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Author Topic: Insurance Switch  (Read 1525 times)

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Offline DudeSaus

  • Member
  • Posts: 6
Insurance Switch
« on: November 14, 2006, 09:42:07 PM »
I've been pondering this for a long time. I hate my insurance company and want to change but am afraid of not getting accepted due to "pre-existing" conditions. I live in California and thought there was an ordinance that states you cannot be turned down do to pre-existing conditions. Anyone have any experience? Thoughts?

BTW...I'm with Blue Cross. I'm self-employed so it's about the best I can get. They recently changed my ability to buy my meds anywhere I want (like the local Walgreens) to being able to only buy it through their own pharmacy, through the mail, a company managed by one of their companies...I smell a RAT!!! Anyway, they were 3 days late on delivery so I missed 3 days. My last labs showed a huge drop in CD4s and I know it's due to the stress they've put on me getting my meds! My doctor agrees. What if I were a diabetic and needed that insulin? GRRRRR....Sorry...this turned into a rant. I think I'm gonna call Dateline and report them! LOL  >:(

Thanks all!

Dude

Offline Eldon

  • Member
  • Posts: 2,664
Re: Insurance Switch
« Reply #1 on: November 14, 2006, 09:47:40 PM »
Hey Dude,

It is unfortunate that you are going through the mail-order nightmare. However, if you "choose" to change your current Insurance Company, then please DO consider your options carefully before making such a change.



Make the BEST of each Day!

Offline aztecan

  • Member
  • Posts: 5,384
  • 29 years positive, 56 years a pain in the butt
Re: Insurance Switch
« Reply #2 on: November 14, 2006, 11:24:02 PM »
Hey Dude,

It is my understanding if there is a pre-existing condition clause in an insurance policy, there must be a specified time limit, usually 6 months or a year.

I know that doesn't help your situation any, but I thought I would point it out.

I also hate the mail-order crap! My plan has the option of using one named Pharmacare. It is owned by JC Penney. I am not pleased with them. The last time I ordered through them, it took three weeks to get the shipment. If I hadn't had a surplus supply, I would have been in deep manure.

I have had continual problems with them. I am now in the process of ordering the meds through my local pharmacy. It will cost more over the course of a year, but the reduced stress level is worth it to me.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline gerry

  • Member
  • Posts: 522
  • Joined AM Feb 2003
Re: Insurance Switch
« Reply #3 on: November 16, 2006, 11:17:02 PM »
Dude:

Are you talking about an individual plan or a group plan? It was not clear from your post other than you mentioned you were self-employed.  Insurance rules are very different if you are trying to purchase an individual plan.  So be very careful before you change if this is the case.  You don't want to find yourself without any health insurance at all.

If the mail-order allows you a certain number of days in advance to get your meds, it would not hurt to order them early each time so you can build up some surplus in case you need them later when delays happen.  It would mean paying the co-pays a little earlier but it saves you from the stress of having to run out of meds in the future.  Not the perfect solution, but something to consider.

Gerry

Offline DudeSaus

  • Member
  • Posts: 6
Re: Insurance Switch
« Reply #4 on: November 17, 2006, 01:05:57 PM »


     First of all, I've decided that I'll just keep my insurance. It is an individual plan and in reviewing my policy, I  actually have excellent coverage compared to other plans. As far as the Meds through Mail Order thang...They have messed up with each order. The first time I ordered them a month in advance and they still delivered them late!! Precision RX is the pharmacy and if anyone should ever have to deal with them WATCH OUT! My doctor's assistant says it's always the same with these people...they never get it right. All of your collective advice has been a huge help and I'm very grateful!

Thanks so much everyone!

Dude

Offline acsmith

  • member
  • Posts: 1
Re: Insurance Switch
« Reply #5 on: January 19, 2007, 02:15:00 PM »
1st of all PharmaCare is not owned by JcPenny.  PharmaCare is owned by CVS.  PharmaCare is a Specialty Pharmacy, specializing in HIV care.  If you can find a local PharmaCare you will find a highly educated dedicated HIV Pharmacist that will provide excellent service!

Offline Miss Philicia

  • Member
  • Posts: 23,902
  • celebrity poster, faker & poser
Re: Insurance Switch
« Reply #6 on: January 19, 2007, 02:36:11 PM »
It is my understanding if there is a pre-existing condition clause in an insurance policy, there must be no gap in coverage when you switch to a new policy.  That's how it was in New York as I switched policies several time (this was even a decade ago!) with no problem.

If there is a gap in coverage though, THAT is when you run into problems with the pre-existing coverage crap.
"Iíve slept with enough men to know that Iím not gay"

Offline Eldon

  • Member
  • Posts: 2,664
Re: Insurance Switch
« Reply #7 on: January 19, 2007, 04:23:37 PM »
Philly: If the one is presented with the situation of a pre-existing coverage matter, then what would be the order of steps needed to be taken in order to obtain coverage?


"What Can I do today to make a better Tomorrow?"

Offline Miss Philicia

  • Member
  • Posts: 23,902
  • celebrity poster, faker & poser
Re: Insurance Switch
« Reply #8 on: January 19, 2007, 04:33:40 PM »
Not sure.  I've always made sure I never had to deal with that by not having any gap in coverage.  I think if you fail in that endeavor then you have to comply with whatever waiting period is laid out in that insurance policy for the pre-existing condition to start being covered.

I work in a small architectural office in Manhattan and had to deal with our insurance policy yearly, though I did it through a broker who dealt with the minutiae of it all, but became somewhat versed in this stuff.  Obviously since I was HIV+ I was always on the watch though I didn't tell others at work about my medical problem at the time.  By the time I departed there they knew.

Mind you, this is for group coverage.  I don't know anything about an individual policy which I believe has different rules.
"Iíve slept with enough men to know that Iím not gay"

Offline Eldon

  • Member
  • Posts: 2,664
Re: Insurance Switch
« Reply #9 on: January 19, 2007, 04:37:58 PM »
Philly: Thanks. Indeed the Group coverage differs from an Individual situation. From what I gather there are ways to work with the situation for the gap that exists.


"What Can I do today to make a better Tomorrow?"

 


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