Question about "pre-existing" conditions:

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Fearless_One
Fearless_One Member Posts: 3,300
edited June 2014 in Employment, Insurance, and Other Financial Issues

How long does our "pre-existing" condition stay with us for purposes of health insurance?   Or does it vary by state?

For example, If I lost my job, I would be unable to afford Cobra and would lose my insurance.   At what point could I take out a plan without disclosing that I had a preexisting?   Or does it stay with us forever? 

What if we have been cancer free for a couple of years?

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  • Sherryc
    Sherryc Member Posts: 5,938
    edited July 2011

    I used to be in the insurance business.  You always want to answer the questions as asked.  Most pre-existing is 2 years however breast cancer is a cancer that is never curable in the scientific world.  We are at risk for the rest of our lives to have it again.  I have a friend who had uturine cancer and it took 20 years before she could get health insurance again.  With Obama care you will be able to get it but it will be so expensive it will probably be more than Cobra.  My sugestion is don't leave your job and insurance unless you have another job lined up with group health care.  I am 49 and DH is 62 I have come to realized that I will never retire until I can get on medicare because I need the insurance coverage.  My orginal plan was to retire early so DH and I could travel.  But BC has changed those plans for me.  Bottom line is it stays with your forever.

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  • mrsnjband
    mrsnjband Member Posts: 1,409
    edited July 2011

    You can only go 63 days without insurance before pre-exsisting conditions kicks in.  Depending on your income you might qualify for medicaid.

     I am in the same boat as Sherry, I will have to work until I qualify for medicare. I will be 57 soon, so I will have to work at least 8 more years. NJ

    Google Hippa laws in you want more info on it.  

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  • Fearless_One
    Fearless_One Member Posts: 3,300
    edited July 2011

    So if I lost my job and applied for cheap, temporary, individual coverage within 63 days of losing my insurance, they have to take me?   My Cobra would be $515.00 a month (just for me, no kids, no spouse).   A temporary plan (until I was covered through a new employer) would only run me about $180.00.

    I would never quit without having another job, but it's very slow and I am fearing lay-offs.  Cobra would be out of the question for me.

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  • msippiqueen
    msippiqueen Member Posts: 191
    edited July 2011

    My husband is self employed and we pay boo coo dollars for catastrophic coverage with a $Ten Grand deductible. That was before breast an "offical" diagnosis of breast cancer having had LCIS.



    I haven't had the stomach to ask my bill paying husband what the cost is now.



    The sad state of affairs involving access to health care in part informed my decision to have a mastectomy.



    But hey, maybe the insurance companies will recognize the value of PBLM's and will applaud those of us who make this conservative decision and not penalize us.

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  • Fearless_One
    Fearless_One Member Posts: 3,300
    edited July 2011

    Msippiqueen, 10K deductable!  Yes, it is sad, isn't it?   That also went into my deciding to have a PBLM.   With dense breasts, I thought for sure if the beast came back, they wouldn't find it in time and I wanted to do the surgery while I had good health coverage.  

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  • Sherryc
    Sherryc Member Posts: 5,938
    edited July 2011

    Feerless One you probably would not qualify for the indiviual market at this time because of your cancer.  so if you were laid off I dobt very seriously that you would find a company that would cover you.  Once the Obama care goes into effect which I am not sure but I think it is 2014 then you would be able to get coverage in the individual market, but it will be very costly.  The individual market has different rules than the group insurance market.  That is why I know for now I will be working until I am 65. 

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  • Medigal
    Medigal Member Posts: 1,412
    edited July 2011

    Isn't this pathetic?!  We are living in what "used" to be one of the so called greatest countries in the world and people have to work until they collapse just to get health insurance!  What makes all you ladies think your employers will keep you until you are 65?  My DP and a whole group of his fellow employees had taxis waiting for them one day when they showed up for "work".  What a joke that is becoming.  DP was about 57 years old and the only way he got to keep his health insurance was because they knew they were being "let go" so the company could hire younger men at cheaper wages.  They offered them the option to keep their health insurance if they all signed a document not to sue the company.  Health insurance was so needed (as it is now) that they signed the release.  So don't be so sure you will have the option to keep working as long as you want.  By letting employees go earlier, they also did not have to pay full retiree benefits.  The companies have all the answers and when the time comes they don't hesitate to stick you in the behind with them without concern for your needs.  Sorry to be such a party pooper but working until "65" is getting to be a joke these days!  We all had better hope the idiots in Washington come up with some type of Universal Healthcare for us "soon" or we will be up the river without a paddle as the old saying goes.  I am SO thrilled to be old enough to be on Medicare even if I have to pay more for an Advantage Plan.  At least we are insured (at this point, at least!).

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  • reesie
    reesie Member Posts: 2,078
    edited July 2011

    Fearless, unfortunately, Sherry is correct - the 63 day rule is only for group insurance.  Individual policies can still deny coverage fully or exclude for the pre-existing condition until 2014 when the changes take effect under Obama care.

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  • Medigal
    Medigal Member Posts: 1,412
    edited July 2011

    I hate to burst your bubbles gals but no one can know for sure they will be able to keep their jobs until they are 65.  Like you get a choice??  My DP was shocked when at 57 years old, he and an entire group of employees his age were told their "taxis" were waiting and they were now unemployed!!  This meant the company could hire younger people at cheaper wages and keep from giving them their full retirement at 65!  DP never did find another fulltime job at his age.  So don't count on "working until 65" and being able to keep your health insurance.  We won't be protected until this country comes up with some type of Universal Healthcare!  Best of luck to you anyway!

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited July 2011

    Unfortunately, there's not a lot of good news, though it's possible that your state may help you. I believe MASS and VT have good health insurance options. Maybe it's worth moving? (I had a friend who had a congential heart condition who joked about moving to Canada for health insurance)

    When I applied for individual insurance years ago (when I had no serious pre-existing condition) they asked me to list every time I went to the doctor and had surgery in my life. (yes, I was 35 and listed my tonsillectomy when I was 5). They pulled medical records from places that surprised me, like my allergy doc (the insurance agent said that allergy meds can be expensive). If you omit something, they can rescind your policy at any time due to fraud. (they usually only check this if the bills are high. So just when you need the insurance the most you could lose it). As a bonus, the applications ask if you've ever been denied coverage, so if you apply "just to see" that can potentially work against you when you apply somewhere else. I wish I had better news but my sense (talking to the CA gov't consumer group on health insurance issues) is that once we get a cancer Dx we have a pre-existing condition for life. ;(

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  • Fearless_One
    Fearless_One Member Posts: 3,300
    edited July 2011

    I was doing some further research, and apparently in my state (Florida), breast cancer is a preexisting condition for only 2 years.   This does not apply for other types of cancer and I don't know about any other states, but for Fla is 2 years.  

    I have gotten every surgery out of the way that I can think of.   If I lose my insurance, I should be okay unless I get mets.   End of next month marks my 2 year anniversary. 

    Oh- and I agree with many of you that nothing will change until 2014 - assuming it doesn't get taken away by then (which is possible).   Lord knows they're trying to.

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited July 2011

    Glad to see the light at the end of the tunnel. I'm not sure what they use to measure the end of a treatment but I know, for example, that one insurance company asks which Rx meds you are on, so if you're taking hormones they might still consider you under treatment. Don't want to be the bearer of bad tidings but FYI in case that's something you can check on.

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  • Fearless_One
    Fearless_One Member Posts: 3,300
    edited July 2011

    Peggy, good point - I assumed it meant 2 years from diagnosis with no recurrance, but you are probably right - it's probably 2 years from any form of treatment, including hormonal.

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