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3221216 tn?1373640059

Need help understanding health plan

My husband and I have decided I will go to a herpetologist after he puts me adds me to his Kaiser health insurance.  I am very grateful because this will make it possible for me to find a specialist and get good treatment.    The thing is my husband told me that in order for me to get on the health plan I must not mention I have a pre existing condition.
My question is this:  When I see the heptologist. what do I say to him?   Do I need a referral to see him or do I just make an appt.  Do I let him re re test me or do I explain to him about the health insurance and transfer my records! This is really confusing me.....
10 Responses
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3221216 tn?1373640059
I appreciate learning all the words I can.  Thank you.   Nice messages and  very special people!
Helpful - 0
766573 tn?1365166466
The FireFox spell check always wants to change the word, "antiemetic" to "antisemitic." (or semantic)



For those unfamiliar with the term: An antiemetic is a drug that is effective against vomiting and nausea.
Helpful - 0
201379 tn?1319991331
It may not be that easy to add you to your husbands plan. Many group plans you can only add dependents (except a new baby or an adoption) during their open enrollment period (for my plan open enrollment is Nov, coverage begins jan 1 of the following year). There are a few "qualifying events" that allow adding someone immediately such as a dependent's loss of coverage under own plan and the aforementioned baby. I don't know what your current insurance status is but you may be impacted by the open enrollment requirement.
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3221216 tn?1373640059
Your right.  I corrected it a few times and it still did it! I am glad you caught that.  Smiles
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163305 tn?1333668571
I bet your wrote hepatologist and the spell check, which doesn't recognize our liver specialists, put in herpetologist instead.
It tries to do that to me, too:)
Helpful - 0
Avatar universal
I have coverage through my state for pre-existing conditions.  I pay $283.20 per month for the insurance and then they cover 80/20.  The 20% I have paid so far has been pennies on the dollar.  So I would check into your state and see what they offer.  Believe me, this has been a life saver and bank acct saver to say the least.

Have a great day!

Jules
Helpful - 0
3221216 tn?1373640059
Thank you Cean you are so right!  It is so difficult to find my way through this maze!

Hugs
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3221216 tn?1373640059
Thank you so much.  To be educated on all of this is most important!

Smiles
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446474 tn?1446347682
FYI: Many parts of "Obamacare" has already been in effect since 2010.
The provision for the elimination of insurance companies policies of "pre-existing condition" will take effect Jan, 1, 2014. At that time insurance companies won’t be able to turn anyone down or charge more due to a pre-existing condition.

Currently
Insurance companies can no longer deny coverage to children under 19 with pre-existing conditions.

Some of the reforms already in effect:

Temporary help for people with pre-existing conditions. To tide people with health problems over until 2014, the law created temporary Pre-existing Condition Insurance Plans in all 50 states plus the District of Columbia. Thanks to federal subsidies, people who have been denied coverage or quoted outrageous premiums because of their health history can buy these comprehensive health plans for about the same price as a healthy person their age would pay for a private plan. The catch is that to qualify for the program, the law says people must have gone without insurance for at least six months. Even so, 67,482 Americans had enrolled in these plans as of April 30, 2012. This program is scheduled to expire in 2014, when people with pre-existing conditions will no longer be locked out of the health insurance market.

More young adults with insurance. All health plans must allow young adults to remain as dependents on their parent’s health plan until they turn 26, whether or not they live at home or can be declared as dependents on the parent’s income tax return. An estimated 6.6 million young adults who would otherwise be uninsured have gained coverage during the first year of eligibility, according to a recent analysis by the Commonwealth Fund, a nonprofit health policy think tank.

Cheaper drugs for people on Medicare. Seniors who reach the “donut hole” – the point when they have to start paying prescription drug expenses themselves – now get a 50 percent discount when buying brand-name drugs and a 14 percent discount on generic drugs covered by Medicare Part D. More than 5 million older adults and people with disabilities have saved $3.5 billion in prescription costs since the law was passed. The donut hole will continue to shrink until it  disappears completely by 2020.

Free preventive care. New private health plans must cover and eliminate cost-sharing (co-payment, co-insurance or deductible) for proven preventive measures such as immunizations, Pap smears, and screening colonoscopies. Beginning August 2012, private health plans must provide additional preventive measures to women, including free well-woman visits, screening for gestational diabetes, domestic violence screening, breastfeeding supplies, and contraception. Workplaces run by religious organizations that object to birth control  are to receive a special accommodation: their health plans must still offer the coverage, but the cost of it will be borne entirely by their insurance companies.

People on Medicare are also now entitled to the same free preventive coverage, and in addition get a free annual “wellness visit.”

More consumer protections. Health insurers can’t set lifetime limits on your coverage or cancel if you get sick. Annual limits on coverage in job-related and individual plans are now restricted to a minimum of $1.2 million, which will increase to $2 million beginning Sept. 23, 2012, before being completely phased out in January 2014.

Hector
Helpful - 0
1840891 tn?1431547793
First, please allow me to make a small but important correction: you want to see a hepatologist, not a herpetologist (unless you have a pet reptile who needs care).

Now to your question: this is kind of shaky ground, and seems like it could be dangerous for you. I would recommend first of all to look carefully at whether you can get on your husband's policy without hiding your medical info. If his policy is through an employer they usually offer an open enrollment season for about one month out of the year (usually November-December) when they allow insurance changes without regard to pre-existing conditions, and I really hope something like that will be available to you. There are multiple dangers in trying to hide your medical history. If you pull off the deception really well you are at some risk of your care being less than optimal, but the biggest danger is that it would be very hard to never slip up on the deception and if you are found out, especially if they discover you were hiding something after they've already provided expensive care, well it wouldn't be pretty. Your coverage would be retroactively suspended and you'd be stuck with huge bills and no coverage. All the big insurers are very ruthless about cutting off care and billing out the whazoo for  care that was utilized under any sort of deception. They spend a lot of time and money trying to minimize losses of that sort. Try really hard to find a way to do this without hiding your medical history. If Obamacare ever gets implemented insurers will no longer be able to deny coverage for pre-existing conditions like this!
Helpful - 0
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