continuation of services?

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spark73
spark73 Member Posts: 2
edited April 2015 in Employment, Insurance, and Other Financial Issues

Hello,

my wife was diagnosed with stage 2-c triple negative breast cancer in her right breast. She had a mastectomy and tumor removal and was put on chemo for the last six months which she just completed. Her oncologist then recommended that due to her testing positive for the BRCA-1 (pretty sure it was 1 and not 2) gene mutation that she have a mastectomy on the other breast and a procedure to remove her ovaries due to the risk of a recurrence in either the other breast or her ovaries. Everything was very fortunately covered by our Kaiser insurance. Both surgeries would be covered and are tentatively scheduled for late July.

Two weeks ago a company contacted me for an interview and after a few rounds and a trip up they offered me a position. Their health insurance is provided by United.

I called United to check in and see what were the chances were of them taking over for her surgeries; if they would need to do re-testing, or if their clinic would say, "Well, shoot, we didn't diagnose her so we're not gonna perform the surgeries. Oh, and since she was 'declared cancer-free, we're not gonna bother testing ourselves.'" The folks I spoke to were fairly helpful, but they essentially came back and said, "Well, I *think* everything should be covered ... and it'd be a continuation of services ... so I wouldn't worry about it ... but don't quote me on that." Of course, that provides no comfort whatsoever.

I've adamantly told them that we are not going to go if these surgeries aren't going to be covered.

Has anyone else had an experience like this? What other questions should I be asking United or Kaiser?

Any advice is appreciated -



steve

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  • BrooksideVT
    BrooksideVT Member Posts: 2,211
    edited April 2015

    As long as there is no gap in coverage, you should have no problem. I would want something in writing from the new carrier, however.

    You might also contact your State insurance commissioner to clarify the obligation of the new carrier.

    Do think about continuing your current insurance through Cobra until after the procedure. Double coverage, although it pays for the procedures only once, will take care of any deductible and/or copay on your new plan.




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  • kareenie
    kareenie Member Posts: 339
    edited April 2015

    I agree if there is no gap in coverage you should have no problem. My hubby has changed jobs several times and we have also moved for job changes. She will have to get new doctors of course but Kaiser should be able to send all her records over. There should be no problem with prophlactic mx and ooph since they are medically necessary. The womens health and cancer rights act gives her the right to second mx even for symmetry if she so chose.

    P S check with hr but generally old coverage lasts to end of month you quit old job and new coverage begins day you start new job.

    Edited to add: Oh I see what Brookside is saying about COBRA. If you don't mind paying the Kaiser premiums for a few months you could stick with Kaiser til after the surgery.


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