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Author Topic: Career Move or Not (Pre-Existing Conditions with Insurance) ADVICE??  (Read 3049 times)

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Offline YnotinVA

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  • Posts: 8
I moved back to the East Coast from California when my parents became ill.  After moving back, I wasn't able to immediately find a job in the field that I was pursuing in California nor the salary (Human Factors Engineer).  So after a while I just had to take any old job (a secretary/office manager job) to get some kind of an income while still taking care of my parents....During my employment as the Office Manager (which is at a hospital), that's when I was diagnosed HIV+.  I still have the need, motivation and drive to get back out into the world and pursue my real career interests and get back to making a salary that I was prior to me moving back to the East Coast.  But now that I'm HIV+, I feel that I may be pigeon holed not knowing if I move to a new company where I'd more than likely be switching insurance companies, that HIV can be considered a "pre-existing" condition and might not be covered (or covered at a lot lower percentage) than what I'm getting at my current Office Manager job.  Has anyone else had a similar experience with transferring insurance/jobs after being diagnosed?  I would greatly appreciate any insight or resources.  Also, when switching to a new company, are you under any obligation to disclose the status of your health?

Thanks guys!

Offline puertorico2006

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Im pretty sure that if you havent had a 60 lapse in coverage they have to except you and waive the pre-existing conditions clause....If you cant get the insurance that quickly with your new company (some have a 3 month waiting period) you can get COBRA insurance which you pay the full cost of the insurance but its still reasonable for temporary coverage....

but im sure some of the vets here can explain it better and answer your question in more detail
Infected Probably: may 2005
Diagnosed: 11/2006

11/28/2006 CD4:309 / VL: 1907 No meds yet
12/27/2006 CD4:339/  VL:1649 No meds yet
  4/28/2007 CD4:550/  VL:1800 No meds :-)

Offline md

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  • Posts: 196
You should be OK if you change jobs and switch to a new group health plan as long as you enroll in the new plan as soon as you are eligible (usually your first day of employment) and you can show that you have at least 12 months of "creditable coverage" without any "significant breaks" immediately prior to enrolling in the new plan. (A "significant break" is any period of 63 days or more without creditable coverage).

If you don't have enough creditable coverage then the new plan can (and will!) refuse to cover pre-existing conditions for up to 12 months less whatever creditable coverage you do have.

Note that if you do not enroll in the new plan as soon as you are eligible, the waiting period is 18 months (but, once again, that can be completely offset if you have 18 months of creditable coverage)

So, once you have accumulate 12 months of coverage you should be able to switch jobs and still be fully covered provided that you don't let your insurance lapse for 63 days or more between jobs.

Having said that, be prepared for a lot of arguing with the new insurance company when they try to deny your claims :-(

Offline YnotinVA

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Ok.....well if having continuous, uninterrupted insurance for a while before switching over to a new insurance goup/plan is all that it takes to ensure coverage, then I should be OK.  I have full paid benefits where I currently work (which is at a hospital)...and I have been covered/working there for over 3 years.  I'd always heard of pre-existing condition from insurance companies, but never had to worry about what they meant by that and how they defined them.  But this time I do.  So I was thinking that a pre-existing condition was something you had already, even though you may have been covered by another insurance plan previously, uninterrupted.  But legally, are they allowed to not cover me in any way?

Again, thanks for all your feedback and input guys!

Offline md

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So I was thinking that a pre-existing condition was something you had already, even though you may have been covered by another insurance plan previously, uninterrupted.  But legally, are they allowed to not cover me in any way?

It is complicated, but the bottom line is that a new health plan  cannot refuse to cover you for pre-existing conditions provided that you have sufficient uninterrupted coverage prior to joining the new plan (and in your case you do)

This is all spelled out in detail in the Health Insurance Portability and Accountability Act (HIPAA) http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act

Offline Dennis

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I switched jobs within the past year and haven't had any problem with my new insurance paying my claims.  I went almost slightly over 90 days between coverage.  I always thought if you enrolled during the enrollment period with an employer group plan there was no pre-existing condition clause.  When I started my last job 5 years ago I was without coverage, other than medicare and didn't have any problem when I enrolled with my employers insurance. 

Offline Miss Philicia

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  • celebrity poster, faker & poser
This is all spelled out in detail in the Health Insurance Portability and Accountability Act (HIPAA) http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act

thank you Bill Clinton
"Iíve slept with enough men to know that Iím not gay"

Offline Iggy

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I just posted an article about health insurance and disclosure in a new thread http://forums.poz.com/index.php?topic=12035.new#new and your post was very much on my mind when I did so.

I was employeed by a very large (80K+ employees) international business when I was diagnosed and felt comfortable about my coverage for the following 2 years while I was still at the company.  After being let go, part of my paralysis at getting my life together again was fear of finding work where I would have some sort of security in my insurance.

My job now is vastly different than what I use to do and like you have gone from an specialized executive in one feild to a more administrative role in a different field.  In my case the salary is less than half of what I use to make, but the culture of the org, and the focus of the what it does offers me a sense of security about my future that at this time is worth it for me - and in truth it is work that gives me meaning in a way I didn't have at my old job so I feel fortunate in this situation.

I do though greatly apporeciate your concerns as regardless of laws, I've always partially wondered if my dismissal at the other company had anything to do with my HIV status and medical rates.
« Last Edit: May 05, 2007, 12:06:08 PM by Iggy »

Offline YnotinVA

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As usual, you guys give me the informationt that I was looking for.  To each one of you, thanks a bunch!  I'm very motivated and excited about making a career move to get back to what I love doing.



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