Topic: Question about "pre-existing" conditions:

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

Posted on: Jul 11, 2011 01:53PM - edited Jul 11, 2011 02:25PM by Fearless_One

Posted on: Jul 11, 2011 01:53PM - edited Jul 11, 2011 02:25PM by Fearless_One

Fearless_One wrote:

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?

lump/chemo/rads/hyster-ooph/mastectomy/implants
Log in to post a reply

Page 1 of 2 (13 results)

Log in to post a reply

Jul 11, 2011 02:49PM Sherryc wrote:

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.

Sherry--lump left breast 9/30/10. No chemo, Zometa-6tx over 3 years.Oncotype score 23 with 14% recurrence rate. 34 rads. No family history, BRCA neg. 48 years old @ diagn. BMX/TE 3/26/2012, Exchange surgery 8/21/12, Revision surgery 11/27/12 Surgery 5/11/1997 Lumpectomy: Left Dx 9/27/2010, IDC, Left, 1cm, Stage IB, Grade 1, 0/3 nodes, ER+/PR+, HER2-, Surgery 9/29/2010 Lumpectomy: Left; Lymph node removal: Left, Sentinel Radiation Therapy 12/2/2010 Hormonal Therapy 2/6/2011 Surgery 11/2/2011 Lumpectomy: Right Surgery 3/25/2012 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/20/2012 Reconstruction (left); Reconstruction (right) Surgery 11/26/2012 Reconstruction (left); Reconstruction (right)
Log in to post a reply

Jul 11, 2011 03:02PM mrsnjband wrote:

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.  

Norma June, Bi-lateral MX 2008, Bi-lateral DIEP 2011 Dx 1/10/2008, IBC, <1cm, Stage IIIB, ER-/PR-, HER2- Chemotherapy 1/24/2008 AC Chemotherapy 3/9/2008 Taxol (paclitaxel) Chemotherapy 5/28/2008 Taxotere (docetaxel) Surgery 7/9/2008 Lymph node removal: Right; Mastectomy: Right; Prophylactic mastectomy: Left Radiation Therapy 8/10/2008 Surgery 8/14/2011 Reconstruction (right): DIEP flap Surgery 8/14/2011 Reconstruction (left): DIEP flap Surgery 12/11/2011 Reconstruction (left)
Log in to post a reply

Jul 11, 2011 03:33PM Fearless_One wrote:

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.

lump/chemo/rads/hyster-ooph/mastectomy/implants
Log in to post a reply

Jul 11, 2011 03:37PM msippiqueen wrote:

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.

Support a woman's right to choose...mastectomy. Dx 4/28/2010, LCIS, <1cm, Stage 0
Log in to post a reply

Jul 11, 2011 03:43PM Fearless_One wrote:

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.  

lump/chemo/rads/hyster-ooph/mastectomy/implants
Log in to post a reply

Jul 12, 2011 07:40AM Sherryc wrote:

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. 

Sherry--lump left breast 9/30/10. No chemo, Zometa-6tx over 3 years.Oncotype score 23 with 14% recurrence rate. 34 rads. No family history, BRCA neg. 48 years old @ diagn. BMX/TE 3/26/2012, Exchange surgery 8/21/12, Revision surgery 11/27/12 Surgery 5/11/1997 Lumpectomy: Left Dx 9/27/2010, IDC, Left, 1cm, Stage IB, Grade 1, 0/3 nodes, ER+/PR+, HER2-, Surgery 9/29/2010 Lumpectomy: Left; Lymph node removal: Left, Sentinel Radiation Therapy 12/2/2010 Hormonal Therapy 2/6/2011 Surgery 11/2/2011 Lumpectomy: Right Surgery 3/25/2012 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/20/2012 Reconstruction (left); Reconstruction (right) Surgery 11/26/2012 Reconstruction (left); Reconstruction (right)
Log in to post a reply

Jul 12, 2011 12:01PM - edited Jul 12, 2011 12:02PM by Medigal

This Post was deleted by Medigal.
Log in to post a reply

Jul 12, 2011 12:59PM reesie wrote:

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.

Marie - It's A Great Day To Be Alive. Dx 10/29/2010 ER+/PR+, HER2- Stage IV mets to bones, liver, lungs, skin, pleural effusions
Log in to post a reply

Jul 12, 2011 02:28PM Medigal wrote:

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!

Log in to post a reply

Jul 13, 2011 09:24AM peggy_j wrote:

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. ;(

Dx 2/2011, IDC, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-

Page 1 of 2 (13 results)

Scroll to top button