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Posted by: violet516 ® 10/14/2009, 11:25:22 |
Has anyone switched insurance companies while having SD and had the new insurance company not cover Botox injections as they felt the SD was a 'pre-existing condition'? Right now I my injections are covered, but I'm worried that if I switch jobs and get new insurance, I will not be covered. Do I have to stay with the same job/health insurance co. for the rest of my life?!?! This can't be... Anyone have experience with this? |
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Posted by: Lorib724 ® 10/14/2009, 16:01:52 |
Yes, its ok to change insurance companies. Depending on the new insurance, you might have a waiting period-but that's not always the case. I'll email you all the details. I've had to deal with it a few times. Lori B. |
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Posted by: Laurie ® 10/14/2009, 20:27:32 |
The key is that there is no "gap" in insurance coverage greater than 63 days. That is, you can't leave your current job, wait 6 months, get a new job and expect to have your SD covered. In that case, it would be deemed a pre-existing condition. HOWEVER, you can leave your current job, start your new job immediately (get on their health plan right away -or hold onto Cobra from your old job until you are eligible for coverage at the new job as some make you wait 1-3 months) and they are required by law to cover Botox for SD. In other words, pre-existing condition exclusions do not apply if you are switching (immediately - or within 63 days) from one insurance plan to another. So it's a matter of not having a gap in coverage. The only time you run into problems is if you never had insurance coverage before or had a gap in your coverage greater than 63 days. You have to be super careful about coverage gaps. By no means are you trapped in your job for life. That would mean anyone who is diabetic, etc., would be in the same situation and could never switch jobs. Also - there will be no waiting period from the insurance company unless you had a gap in coverage. Some businesses, however, make you wait 1-3 months before putting you on their coverage so in that case, you should buy Cobra from your former employer for that time period. If this is not clear, let me know. Laurie Modified by Laurie at Wed, Oct 14, 2009, 20:29:34 |
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Posted by: violet516 ® 10/21/2009, 11:44:56 |
Thank you so much for your explaining that to me, Laurie. I knew I was missing something, and I feel so much better now that I don't have to worry so much. Is Cobra expensive? I'd imagine for me it would be close to the cost of my current policy. Does that sound about right? I had an additional question that perhaps you could also answer. If I didn't have health insurance for an extended period of time for whatever reason, would I be denied coverage, end of story, or would it just be more difficult to get coverage? This isn't the case, and I won't worry about specifics unless I get in the situation, but I am curious how difficult it would be for someone who didn't have insurance or have lapsed in coverage. Thanks again! |
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Posted by: Laurie ® 10/21/2009, 13:10:39 |
Yes, Cobra would cost exactly what your policy costs now. Cobra is just a law that allows you to buy your current policy. So say you have Blue Cross with your current employer, if you leave the job and purchase it through Cobra it's still the same exact Blue Cross policy. At the same price. You're just paying for it. Technically, they can also add a 1-3% administrative fee. One other thing.... Cobra laws vary by state. Federal law (applying to companies with a large amount of employees) allows you to purchase Cobra for 18 months. If you work in a small business, how long you can purchase Cobra will depend upon the State in which you live - just google "Cobra laws by State." In New York (and often more liberal states), you get the same protection of 18 months, but it some states it can be as little as 6 months, etc. This only applies if you work in a small company. As for buying coverage after a gap, etc., again it depends on the state in which you live. Some states have guaranteed issue laws (all applicants are accepted regardless of health status) and community rating (applicants cannot be charged higher premiums because of these health conditions) but other States have laws where insurance companies can completely deny you coverage all together (it's totally up to them)... say... perhaps a state like Texas. But even in states with guaranteed issue laws/community rating, coverage for an individual will be crazy expensive -- far far more expensive than Cobra. Also, when you have a gap in coverage, *even if* you live in a wonderful state like NY with guaranteed acceptance, a pre-existing condition waiting period will usually apply but it's usually just for 11 months or a year. So the answer is it all depends on where you live. The more liberal the state, the better. However, premiums can run over $1,000 a month for individual coverage. If, however, you leave your job for 2 years, don't buy Cobra, then get another job even in state with backward laws that like to deny people coverage, you cannot be denied coverage as part of a *group.* But if there were these gaps in coverage, pre-existing condition waiting periods of about 1 year will come into play. The American Diabetes Association outlines the info. by state if you want to check it out. It wholly depends on where you live. Laurie Related link: American Diabetes Assoc. Health Insurance by State Options |
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Posted by: violet516 ® 10/21/2009, 15:11:57 |
Wow, so many stipulations! Thanks again for all of the info and the link. It is very helpful. |
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Posted by: pattysv ® 11/03/2009, 12:45:07 |
If you have insurance coverage, why don't you get the
surgery and be done with it. I had the surgery - if you want more info, email me at
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Posted by: MissJanae ® 10/15/2009, 10:12:36 |
Thank you for the info, I'm pretty much up sh*t's creek. :( |
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Posted by: lorib724 ® 10/16/2009, 00:53:57 |
Never give up! There's all sorts of things you can do to try to get covered. If you want to email me directly you can. My email is entlaw1@aol.com. I'm not a pro, but I've been through alot with insurance companies. Lori B. |
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Posted by: violet516 ® 10/21/2009, 11:46:39 |
Thanks for the info you sent me, Lori. It was extremely helpful! |
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