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Insurance Question... pre-existing conditions

GreenPeaMamaGreenPeaMama
in Special Needs
My daughter was born with cancer, but she is in remission and has been for several months. She is required to go for follow up MRI's every 3 months for the first year, every 6 months the 2nd year and then once a year until she is 5. I am considering a job change. She is on my insurance. I am concerned that if I do my new insurance will not cover the MRI's because they may consider it treatment for a pre-existing condition. Now I know the law has changed in regards to children and pre-existing conditions, I just don't fully understand the changes. Anyone have experience with this? I just do not want to take this job if it means I will have to pay for nearly 10 MRI's out of pocket or God forbid her cancer comes back.TIA
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Re: Insurance Question... pre-existing conditions

  • JenGKJenGK

    Glad to hear she is in remission!

    As I understand it, you can genearlly switch jobs and health coverage without worrying about preexisting conditions so long as you make sure that there is not a "break in coverage" (63 days without coverage).

    Here's a good website that explains it.  https://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

    With respect to kids, it says: 

    Are there illnesses or injuries that cannot be subject to a preexisting condition exclusion?

     

    Yes, as follows:

    • Conditions present in a newborn or a child under 18 who is adopted or placed for adoption (even if the adoption is not yet final), as long as the child is enrolled in health coverage within 30 days of birth, adoption, or placement for adoption. In addition, the child must not have a subsequent, significant break in coverage (defined as 63 days). For instance, a significant break might occur if a parent lost his job and health coverage for himself and his family shortly after a child?s birth. This break will be discussed in the Creditable Coverage section.
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  • Assembly_ReqdAssembly_Reqd member
    The new pre-existing condition change in the Health Care bill will not even go into effect until 2014 anyway.
    WAY 2 Cool 4 School


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  • ToastieSimonsToastieSimons member

    I had cancer 4 years ago and a rare disease to accompany it. As long as there is NO LAPSE in coverage they cannot disqualify you for a pre-existing condition.  Obama's healthcare law actually specifically included children, there are no more pre-existing conditions for children.

    If you were to leave your job you would either have to COBRA out your current insurance or pay privately until you were elgible at your new position.

    To my boys:  I will love you for you Not for what you have done or what you will become I will love you for you I will give you the love The love that you never knew
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  • jsugrinjsugrin member
    imageToastieSimons:

    I had cancer 4 years ago and a rare disease to accompany it. As long as there is NO LAPSE in coverage they cannot disqualify you for a pre-existing condition.  Obama's healthcare law actually specifically included children, there are no more pre-existing conditions for children.

    If you were to leave your job you would either have to COBRA out your current insurance or pay privately until you were elgible at your new position.

    This is the key when changing insurance, making sure that you always have coverage.  It's called " Creditable Coverage"

    If you had at least a full year of health coverage at your previous job and you enrolled in your new health plan without a break of 63 days or more, your new health plan cannot subject you to the pre-existing condition exclusion.

    Also...

    Effective September 2010, children (below age 19) with pre-existing conditions may not be denied access to their parents' health plan and insurance companies will no longer be allowed to insure a child, but exclude treatments for that child's pre-existing condition.

    Starting in 2014, this provision will apply to adults as well. Until 2014, the information below remains valid for anyone over age 19.

    Information copied from...

    https://healthinsurance.about.com/od/healthinsurancebasics/a/preexisting_conditions_overview.htm

     

    I've had cancer since I was 12 (37 now) and I've never had an issue with denial due to pre-existing condition because I have always maintained coverage, even when changing jobs.

    Congratulations on remission, I can only imagine the road you've been on with an at birth diagnosis.

     

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