Insurance Questions

[Larry B.]

Hello all,

Maybe someone here can answer some questions on Insurance Issues. I may have to change jobs soon, and am not sure of some of the new Hippa laws. Is there any reasonable reasons I need to disclose the fact I had TC, and am on surveilence? If I change jobs, and have no lapse in coverage, can they deny payments? I just cant lose insurance now, I would not be able to pay all the cost of lab work, and DR visits if I am uninsurable. I may be a jumping the gun on the job I have, but need to know all the facts before making a move. Thanks all in advance.

[tonytigre]

Hi there Larry, well I am not sure if I have the answers you need but I thought I would let you know my story. I lost my job at the end of September of 2005 and went on COBRA paying the full premium for my insurance benefits. Then I was able to land a great job last month that offered the same insurance that I had with my previous employer. I let the lady at my new job know that I was on COBRA and she told me that I couldn't keep both my COBRA and new policy at the same time. My new insurance starts on Feb 10th. One thing that worried me was the "Waiting Period for a Pre-Existing Condition" clause in some insurance policies. Some have anywhere from 90 days to a year, so you might want to look into that. I was lucky that my new job's insurance has a "No Waiting" period on a pre-existing condition so I will have no lapse in coverage. Maybe you can go on COBRA so that way you don't have a lapse in coverage. I still can pay my COBRA payment by the end of Feb and keep it active just in case something funny comes up but my new job guaranteed me that there would be no waiting period and I just recieved my new insurance card. I talked to some co-workers and some are going through the same as me (cancer, heart conditions, etc.) and they told me that there was no waiting period, so that put me at rest. I was giving a health questionere before I started and one of the questions was if I ever had cancer, I was honest on it and it has never become an issue. I also opted for a long term disability insurance that would pay for 75 percent of my wages for up to 56 weeks, which might come in handy if cancer shows it's ugly face again. I am not sure if any of this helps but I am sure there are others that can help too. Just make sure to see if there is a "Pre-Exisiting Condition" clause in the new insurance policy and if not go on COBRA. COBRA is good for up to 18 months, the only downside is you pay full premium but in my case it was only $255 a month which is still cheaper than a urologist visit. Take Care

[cotoram]

Insurance Answers

I am in the TC club here and had an Orchiectomy in December, 2005. I also do health insurance for a living!

Here is how you make sure that you do not have a problem with insurance when you switch jobs:

1. Make sure you do not have a lapse in your coverage (if you do no more than 63 days - see below).
2. Make sure you understand the waiting period at your new potential job (i.e. period to be working before you are benefits eligible).
3. HIPAA - this federal law states that as long as you do not go more than 63 days without coverage then your new plan cannot apply a "pre-existing condition" clause, limiting the coverage for any medical condition you have had recent treatment for (TC).
4. COBRA - you have 60 days to elect COBRA and 45 days to pay. You could almost milk the COBRA deal for 105 days if you were to elect on the 59th day and then not pay until the 104th day, but then again you want to have no gap longer than 63 days per HIPAA.
5. Privacy laws - another aspect of HIPAA is that it protects your PHI (Private or protected health information). Do not release your medical information to anyone that does not need to know including your employer.

You should be fine switching jobs particularly if your new employer is a larger employer and offers a good quality program.

I hope this helps.

[tonytigre]

Great information Cotoram, I have two questions for you.

1. If before you are hired and have to fill out a medical history form, do you have to fill it out or do you lie on it and don't put your medical history on it? I ask because it was part of my pre-screening process and it didn't affect me on getting hired. To come to think of it the only person that I really talked to about it was the lady in HR who deals with the insurance. I just wanted to make sure I didn't let go of my COBRA if there was a waiting period in my current policy.

2. Can you carry COBRA and a current policy at the same time? Or do you have to terminate COBRA as soon as your new insurance starts?

Thanks for your help

[Mom]

It is against the law to ask medical history before you are hired. The only question they are allowed to ask is if you have a condition that would prohibit you from doing the essential functions of the job. Your answer is NO. TC does fall under protection of the Americans with Disabilities Act which means that your employer will have the "accommodate" you in certain instances, e.g. doctors visits, chemo treatment, etc. Once you are hired, if the company offers a health plan to its employees it cannot deny you health coverage, but there may be an issue of "pre-existing" conditions which Cotoram has addressed. Under no circumstances should you discuss your health situation with a potential employer. Even though there are laws against discrimination, your chances of being hired are slim. Also, if the company you are with doesn't have to comply with COBRA, make sure you do not have a lapse of coverage greater than 63 days. Find insurance elsewhere, even though it will be costly. Hope this helps, I am not a lawyer, but it is my understanding of the law. I am also giving you advice through practical experience. Dianne

[cotoram]

Answers

Way to go mom,

Larry B.....
In answer to your question regarding simultaneous coverage of COBRA and new group health coverage, the answer is not real clear cut as this is dependent upon the carrier and is not regulated by Federal law. You have to read the fine print of your COBRA coverage or call their customer service to see if they would require you drop the coverage once you became eligible for and enrolled in other group coverage.
Mom is right that not all employers have to offer COBRA, only those employers with 20 + employees are required to. Also another thing about COBRA, it is only required to offer the same coverage to COBRA particpants as it does to active, therefore if you are on an HMO say in Arizona, and you move to a new state outside of the HMO service area, say Idaho, you could be screwed..... no coverage or option for COBRA.
Another resource for you should be the consultant/broker that works for your new employer, you should be able to discuss these types of options with them including the type of coverage and exclusions, etc. for the new policy. And if your new company does not have a broker/consultant.... I can do that for them!
Let me know if you have any additional questions.

[huckchef]

great info guys and gals!! thanks a bunch!

[Larry B.]

Thanks all

Thanks to all of you. Cotoram, I knew there would be some great advise here. Well, I still am stable at my current employer, we had some good news on the year end report. But it is good news that I should not have much difficulty if I do need to change jobs. I am in great health other than the TC. Thanks again.