ANA Discussion Forum
General Category => Insurance => Topic started by: Ric on August 14, 2007, 03:35:45 pm
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Hello,
Do any of you know if it is more difficult to get future insurance coverage after radiation for an AN as opposed to if it is removed surgically? I understand that once diagnosed and treated that the patient (if they carry their own ins.) must work for a large company or the government in order to get a Group Policy that does not allow preexsiting conditions. Can your treament choice make a difference? I argument I have heard from people is that if not removed surgically, the insurance companies see you at a higher risk b/c the tumor is still in your head. Has anyone run across this issue or have advice. My insurance can not tell me hypothetically how they would handle this. ???
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I'm not sure about this issue. However, I can tell you from experience that it is much better to have group insurance. The larger the group, typically the better the benefits. Also there can't be a lapse in insurance coverage greater than 45 or 60 days (can't remember exactly), or the new insurance can slap that pre ex on you.
At one point years ago, I had to obtain an individual policy. My history included several minor surgical procedures. When I received the agreement letter I was to sign, it had loads of ICD-9 (diagnosis codes; some releated to my history and others not) that would be considered pre ex. I'm a nurse and was shocked that some of these diagnoses I had never even heard of. Needless to say, I didn't sign it and went with another company. By the way, this was with BCBS and I had not exceeded the lapse in coverage when I applied.
Insurance issues can be more than frustrating. I just know that I hope to never be without it.
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I don't have a specific answer to your question, Ric, but I would imagine that obtaining medical (health) insurance following AN surgery or radiation would be difficult. I assume that the AN would be considered 'pre-existing', which would be true. Whether radiation or surgery gives you a better chance at obtaining medical insurance coverage in the future is beyond my expertise to answer. My experience has been that when an insurance company sees you as too high a risk they either refuse to insure you, charge exorbitant rates if they do insure you and/or preclude the condition in question (your AN) from any future coverage. Insurance companies want to limit their liability so granting health care coverage to anyone who has had a serious medical condition always makes them nervous.
A group plan is still your best bet, even if you have to join a 'group' to obtain it.
Jim
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Please check with your state insurance commission but as i understand it if insurance coverage is kept continuous with no lapses between policies a person can change insurances without falling into the pre existing hole. As an example Chet's insurance thru his company was set to expire the end of March, at the time we has a surgery planned for April. The insurance plan we purchased (as individuals) started the first day of April. Since coverage remained continuous the AN did not fall under pre existing conditions and the all ready planned surgery was covered. They had to accept him, no choice. Had we let the insurance coverage expire then we would of had a very difficult time obtaining coverage, plus he would of fallen under the pre existing clause. Again, please check with your state insurance commission or a trusted insurance agent.
Best to you
Raydean
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"Pre-existing" can have different meanings for different insurance policies, depending on the State laws, insurance company policy, etc. For example, I've seen "pre-existing" as defined as "received treament for the condition in the last year". In this case, if there was no treatment for the condition in the year before joining the new policy, even if the condition was known before that time, then the policy had to cover it. If you're curious or worried about pre-exiting coverage, check out the actual policy involved. I say the actual policy, because someone else, like someone in an HR department, may give you an answer, but they could be wrong.
Regards,
Rob
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In my case I am self employed and my husband wanted to join me in the business but can't quit his job because no insurance will cover me. up until 5 years unless i am on a group plan no one will insure me. It is a total denial all around.
At 5 years i can be covered but for the following 2 years anything related to the tumor or surgery or after affects are not covered. i live in AZ and they very much have the right to do that.
So if you can stick with a group plan it might be wise.
Good Luck!