<p>My daughter is only a sophomore in college, so this is a long-term question re: future insurance. Currently, she’s covered by our insurance (husband is retired military) and will continue to be covered as long as she’s a full-time student (up to the age of 23). She asked me the other day if the fact that she has rheumatoid arthritis is going to make her uninsurable in the future. Since we’ve never had to look at other insurance plans, I had no answer for her. Does anyone have any knowledge about this? If someone has a pre-existing condition, what is the best way to search for health insurance? </p>
<p>Right now it seems likely that she’ll work for a few years before attending grad school, and her interests make it even more likely that she’ll look for work overseas (NGOs or Peace Corp-type work). Does living/working overseas make it even more difficult for her to have US-based health insurance?</p>
<p>I recognize that there are a lot of implied “ifs” in my questions, but if anyone can point me in the right direction to research her options, I’d be very grateful.</p>
<p>first call your state office of the insurance commissioner. That is the best place for answers. They establish the laws for coverage in your state. They can also provide a list of approved companies to contact and simply ask. </p>
<p>I’d love to tell you yes, but I really only know my state well. We have guaranteed issue for everyone, but we use a high risk pool subisdized by all carriers through a premium tax and provide uninsurables with coverage.</p>
<p>Start with your OIC. They will give you the exact information. then from there check with carriers.</p>
<p>The insurance company is very greedy. They will deny insurance for her. She can apply for HPIAA coverage (required by law) if she does not have health coverage discontinued for more than 2 months. But the premium is very high. It depends on the age also.</p>
<p>My company would consider RA an uninsurable condition for major medical plans, though we could offer a discount plan to someone with that preexisting condition. My observation has been that, while different companies do vary somewhat on which conditions they will cover, they are generally pretty much the same on the major conditions.</p>
<p>I’m not sure if this is true of all states, but many, if not most or all, states have a ‘risk pool’ insurance that is guaranteed acceptance for those with preexisting conditions. Unfortunately, it is likely much more expensive. As with car insurance being more expensive for those who’ve had tickets and/or accidents, so it is with health insurance.</p>
<p>As long as she has a job and her employer covers her insurance, she should be fine. But I suggest you plan for higher costs if she has to buy her own insurance.</p>
<p>As for the overseas question, my company covers medically necessary procedures done while traveling up to 30 days, but has no provision for those living overseas. I cannot speak for other companies. I would think that the Peace Corps would have some sort of coverage available…?</p>
<p>In my search for HI for DS who is on internship in India (big software company, big city, access to medical), who is moving from our family plan to individual program, and has no pre-existing conditions; I was looking for portability between states, insurability in case he contracted something, and insurability in a foreign country. I went to a broker who said, go with the big Blue+/BlueS, they may be more expensive but they are recognized across the US and will pay for overseas. How true this is unknown and I hope that we don’t have to find out. </p>
<p>Also for life insurance, there is a question where if you intend travel or have travelled to a foreign country other than US/Canada, that you may be given a different rate or declined. DS has sufficient life insurance and the extra insurance cost for more insurance was not cost effective, for him. </p>
<p>Today received the Travel Insurance Policy. I think that this is a good supplement to his longterm health insurance and has a couple benefits in addition.</p>
<p>Leal, I doubt my daughter will even be considered by the Peace Corps (although she intends to apply). They consider RA to be an “unaccomodated condition”, so she’ll be starting with a black mark on her application. <em>sigh</em></p>
<p>I had told her I thought she would probably be able to find [expensive] coverage, and my husband and I have assumed all along that we’ll have to subsidize her income so she can pay the premiums. <em>another sigh</em> </p>
<p>She handles the RA (both the physical toll and the knowledge of what she faces in the future) remarkably well for a “mere” 19-year old, so we’ll do whatever it takes to keep her from having to deal with insurance issues on top of everything else.</p>
<p>has had Type 1 diabetes since 9 years of age. Continuous insurance coverage is important so that he will be less likely to be denied coverage for this pre-existing condition in the future. After he graduated college in 2006, he lived at home for a year. At first he was covered under our policy until age 23. Then we had to purchase COBRA (which is $$) for him. Luckily that lasted only a few months. Then the state of New Jersey passed a law allowing coverage of young adults on their parents’ insurance until age 30. </p>
<p>Even though he is abroad in China now, we are continuing to pay insurance premiums for him here so that he will have continuous coverage; he will probably return to the USA after 1 1/2 years abroad. He is finding it difficult to find medical care in China (he is not in Beijing or Shanghai) comparable to the quality of diabetes care here. It seems that his part of China is 20-30 years behind us in diabetes care. He also will have to pay out of pocket for insulin pump supplies there; I had hoped to order supplies here and send them to China but package delivery is variable there plus the supplies might need to be quarantined prior to delivery. I really don’t know how Type 1 diabetics, especially children, manage in China when meds and pump supplies are so expensive there. (For example, a pump here costs about $5000 but our insurance covers 80%; 3 months of pump supplies cost about $500 here but insurance covers most of that. He thinks – but doesn’t know for sure – that most people in China need to pay for their own pumps and supplies). Very sad. I guess that if he were to work for an international company and stay in China that their health insurance benefits for him would cover care and meds in China. I imagine there are better doctors and hospitals in Shanghai and Beijing. He is just beginning to realize that his diabetes might limit him to working in the USA and working for a firm which provides good health insurance.</p>
<p>Before he left for China, I purchased several types of insurance for him since his school in China provides insurance for in-patient hospitalization only in his city. I consulted with an insurance broker and purchased medical evacuation insurance (make sure you are the ones deciding upon the location for medical evacuation; some policies stipulate that they decide and often it’s to a nearby place in that same country) plus hospitalization insurance (it gets tricky since I am not sure China honors these policies plus there are technicalities for pre-existing conditions). Good luck and email me if you want.</p>
<p>Mezzomom,
Under COBRA, if she has had coverage in the 18 months before she gets new insurance coverage, she cannot be excluded for a pre-existing condition. The catch is that she needs to work for an employer with >50 EEs to fall under COBRA guidelines. Check with your DH’s HR folks – they may be able to give you some more specific (and current) info, as they are the ones who actually issue a certificate of coverage that is passsed on to the new employer.</p>
<p>Most large companies will not exclude for pre-existings anyway.</p>
<p>There is a lot of misinformation floating around on this thread. HIPAA, which is a federal law, places limitations on the ability of an insurance company to deny coverage based on a pre-existing conditions and also prohibits group health plans and insurers of group health plans from charging higher premiums to an individual based on a medical condition the individual may suffer. The rules are complex but in general, an insurer can exclude a pre-existing condition from coverage, NOT the person, for a maximum of 12 months from the date of enrollment. However, if the person was previously insured, the person has the right to get a Certificate of Creditable Coverage from the prior insurer and the period of disqualification is reduced for each day the individual was insured with the prior insurer provided there was not a 63 day break in the prior insurance. If there was a 63 day break, only the period of prior insurance subsequent to the 63 day break and before the enrollment with the new insurer will count for purposes of creditable coverage. If the period of creditable coverage is 12 months or more, the subsequent insurer can NOT deny coverage for the pre-existing condition.</p>
<p>More over, an insurer can NOT charge higher rates to an individual in a group health plan than are charged to other participants in the plan based on a medical condition the individual has. The existence of the individual’s medical condition and payment of claims for that condition can be factored into the underwriting process in coming up with rates for the group health plan but everyone taking the same coverage must be charged the same premium.</p>
<p>So, to the OP: 1) make sure to keep your daughter covered under your husband’s military group plan and 2) make sure her subsequent coverage is through a work place group plan. As to coverage overseas, it can vary depending on the plan the employer picks but there are domestic health plans that provide coverage overseas for employees of US based employers that station employees overseas. I don’t know what the Peace Corps has but I bet its Human Resources or benefits department can answer the question It may even be posted on their website.</p>
<p>By the way, COBRA addresses the right of an individual to self pay the entire premium necessary to maintain coverage under their former group health plan after an event occurs which would otherwise cause the individual to no longer be eligible for coverage as an active participant in the plan. There are certain enumerated occurrences which are defined as “COBRA events” that trigger this right, but the right is only a right to “self pay” to continue your coverage in the group health plan in which you were a participant. This is only tangentially relevant to HIPAA “portability” rights in that if one avails themselves of COBRA entitlements, one can continue to participate in their group health plan after a COBRA event occurs, which would otherwise cause a cessation of coverage, thereby preserving their eligibility and therefore creating a continuation of “Creditable Coverage” which can be used when changing health plans.</p>
<p>I also have a child with pre-existing conditions we presently have a family plan through Blue Cross. We have been told she can move straight into an individual Blue Cross plan without an application when she no longer is covered by us.
My sister has RA and had no trouble moving jobs. I don’t know if it is due to certain laws. She works for a government agency and has had excellent coverage of all types of treatments including experimental. I think she did have a discussion about insurance when she was changing jobs. Took another job with the public sector versus going into consulting due to health insurance.</p>
<p>MichaelNKat, thank you for your explanation re: coverage for pre-existing conditions. It was very helpful and informative. My son’s issues for a year or more abroad are somewhat different from the OP’s in that he needed supplies and insulin for a whole year. Our insurance company was far from helpful in this regard.</p>
<p>COBRA is often very expensive, maybe even more than risk pool, so be sure to check it out before deciding. Also, in Texas, the person can get other insurance (assuming she’s accepted) if she gets it lined up before quitting her job (& losing the group insurance) with no break in coverage, but if there is a lapse, she’ll have to wait about 2 months to get anything other than COBRA. (Research HIPAA laws) So if the COBRA is expensive (sometimes it is and sometimes it isn’t, but more often it is, from what I’ve seen) then she’d be stuck with the higher price if she doesn’t work out the timing right.</p>
<p>This is all based on my experience in Texas and may not apply in your state. You might want to talk to some local agents (tell them upfront you don’t want to buy anything right now but just need some info).</p>
<p>COBRA rates are limited by law to 102% of the premium the employer pays for the coverage (including any employee premium copay). So if it costs a total of $500 for the coverage, the COBRA rate can be $510. Where it gets complicated is where the employer’s rate structure is a tiered structure (single, employee and dependent, employee and spouse, family, etc) and there are many levels if premiums. It gets even more complicated where the employer’s plan is a self insured plan (i.e. the “cost” to the employer is for the actual claims paid plus an administrative fee) and it is necessary to go through a cost averaging approach or some such other mechanism to come up with a calculated “premium”.</p>
<p>By the way, HIPAA preempts state law and any state law that is inconsistent with HIPAA is generally invalid, although states can have more beneficial laws. There is no 2 month “waiting period” under HIPAA. You can have a break in Creditable Coverage after a 63 day gap in insurance but what ever creditable coverage you have at the time of applying for new coverage serves as a set off against the 12 month preexisting condition exclusion that group plans can impose. A pre-existing condition is generally defined as a condition for which you received treatment within 6 months of applying for the coverage.</p>
<p>My son has an arthritis as well, not RA though, and he knows he will probably have to work for a mid size to a larger company that provides health insurance. He probably will have a harder time starting his own business or buying a private policy though. Health Insurance is on the front political burner though and who knows what will happen in 4 years.</p>
<p>I have recommended a possible job with a state or larger local government. It won’t pay as much but the benefits are there.</p>
<p>I have also purchased insurance through his school and he is covered by my plan as the primary plan and the schools as a secondary plan. His condition is mild now and I pray it stays that way.</p>
<p>They should extend the age past 23 for people going to grad school. What are you supposed to do if you want to go to law school and have an uninsurable condition? Or even if you are insurable, how are you supposed to afford an individual plan while going to school full time?</p>
<p>Stories like these are why Im dying to see healthcare reform. Im not sure if universal healthcare is necessarily the answer, but it’d beat the corporate care we’re going now. Even though Im a libertarian, this is an issue where I diverge from those who keep a copy of Atlas Shrugged under their pillow. Genetic health conditions are solely a province of bad luck.</p>
<p>Almost all colleges offer health insurance to students through the University. It is when you get out of school that there is a problem. At least that is my experience.</p>
<p>Son is also thinking of looking for a job in Canada btw.</p>
<p>as I posted on another thread, my husband’s company will continue health insurance up to age 25 as long as you are providing at least 50% of the child’s living expenses, or they are not working full-time. So if they’ve graduated and are looking for a job, they will have coverage until they begin working full-time. This would include grad school, and when my H was in grad school, the health insurance they offered to RAs in grad school was excellent… never saw a bill for pregnancy nor birth of D1.</p>
<p>Some insurers offer an option to extend the definition of an eligible student dependent to include age 25. It will increase your premium but not nearly as much as the cost of a separate individual policy. I recently amended my office’s policy with Blue Cross to provide this.</p>
<p>Is anyone besides myself a licensed agent? show of hands? Just curious… Again. I would follow my advice, the very first post. Contact your state’s OIC. They really aren’t bad people and they know the laws for your state. There are in case anybody’s listening 49 different sets of states laws when it comes to health insurance along with the federal laws. Hawaii does their own thing. What is common place, everyday in your community or situation may not apply in another state. </p>
<p>Is your health plan military? If so, you may need to contact them and seek advice. I would guess, without looking that military coverage is exempt from state requirements and only subject to federal rules and they may be exempt from that too… </p>
<p>Do you have a plan booklet? if so, have you gone through it? The answers you seek may be in it as well. I’m not up on the military plans and have no idea how they work. But if it were me, the first place I would start is in that booklet. Then OIC. Both will have credible sources who can give you the most accurate insight into exactly what you have. Honestly without offense to anybody here as I know you all mean well, but unless you are up on champus or tri care (or what ever they call it per branch) and live in the same state as the OP, your advice may be just wrong. Right for you, wrong for her. </p>
<p>I am guessing Mnkat does some hr or picks bennies for work. Mike… states and feds determine dependent eligebility via mandates. For example WA state residents dependent coverage has been mandated (we actually have state and national health care. they’re called mandates) for all providers serving WA (except those exempted by federal law, or erisa type plans) to exend dependent coverage to age 25 school or not. You may have to produce tax forms that show dependence. I must say you are spot on though, pretty sharp. </p>
<p>As far as life insurance for kids and all that advice the pros lay out there about unnessary… remember this situation and the word “NO”. There’s this wonderful option you can add to a child’s life policy called guaranteed insurability… for pennies… that takes away the insurers ability to say no down the road. When the financial gurus speak in books, tv print… remember to ask what if they’re wrong, even slightly… is their advice still good? Sometimes the things they slam do the best good in ANY situation, not just the perfect path… besides how many of us have had everything in life go exactly as planned? there’s my professional gripe, too many people giving exact advice in situations that vary…</p>
Again. I would follow my advice, the very first post. Contact your state’s OIC. They really aren’t bad people and they know the laws for your state. There are in case anybody’s listening 49 different sets of states laws when it comes to health insurance along with the federal laws. Hawaii does their own thing. What is common place, everyday in your community or situation may not apply in another state. </p>