Topic: What are the chances of being denied?

Forum: Employment, Insurance, and Other Financial Issues — Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Jan 14, 2011 05:34AM

Posted on: Jan 14, 2011 05:34AM

jenlong wrote:

Hi

My husband and I are about to move back to the states in April. While over here in Germany I've been diagnosed with bc. That was in 2007. What are the chances that insurance companies will turn me down? I have no clue on how this works. My husband will be covered through is job by Blue Cross Blues Shield. Will they cover me? Any experiences? Thx.

Any day above ground is a good one Dx 3/9/2007, IDC, 1cm, Stage I, Grade 2, 0/5 nodes, ER+, HER2-
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Jan 14, 2011 08:14AM - edited Jan 14, 2011 08:15AM by lago

I'm not sure if they can refuse you. If you had continuous coverage I don't think they can but if not they can refuse to cover a precondition. That won't change till 2014.
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Here is what passed under Obama's health care reform in 2010:

* Children age 26 and younger will be able to remain covered under their parents health insurance plans (this is increased from past age limits which were anywhere from age 22-25).

* Medicare recipients will receive a $250 rebate to help in closing the "doughnut hole" (with the goal being to close the doughnut hole completely by 2020).

* Health insurance companies will be banned from excluding coverage for pre-existing conditions for children.

* Adults with pre-existing conditions will be eligible for coverage into high risk health insurance pools until future health care exchanges are up and running.

* Health insurance companies will be prohibited from levying annual limits and lifetime limits on coverage.

* All new health insurance plans must provide coverage for preventative services with no out of pocket cost (all health plans will be forced to comply by 2018).

* Those companies that offer health benefits for early retirees ages 55 to 64 will receive assistance from a temporary reinsurance program.

* All new health insurance plans will have to comply with new regulations that lay out an appeals process for when health insurance claims are denied.

* Small businesses that employ less than 50 people are eligible for a tax credit equal to 35% of their health insurance premiums (this increases to 50% by 2014).

Source:  http://www.csmonitor.com/Business/Christian-Personal-Finance/2010/0325/What-Obama-s-new-health-care-bill-means-for-us 
See source for changes for 2011-2014

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Right now I am on my states high risk pool insurance. It's not cheap but it's bettter than nothing. Check here to see if your state will be participating. If not then I think the federal government offers something. Once you have been on some kind of insurance for a  year then I think  your husband's employer can not refuse the precondition.:

http://www.cobrahealth.com/statehighriskpools.html 

DONE!! goo.gl/IoaN6U • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010 Dx 7/13/2010, IDC, 5cm, Stage IIB, Grade 3, 0/14 nodes, ER+/PR+, HER2-
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Jan 14, 2011 03:29PM Bren-2007 wrote:

If I went on my DH's insurance, I would have a 12 month wait.  He has BC/BS and it would be considered a preexisting condition.

I hope that isn't the case for you.

Best of luck to you,

Bren

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Jan 15, 2011 08:48AM jenlong wrote:

Thanks you guys for the info...

Well, this sounds pretty confusing. Aren't Obama's plans gonna be 'reversed' because the republicans have more power now? I thought I read they wanna get rid of his health plans?

Jen

Any day above ground is a good one Dx 3/9/2007, IDC, 1cm, Stage I, Grade 2, 0/5 nodes, ER+, HER2-
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Jan 15, 2011 10:30AM lago wrote:

jenlong Republicans have more power in the house of representatives but not in the senate. It has to pass both so right now I doubt it will be reversed. Of course if in the next election the republicans take the senate majority then it might be reversed.

Jenlong you should call the insurance plan and ask. There is always that state/federal high risk insurance. Expensive but trust me cheaper than not being covered. That's why I'm on it. If you need help let me know. I used to deal with insurance in a dental office back in the late 80's. This is why I know some of the issues and how it works. 

BINVA, Not sure if that's true of every BC/BC plan. Typically you need to wait 12 months for preexisting only if you have been out of insurance for any length of time within a year. If it's continuous you should be OK. My husbands new company has BC/BC PPO and it doesn't seem to be rejecting precondition from what he can see. But since jenlong has been out of the US system I do believe the precondition would apply. She would need to check with her husbands insurance.

DONE!! goo.gl/IoaN6U • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010 Dx 7/13/2010, IDC, 5cm, Stage IIB, Grade 3, 0/14 nodes, ER+/PR+, HER2-
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Jan 20, 2011 04:40AM jenlong wrote:

Hi lago

Sorry had problems with my computer. Well, in the meantime my husband made a few phone calls regarding insurance. For roght now it doesn't look too good. He called about the corbra plan, but I'm not qualified. I'm really worried now about not gonna be able to get insurance. You offered to help me out, I 'd really appreaciate it! What would you recommend?

Thanks

Jen

Any day above ground is a good one Dx 3/9/2007, IDC, 1cm, Stage I, Grade 2, 0/5 nodes, ER+, HER2-
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Jan 20, 2011 07:44AM lago wrote:

Have you called about the highrisk pools: http://www.cobrahealth.com/statehighriskpools.html

I'm on it right now since my husband's insurance won't kick in for several months. What state are you planning moving to? Have you contacted the American Cancer Society. They may be able to lead you to some sources as well: http://www.cancer.org/

Let me know what I can do. PM when you get a chance so I don't miss your post. OK I need to take off for a doctor's appointment right now. Hang in there we will figure something out.

What exactly did they say? They wouldn't cover you at all or wouldn't cover the pre-condition for at least a year?

DONE!! goo.gl/IoaN6U • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010 Dx 7/13/2010, IDC, 5cm, Stage IIB, Grade 3, 0/14 nodes, ER+/PR+, HER2-
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Jan 21, 2011 03:40AM jenlong wrote:

Hi there

Yes, we did call Cobra. The problem ist that we are coming from Germany. In order to get accepted you would have to have been insured in the states first.

And I don't qualify for the high risk pool plan because I've been insured for at least the last 6 months.

We are gonna move to Arizona. I read about portability plans but they would cost $475/mo. This is ridiculous. I thought about paying out of my pocket for a year til I can get on BC/BS. Don't really wanna do that, but hey...

This is kind of scary, since over here you can't be turned down and everyone is insured. I don't know why so many people are against this kind of health plan in the states...anyway. I'm gonna have to contact the American Cancer Society and see what they have to say.

I appreaciate your help.

Jen

Any day above ground is a good one Dx 3/9/2007, IDC, 1cm, Stage I, Grade 2, 0/5 nodes, ER+, HER2-
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Jan 21, 2011 07:19AM lago wrote:

jelong didn't have to wait 6 months of being uninsured but I am paying more than $475/mo with a $1000 deductable. I'll have to check on that but I think it's closer to $700/mo for a BC&BS PPO that covers 80% of in-network. Trust me as expensive as that is it's cheaper than no insurance. Granted I should be on my husbands insurance in a few months.

Mine might be higher because I'm older than you and it's different state.

DONE!! goo.gl/IoaN6U • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010 Dx 7/13/2010, IDC, 5cm, Stage IIB, Grade 3, 0/14 nodes, ER+/PR+, HER2-
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Jan 21, 2011 11:43AM EstherMSKCC wrote:

Dear Jen,

I'm sorry to hear of your diagnosis. I'm an employee of Memorial Sloan-Kettering and wanted to suggest some resources that may be helpful in obtaining financial assistance during and after you sort out your insurance issues.

The National Cancer Institute (NCI) has good information on government-sponsored and other national organizations that offer financial aide for cancer-related expenses, including cancer-related expenses, including treatment, copays, etc...
http://www.cancer.gov/cancertopics/coping/financial-legal

Cancercare also provides links to resources that offer financial assistance for cancer patients:

http://www.cancercare.org/get_help/assistance/cc_financial.php

Livestrong offers a searchable listing of resources (financial, legal and others):

http://www.livestrong.org/Get-Help/Find-More-Resources#/f/FinancialGovernmentAssistancePrograms

Cancer.net (patient information from the American Society for Clincial Oncology) offers an overview on managing the cost of cancer care and some helpful resources:

http://www.cancer.net/patient/All+About+Cancer/Managing+the+Cost+of+Cancer+Care/Financial+Resources

Patient Resource.net: http://patientresource.net/Financial_Resources.aspx

I hope this information is useful and wish you the best of luck finding the assistance you need. --Esther

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Jan 21, 2011 12:57PM 3monstmama wrote:

Jenlong,

A couple of questions:

are you a german citizen?  I know some countries with national healthcare allow you to move to another country--if the move is not permanent---and take your health coverage with you.  Not sure how it works but worth checking out.

How is your husband insured now?  Is he a us citizen with a US policy?  Can he switch to a family plan?  And it you don't mind my asking, is he employed privately or publically?  If he will be employed by the US government, you should be able to be added onto his policy with BC/BS as they don't bother with the preexisting condition issue.

good luck!

Pain is inevitable. Suffering is optional.

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