Insurance running out

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carr
carr Member Posts: 1
edited June 2014 in Caring for Someone with Breast cancer

Hey, i'm trying to find out some information for my best friend who has survived IBS. She had a single mastectomy and when last week to find out about finishing her surgeries (another mastectomy and reconstructive surgery.) The surgeon was not encouraging and basically has talked her out of it. Her Cobra runs out in January and she's supposed to go back to work. But it's clear she will not be able to continue in her previous position as she cannot meet the physical requirements. It's also not clear if she will be considered a new hire (she's been off for nearly two years now) and if the insurance -- BCBS -- will cover her condition. I'm afraid if she doesn't move forward now, she will not be able to change her mind later because she will not have the coverage. Does anyone have any idea where I can go to find out about these issues and what her options for coverage are. I have her permission to start this research and will have a signed HIPPA form the next time I'm in town to see her. Thanks in advance.

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  • jenn3
    jenn3 Member Posts: 3,316
    edited November 2009

    I really don't have the answers or know how the insurance works, but the first thing that comes to mind is that if she is on COBRA now and is reinstated before it runs out, would her policy be reinstated because she is going back to work for the same employer?  It sounds like her employer needs to give her more information so that she knows where she stands with the insurance. 

    Good luck.

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  • barbergirl
    barbergirl Member Posts: 15
    edited November 2009

    Why did her surgeon not want her to do the surgery.

    I would say if Ins. is about to run out, she better do it.

    Her next ins. will not cover pre existing condition

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2009

    My husband was laid off at the same time that I was diagnosed.  That is a post for another thread, but we have been on Cobra which ends in February.  We do not have additional coverage yet, and have Regence (used to be BS/BC).  We can purchase a policy directly from them - which will be about the same cost - without any pre-existing conditions as long as we do so without any lapse in service.  This is called continuous coverage.  The most important part is that there can be no time that she is not covered - not even 4 hours!  If we lapse then what ever health coverage we get will have pre-existing conditions excluding breast cancer and the scans etc.for a set time period - at least one year.

    She should get a policy from BS/BC for the  60 day time period that she will not be covered.  She can also discuss this with the HR person in charge of benefits - they are very knowledgeble on these matters. I suppose it is possible that they can reinstate her benefits immediately but I would not count on that and get all  information in writing.

    The continuous coverage = no pre-existing conditions is a federal law.

    hope that helps

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  • Estelle67
    Estelle67 Member Posts: 2
    edited November 2009

    I was on COBRA when I was first diagnosed with breast cancer a little over a month ago.  I'd started my new job back in July and had not qualified for the insurance at my new job yet.  I'm actually still on COBRA, though I've since become eligible for insurance at the new place but I've decided to stay on COBRA because the plan actually has better coverage.  Anyway, that's not the point of my post.

     When I was trying to decide whether I should stay on COBRA or move to my new insurance, my friend (who works in health insurance) told me that since I've been on COBRA, I've maintained continuous health insurance coverage; therefore, the new plan (or any new plan) can not not cover me for a pre-existing condition.  Therefore, your friend should be able to get coverage with her new job.  If she's going to have to wait with her job to be covered, she should look into getting a short-term plan (which ALSO can not not cover her because she's maintained coverage the whole time with no break in service).

     I hope this info helps.  Good luck to your friend. Smile

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