Blue Cross Insurance and new job question

[camario213]

Hello everyone, I need some help and advice, i have been off work on disability for 2 years, I did have cobra until 12-06, after that I have been on ADAP for medications and treatment.  I finally found new employment with a company that offers Blue Cross of CA., I want your advice regarding coverage, should I go for the HMO or PPO, and also I'm concern of the sign up form will it ask for my pre-existing condition? I do not want the HR department to know about it. since this is the reason why I lost my previous job, they found out about my HIV status and started having all kinds of problems, thank you in advance for your comments and advice.

[MOONLIGHT1114]

Hi Camario213,

HMO or PPO?  I strongly suggest a PPO plan because it gives you the freedom to go to any doctor you choose.  I remember when I was working for a former employer, they switched from a PPO to an HMO and I was livid!  We only had 8 employees at the office and the boss was trying to save money and get a good "ER" plan.  Turns out that on a PPO he went to the ER when he was battling the flu and they sent him home and billed him a lot for the "visit."  I explained to him that not everyone relies on health insurance for emergencies ONLY.  Some of us rely on it every damn week of the every damn month!  This employer knew I was diabetic and had no idea about my HIV status.  He switched to an HMO and I had to get a referral from a NEW primary care provider in order to go see my previous primary care provider.  I always have lots of appointments and adding another one just to get back to the health care docs I knew made me really upset.  Also, on a side note, I had been waiting for over a month to get approval through our PPO to start on an insulin pump.  I was approved under our PPO and then my boss went and changed us to an HMO, so I lost the coverage, all within a week.  The pump costs would have been out of pocket!  That was in March 2006.  I left the company in April 2006 and started on my insulin pump Summer 2006 and I am still on it today!  So, all around PPO is the way to go for a chronic condition for many reasons!

As far as your privacy issue with pre-existing conditions, I don't know of anywhere where you have to reveal what you are dealing with.  Someone please correct me if I am wrong?!?!  I live in the state of Maryland and thank God for HIPPA everyday.  Some health care workers are so ignorant, and to this day STILL open their mouths inappropriately.  Read up in the link below, you should have nothing to fear.

http://www.ncsl.org/programs/health/HIPAA.htm

~Cindy

[otherplaces]

PPO PPO PPO.

Do not lie on the application.  I've heard of creative ways of getting around HR seeing the app.  Like telling them you'd like to have your doctor fill out one section and that he'll only fax it directly to the insurance company.  I don't know if that would actually work.  As much as it sucks I think the best way to handle it is to look your HR person in the eye and ask for their assurance that the information in the app is confidential...or some such.  You can also ask about their understanding of HIPAA which forbids them from divulging such info to others in the business. 

Incidentally, my brother told me his app had a box that indicated it to be checked for an AIDS diagnosis only, which seems like a step in the right direction.  But I filled out a bluecross of IL app recently and it was on there, but my HR guy is HIV+ too...so it didn't matter.

brian

[camario213]

  thank you so much for your answers, I will be starting my new job on august 6, I guess I'll find out what the application is all about on that date, I feel better already, thanks again, take care and good karma to both of you.

[David_CA]

Like others have said, I'd choose the PPO.  That's what I have through BC/BS (actually State employees insurance, but managed by BC/BS).  It's very flexible and the co-pays are fairly low.  I really like the fact that my labs don't cost me anything.  Congrats on the job, by the way.

David