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Author Topic: Just not sure what to do...  (Read 1893 times)

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Offline pozphxjohn

  • Member
  • Posts: 3
Just not sure what to do...
« on: July 06, 2006, 03:30:37 PM »
ok - short version:  spent 13 ys in Atlanta after testing poz.  Did absolutely nothing to take care of myself, but I'm one of those cases that is asymptomatic.  No problems.  Recently split with my partner of 7 yrs and just had to get out of Atlanta and start over.  Came to Phoenix and have been here 2 months.  Started meds 1 yr ago, doing well - vl = undetectible, CD4 = 220 and rising.  Now I'm here and my insurance - Blue Cross Blue Shield of GA is dropping me cause I don't live in GA anymore.  You can't just "transfer" to BCBS of AZ - got to re'apply.  Now I'm looking at no insurance b/c of pre-existing...or an outrageous premium.  Any suggestions out there??????

John

Offline Alain

  • Member
  • Posts: 680
  • I am.
Re: Just not sure what to do...
« Reply #1 on: July 06, 2006, 03:41:58 PM »
.
« Last Edit: November 03, 2006, 08:33:46 PM by cowandalehouse »

Offline Cliff

  • Member
  • Posts: 2,645
Re: Just not sure what to do...
« Reply #2 on: July 06, 2006, 03:54:46 PM »
Possible options (maybe):

1.  Change your address back to Atlanta (at least for now) to stop you from being dropped.

2.  Apply for HIV care (ADAP) for the state of Arizona.  Here's a link to their website.

http://www.azdhs.gov/phs/hiv/adap.htm 

3.  I don't know if you are working in Arizona, but you should also check into group policies you can access with your employer, if applicable/available.

4.  Talk to your doctor about obtaining access to HIV meds via the Drug Company compossionate programs or any potential trials/studies available in the area.

Good luck to you...

Offline B99

  • Member
  • Posts: 33
Re: Just not sure what to do...
« Reply #3 on: July 06, 2006, 06:53:08 PM »
Most employee sponsered medical insurance plans have a pre-existing condition limit. (Normally by law of the state) that ranges from 6 months to a year before services that you need for the condition can be covered.  So if you just recently were seen for HIV by your provider, you have 6 months to a year before the new insurer will cover you.  For most policies, that period is retroactive, which means that if it's been 3 months since you've seen someone about your HIV, you only have 3 months to 9 months before they cover you.  Or at least that's my understanding.  So check with your current job and see what their policy is on pre-existing conditions.  And I know that the ASO in Minnesota has a special department that deals specifically with the legality of continuing benefits for those who are moving or switching jobs.  So check with your local ASO so ASAP so that they can help you.
 ;)

Offline whizzer

  • Member
  • Posts: 364
Re: Just not sure what to do...
« Reply #4 on: July 06, 2006, 06:58:35 PM »
John,

If your current BCBS of Ga policy has NOT lapsed, then they have to give you a certificate of credible coverage.  You can then apply to BCBS of Az and get a policy which should not have any exclusions for pre-existing conditions.  HIPAA allows this as long as the previous policy has not lapsed for over 63 days.  I think, but I'm not sure, that they have to give you a policy, but what they may want to charge you for it is anybody's guess.  Is this an individual or group policy?  Group policies have more protections under HIPAA.  

In any case, pre-existing conditions only apply for one year.

http://www.dol.gov/dol/topic/health-plans/portability.htm

This is the Dept of Labor web site with info about the insurance portability provisions of HIPAA.

Hope it helps

Offline otherplaces

  • Member
  • Posts: 398
  • Mutant Super Hero
Re: Just not sure what to do...
« Reply #5 on: July 06, 2006, 11:54:23 PM »

John,

I switched from my crappy catastrophic insurance to a BCBS of IL group policy. With my certificate of credible coverage it offset the pre-existing condition clause. If you're in a group plan you can do the same thing, if your insurance isn't group I'm unsure but would imagine you could still offset the pre-exis. cond. Hope this helps. This stuff is complicated and frustrating. It caused me alot of unneeded stress at bad time. I feel your pain!!

brian

Offline pozphxjohn

  • Member
  • Posts: 3
Re: Just not sure what to do...
« Reply #6 on: July 07, 2006, 06:07:47 PM »
Thanks for the input everyone -
It's an individual policy and I'm covered through July, so I'm getting to work on checking out your suggestions! :)

Offline whizzer

  • Member
  • Posts: 364
Re: Just not sure what to do...
« Reply #7 on: July 07, 2006, 06:11:19 PM »
John,

Some states have insurance requirments that are more strict than the federal requirement.   States are all different on what requirements they have, and whether they apply to individual or group policies,  so you'll have to check for AZ.

 


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