Question regarding employer health insurance

melza89
melza89 Member Posts: 64
edited June 2019 in Employment, Insurance, and Other Financial Issues

I am currently insured through my husband's employer. Our plan is ok but we consider the options every time there is open enrollment. We can choose from a few different providers & many types of plans. But if we switch plans or providers (but still through the same employer), would the new plan cover my BC treatments/tests?

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  • vlnrph
    vlnrph Member Posts: 1,632
    edited May 2019

    Assuming you are in the US where we still enjoy protection from discrimination due to pre-existing conditions via the Affordable Care Act which has not yet been repealed (although some are trying to destroy it).

    Group policies thru employers do not generally use individual underwriting so there is no disclosure of your diagnosis. However, you must beware of self funded plans especially in a small office/firm because those workers who run up big bills are more likely to be easily identified. Then it could be a matter of your husband getting the ax the next time they need to downsize...

    In summary, your treatments and tests should have coverage even if you switch plans or providers but it’s a goid idea to carefully examine the options and try to maintain your privacy as much as possible.

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  • kber
    kber Member Posts: 394
    edited May 2019

    Second vlnrph.  You have legal protections, but check the fine print.

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  • melza89
    melza89 Member Posts: 64
    edited May 2019

    Thank you vlnrph and kber. Yes, I am in the US and my husband works for a very large employer. I'll make sure to check the fine print when we have the opportunity to switch plans later this year.

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  • TwoHobbies
    TwoHobbies Member Posts: 2,118
    edited June 2019

    Melba, yes you can switch. You just have to have no lapse in coverage. I switched from BCBS to UHC and back to BCBS due to premium costs and had no issues. Both me and my son had expensive pre existing conditions.

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  • gb2115
    gb2115 Member Posts: 1,894
    edited June 2019

    Yup if it's an employer provided group plan with no lapse in coverage it should be fine. And if you are switching plans during an open enrollment, your HR will make it seamless. I was switched from one insurance company to another mid-year (we had a June open enrollment), and the new one even upheld my out of pocket met.

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  • Salamandra
    Salamandra Member Posts: 1,444
    edited June 2019

    The new plan should cover your treatments in general but it may or may not cover the same doctors and facilities as your old one. So if you like your doctors/hospitals, it's really important to investigate whether they are in network for the new plan, or what kind of out of network coverage the new plan has, and whether that's affordable for you.

    (I couldn't tell if this was more of a question about pre-existing conditions or more of a question about variation in coverage).

    Can your husband ask around at work to people who are on other plans, and get a sense of which plans people are happy with - especially people dealing with similar health issues? Also, worthwhile to get the full info and paperwork from HR.

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