Is it hard to obtain Health Insurance when you have MS?

I presently have health insurance and will be starting Copaxone, however, my wife and I plan to move to Oregon next year.  We will be looking for work and starting new jobs then and am fearful that I will not be able to get insurance if I have a pre-existing condition that requires life-long medication.  Anyone have this experience?  This medication is so expensive.

[fishyfish]

I don't have any experience with pre-existing conditions (I'm undiagnosed), but I was doing research on new insurance plans for my family, and I did run across that federal workers cannot be excluded by pre-existing conditions through the plan we have.  I think it would depend on the individual insurance company and your company policy.  As you're looking for new jobs, I'd definately get some specs on the insurance they offer before you accept anything.  

Good luck!

Fishyfish

[magoo58]

I'm by no means an expert in health insurance, but my understanding is that a group plan can't exclude you or not cover you for a pre-existing condition.  In fact, in my opinion the best opportunity you have to gain better coverage is to find a new job that has better coverage for your need.

If you try to obtain coverage away from the workplace, I suspect it will be near impossible due to the pre-existing contition.

The health insurance industry is in constant motion.  Very confusing.

[Quixotic1]

Right now this is how it works.  If you already have coverage and can move onto COBRA, or show that you have been continuously covered they can't deny you coverage for preexisting.  If you have a new job, the employer must allow you coverage on the company's plan.

The real problem comes when you do not have coverage and you already have a diagnosis of MS and then you try to get coverage.  That is when you will be denied or priced out of the market AND have a huge waiting period before they will cover anything for the MS.  Magoo stated it the same way I understand it.  The important part is to NOT have a break in coverage for 62 or more days.

What I am not sure of is whether you can obtain COBRA coverage if you voluntarily quit your job.

The new employer has no right to know about the MS - it is a disability and "cannot" enter into the employment equation.

Quix

Can anyone weigh in on this?

[Quixotic1]

Okay, quitting one's job does not make them eligible for COBRA.  If you enroll in a new group health plan with a new employer before there has been a lapse of 63 days or more, there are restrictions on "pre-existing" condition exclusions.  The dates to be concerned about may be the dates that the new coverage ACTUALLY begins - as opposed to the day you are hired.  I am not sure about this.

If the lapse in coverage is 63 days or more, then the new group health plan is allowed to exclude any care of a pre-existing conditon for which you were advised on or treated in the 6 months prior to new coverage beginning.  This exclusion is limited to 12 months (or 18 months for "late enrollees"??)

Here is a FAQ on the Health Insurance Portability Act (HIPAA)

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

Double and Triple check anything I have said here!!!!!!!!!!!!!!!!!!

Quix

[Heartshome]

My husband quit his job and was able to go on COBRA. Perhaps it would be worth talking to your HR rep at work to see what their policy is or if they could advise you.

[Quixotic1]

Thank you!!!!!!!!!!!!   I guess it is a function of the company's policy on the issue.  

Shawnj - See what I mean about double checking things?

Quix

[renklauf]

You must go here:

http://www.healthinsuranceinfo.net/

Click on your state, and you will be able to download in-depth information on your state's health-insurance policies compiled by the prestigious Georgetown University Health Policy Institute. There are federal laws regarding health insurance, and there are state laws. The Georgetown reports are renowned for their completeness and reliability, and I think you will be impressed by the amount of information you will receive.

You should also try to find two very helpful books:

Insurance Solutions: Plan Well, Live Better: A Workbook for People with a Chronic Disease or Disability by Laura D. Cooper

The New Health Insurance Solution by Paul Zane Pilzer

You can find them both on Amazon and probably at your local library. Health insurance is very complex, but these resources will give you a wealth of information that is very practical. Good luck!
-Bob

[Quixotic1]

A treasure trove of info!  Thank you very much!!!!  I should know better than to answer questions outside my area of knowledge, but I didn't know you were lurking.  Your input (and particpation) are very welcome!!!

I printed this out!  Quix

[renklauf]

It's a mere pittance compared to the wealth of information, time and compassion you share, Quix! Thank YOU.

I'm self-employed, so health insurance is a big concern to me, and I've done some poking around. Hope the info is useful to others. This passage from the first book I cited above may prove helpful to some:

"Two insurance brokerages have indicated that they can place private insurance for people with benign MS...Business Planning Systems Agency, Inc., 3195 Linwood Road, Suite 201, Cincinnatti, OH 45208 [phone] or [phone]; and Murray and Zuckerman, Inc., P.O. Box 1429, 670 Frankin Street, Schenectady, NY 12301 [phone] [phone]"

Hope this is helpful.
-Bob

[Shawnj]

Thanks everyone for your help, much appreciated.

[NrssAngel]

Hi... Just wanted to add that depending on what kind of work you do, you could be required to do a pre-employment physical, in which you would be asked about previous health issues.  Not sure if they could exclude your eligibility for work or not unless they determined you were unable physically to do the job.  I am an RN and this gets really tricky for us.  They don't want to see that I have ever had any muscular problems.  I have never had a problem but I don't offer any more info than I have to. I'm in California were most employees are part of unions but this was not the case down South (Mobile) where I am from.  Nurses would loose their jobs just for trying to start unions.  You might consider starting your job search before you actually get there, if this is possible.  Just my 2 cents.

Angel