantac, Fish Oil
Still confused and sometimes angry/frustrated
However I am learning to laugh at all this more often


annyb
Regular Member


Date Joined Feb 2009
Total Posts : 62
   Posted 5/4/2009 3:28 PM (GMT -7)   
Congress passed the landmark Consolidated Omnibus Budget Reconciliation Act (COBRA) health benefit provisions in 1986. The law amends the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Service Act to provide continuation of group health coverage that otherwise might be terminated.
 
COBRA provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain specific events. Group health coverage for COBRA participants is usually more expensive than health coverage for active employees, since usually the employer pays a part of the premium for active employees while COBRA participants generally pay the entire premium themselves. It is ordinarily less expensive, though, than individual health coverage.
 
COBRA establishes required periods of coverage for continuation health benefits. A plan, however, may provide longer periods of coverage beyond those required by COBRA. COBRA beneficiaries generally are eligible for group coverage during a maximum of 18 months for qualifying events due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage.

Coverage begins on the date that coverage would otherwise have been lost by reason of a qualifying event and will end at the end of the maximum period. It may end earlier if:

  • Premiums are not paid on a timely basis

  • The employer ceases to maintain any group health plan

  • After the COBRA election, coverage is obtained with another employer group health plan that does not contain any exclusion or limitation with respect to any pre-existing condition of such beneficiary. However, if other group health coverage is obtained prior to the COBRA election, COBRA coverage may not be discontinued, even if the other coverage continues after the COBRA election.

  • After the COBRA election, a beneficiary becomes entitled to Medicare benefits. However, if Medicare is obtained prior to COBRA election, COBRA coverage may not be discontinued, even if the other coverage continues after the COBRA election.

Although COBRA specifies certain periods of time that continued health coverage must be offered to qualified beneficiaries, COBRA does not prohibit plans from offering continuation health coverage that goes beyond the COBRA periods.

 

All of this information came straight from the United States Department of Labor website.  But I must stress that you can NOT be late with your payment.  They will cut you off.  The good news is that the new Economic Recovery Act that President Obama initiated will subsides the cost of COBRA if you fall into certain categories.

The American Recovery and Reinvestment Act of 2009 (ARRA) provides a premium reduction to certain qualified individuals and expanded eligibility for COBRA.

Individuals who are eligible for COBRA coverage because of their own or a family member’s involuntary termination of employment that occurred from September 1, 2008 through December 31, 2009 and who elect COBRA may be eligible to pay a reduced premium amount that is only 35% of the premium costs for your COBRA coverage for up to 9 months.

Additionally, if you were offered Federal COBRA continuation coverage as a result of an involuntary termination of employment during that time period and you either declined to take COBRA coverage at that time, or you elected COBRA and later discontinued it, you may have another opportunity to elect COBRA coverage and pay a reduced premium.

 

Hope this helps.  COBRA is expensive but well worth it for anyone with CD as the cost of medical procedures and medications can easily exceed the cost of the insurance.  Good Luck.


Crohn's Disease - 29 years
Diagnosed at age 10 in 1979
1st ileosecal resection 1989
2nd colon resection 1993
Chronic "D" and arthritis
Chronic rectal stricture with colonoscopy every 3 months to dialate
Insomnia since 1980 - I love my ambien!
 
SCUBA diver, Master's degree student, college graduate, Pet therapist
 


MerJ2009
Regular Member


Date Joined Apr 2009
Total Posts : 22
   Posted 5/4/2009 4:11 PM (GMT -7)   
I am currently on COBRA...I graduated college 1 week after being diagnosed with CD. I had a job lined up but knew I would have a wait time before I was able to be covered by insurance. I went with COBRA and it is $475 a month for just me(that will obviously be different depending on the employer). Its probablly the best choice I could have made. It covers a large chunk of my meds and I just have a simple co-pay at the Dr.'s. My bloodwork is covered and everything. My dad has great insurance... I even get to pick if I want vision or dental. I do have coverage for them currently but if I dropped them it would cut a big chunk out. I have actually decided not to do insurance through my work because the bennifits of COBRA are better then what I would get through my job. Basically in the end I will be saving money by staying with COBRA. I would look @ the insurance through your work and then look into COBRA. It is expensive but totally worth it! Plus I can go on my fiances insurance in July when we get married now with no issues(lets hope atleast!) Best of luck figuring things out!
23yr F. Diagnosed Dec. of 2008 after 2.5 years of symptoms.
Trying to get into remission. Currently only on Pentaza 2pills 4X daily.  Also a daily vitamin.


jsk218
Regular Member


Date Joined Jan 2009
Total Posts : 29
   Posted 5/4/2009 4:23 PM (GMT -7)   
I, too, had Cobra for a while, and it was almost $700/mo for an individual. It can be very expensive, but you don't want a lapse in coverage - that's what can really get you into trouble!

Good luck!
Diagnosed with Crohn’s Disease in Jan 2007, though sick since mid 90’s. Currently on Humira and Protonix. Have had success with Entocort and Cipro; negative experience with Methotrexate.

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