Insurance and pre-existing conditions?

[Sherryg683]

I know you ladies can help me here, as I am confused about this all. My brother has melanoma that has spread to his liver. He had just retired from the state when diagnosed. They have 3 insurance plans which you can choose, each are carried out by different insurance companies. My brother has always been very tight with money and had the cheapest (Humana). They would not allow him to travel out of Louisiana for treatment. Once a year, the state emplyees are able to change their insurance plans. My bother has run out of options here and needs to go to MD Anderson. So in August, he switched to the better insurance offered by the state and dropped Humana. Now this new insurance is saying they will not pay any of his bills because of a pre existing clause they have..If this is the case..he is totally screwed. He's worked with the state all his life and now has no insurance. He's been on the phone for 3 weeks and keeps getting run arounds. The state said there should be no pre existing clauses here, the insurance company says there is. This bring up ANOTHER question I have. My husband is pretty advanced in the company he works for and we have great insurance. But I worry about something happening to his job. If he had to change jobs, would I not be able to get insurance because of my cancer being pre existing. Is he locked into this company forever because of my disease. And what if he died, would I then be uninsurable and my medical bills paid for. I know you ladies know the answers here. My husband said he thought a bill was passed that insurance companies could not turn you down due to pre exisiting conditions. But I hear it happening all the time, it's happening to my brother and he doesn't have a lot of time to fight this ...sherryg

[Joe]

I suggest that you get in touch with the Cancer Legal Resource Center in Los Angeles. They may be able to help.

Your husband will automaticaly be entitled to continue his insurance under the Federal COBRA laws. He can pay out of pocket the full amount of your health insurance until he is covered under his new insurance. Insurance companies can not refuse to pay for preexisting conditions as long as there is no lapse in coverage.

Regards
Joe

[Sherryg683]

Thanks Joe, I emailed my brother the link to the Cancer Legal Resource Center. Hopefully, he can clear this up soon. Thanks for clearing up the other for me. I not up to date on the way insurance companies work, I just figured that I was pretty much marked with a scarlett letter now and no one else would touch me with a ten foot pole. Glad to see this is not the case..sherryg

[Lala]

Sherry
There is another MD Anderson in Florida as well. Not as large but is still MDA here is weblink http://www.orlandoregional.org/mdanderson/index.aspx

also there is MD Anderson Physicians Network
http://www.mdanderson.org/departments/cancermanager/physicians/

Hope this helps

[Joanne S]

If there was no time lapse in coverage, there should not be a problem (that's how it works here in Michigan). I think they are just pulling his chain so they don't have to pay for his medical claims. Has he brought this to the attention of his employer and their benefit person responsible for retiree health care benefits?

[anne2]

Hi,
Some states have high-risk insurance pools where the state will auth. ins for pre-existing conditions. I forgot what this is called but we talked about some time ago. I called the state and Virginia does not have it, but Maryland does. You need to be a resident of Maryland at least for 1 year to be eligible. I don't know if out of state tx is covered though.
Anne

[Becky]

There are 5 states where it is against the law to exclude pre-existing conditions. NJ, NY and IL are 3 of those states but I can't remember the other 2. Except for COBRA (or being in one of those 5 states), pre-existing conditions can be excluded for a particular timeframe (state to state laws).