[pauld315]

How long does a pre existing condition affect your ability to get health insurance ? My wife had cancer a couple of times with the latest being in 2004. When we were down on our LSP in April 2010, we went to The Villages Insurance to discuss if my wife could get health insurance. They said the only way they could write a policy was one that excluded cancer because of her preexisting condition. I am several years older than my wife and we want to move to the Villages when I retire in 3 years. If we do that, she would have to quit her job here which also provides her health insurance. I would no longer be employed so I couldn't just put her on mine. The only solution that seems to work if the pre existing condition continues, is for us to move there while I am still working (I can work from home), put her on my insurance and then hope she can find a job that offers insurance that she can sign up for so I can retire. Anybody have any other insight into this ?

[coach]

Would COBRA from her employer or from yours if she was on your policy give her enough time to reach age 65 and be eligable for medicare? Company policies are different but almost all provide at least 18 months of COBRA coverage and some allow as much as 36 months.

[pauld315]

No, in 3 years she will only be 54. I have been thinking and looking around and it seems they can only waive coverage for the preexisting condition on a new policy for 18 months. As long as you stay healthy during that time, you can then get that preexisting condition covered. So, I guess an alternative would be to go ahead and sign up for the limited policy 18 months before leaving her job so she could have full coverage while she is still working from her work policy and then gan full coverage with the other policy due to the time she had it. Then she could leave her job. Convoluted thinking, most likely pretty costly and I am not sure it would work with all the restrictions regarding purchasing policies across state lines.

[barb1191]

Originally Posted by pauld315

How long does a pre existing condition affect your ability to get health insurance ? My wife had cancer a couple of times with the latest being in 2004. When we were down on our LSP in April 2010, we went to The Villages Insurance to discuss if my wife could get health insurance. They said the only way they could write a policy was one that excluded cancer because of her preexisting condition. I am several years older than my wife and we want to move to the Villages when I retire in 3 years. If we do that, she would have to quit her job here which also provides her health insurance. I would no longer be employed so I couldn't just put her on mine. The only solution that seems to work if the pre existing condition continues, is for us to move there while I am still working (I can work from home), put her on my insurance and then hope she can find a job that offers insurance that she can sign up for so I can retire. Anybody have any other insight into this ?

If you put a search on "medical pre-existing conditions" you will find a plethora of sites to learn about this. I do believe the following link may help you:

http://Pre-existing Conditions Health Insurance

[hlanders]

We are in a similar situation, effective July 1, 2010 with all the new government backed healthcare changes if you are unable to obtain insurance due to a pre existing condition you can apply for coverage as a FL resident (or whatever state you are in). You do have to be without coverage for 6 months (risky-but...) You just have to provide proof of being denied by a carrier, proof of citizenship and other basic info. I would be hesitant to leave a job that provided it, bound to be cheaper but if you really want to move this is an option. Don't know your profession but a job making much money and with benefits in The Villages won't be easy to land either. Good Luck!

[pauld315]

6 months with no insurance for someone who has had cancer twice is a risk we can't afford. You know what I am talking about if you ever saw bills related to chemotherapy and other cancer treatments.

I think I did find something though. With HIPAA a new group policy has to accept her if she can prove she has had continuous coverage with a break of only 63 days or less. On top of that, group coverage can be purchased in Florida if you open a company with as few as 1 employee that will enroll. Therefore, we could open a business and have her get her insurance through the new group policy purchased for the business. That would work I think since we had been discussing opening a business when we moved anyway.

For information on this ---> http://www.diabetes.org/living-with-...ps-of-one.html

These states guarantee issuance to small groups ---> http://www.statehealthfacts.org/comp...?cat=7&ind=350

[bkcunningham1]

Originally Posted by hlanders

We are in a similar situation, effective July 1, 2010 with all the new government backed healthcare changes if you are unable to obtain insurance due to a pre existing condition you can apply for coverage as a FL resident (or whatever state you are in). You do have to be without coverage for 6 months (risky-but...) You just have to provide proof of being denied by a carrier, proof of citizenship and other basic info. I would be hesitant to leave a job that provided it, bound to be cheaper but if you really want to move this is an option. Don't know your profession but a job making much money and with benefits in The Villages won't be easy to land either. Good Luck!

hlanders, where did you read that change in the new health care bill kicks in July 1? I'm not saying that isn't correct.

The only thing I can find is the pre-existing condition for children goes into effect around Sept. 23, 2010 (six months after the bill was signed). And the pre-existing condition requirement for insurance companies providing for adults isn't mandated until January 2014. That gives the states run exchanges time to get up and running.

http://www.csmonitor.com/USA/Politic...ing-conditions

[pauld315]

bkcunningham1 - take a look at this article

http://www.insurancejournal.com/news.../01/111230.htm

[bkcunningham1]

pauld315, thanks. I found this government site that gives state-by-state information. I truly wish you both the best and pray your wife stays healthy. We forget how blessed we are when we have our health.

https://www.pcip.gov/StatePlans.html

[Pturner]

Pauld315,
I'm sorry to hear of your wife's former cancer and I hope she stays in remission forever. Under the circumstances, I don't think I would give up her job and health insurance benefits until you are certain that you have secured adequate coverage elsewhere.

Insurance policies can be tricky-- you have to read the fine print. My former employer once purchased a group policy with assurance that mammograms were covered. When women in the office filed claims for the procedure, the claims were denied. The policy stated something to the effect that mammograms and other routine office procedures were covered. The "trick" was that mammograms are never actually performed in a doctor's office. The insurance company's argument was that mammograms were covered as long as they were performed in a doctor's office. Gotcha.

The "gotchas" with insurance companies can be almost beyond belief; so before you give up her work coverage for any other coverage, I would have a competent insurance attorney or adviser review the policy.

Wish you all the best.

[Tom Hannon]

I have a similar insurance problem but not as delicate. I have a life insurance I took out 20 years ago. It is expensive but I've always paid the policy every year. I could cash in the policy and take a big dent out of the expenses we have from new furniture, the cost of a golf cart and a possible new car. I could get another policy from my wife's teachers union, just as good for half the price. But, because I had prostate cancer 7 years ago, no insurance company wants me. I am in better shape now than I was ten years ago, and otherwise in perfect health. There is no sign of cancer returning as my last PSA was 0.21. Uroligist said I have some of the lowest numbers he seen. So Paul, cover your ass. Insurance companies are a rare breed.

[2BNTV]

Pturner
Soaring Eagle member Join Date: Oct 2009
Location: Atlanta
Posts: 2,043



--------------------------------------------------------------------------------

Pauld315,
I'm sorry to hear of your wife's former cancer and I hope she stays in remission forever. Under the circumstances, I don't think I would give up her job and health insurance benefits until you are certain that you have secured adequate coverage elsewhere.

Insurance policies can be tricky-- you have to read the fine print. My former employer once purchased a group policy with assurance that mammograms were covered. When women in the office filed claims for the procedure, the claims were denied. The policy stated something to the effect that mammograms and other routine office procedures were covered. The "trick" was that mammograms are never actually performed in a doctor's office. The insurance company's argument was that mammograms were covered as long as they were performed in a doctor's office. Gotcha.

The "gotchas" with insurance companies can be almost beyond belief; so before you give up her work coverage for any other coverage, I would have a competent insurance attorney or adviser review the policy.

Wish you all the best.

Pauld315:

I agree with pturner. Insurance companies have their own rules. I would make sure that she is covered by calling them and asking for a secific clarification on their policies. Trying to figure out the way these policies are written can be extremely difficult as they seem to be written by lawyers to protect the insurance companies. A competent insurance attorney or adviser review the policy is a great idea..
If you ask me, I think insurance policies are a lot of double talk.

I had a family doctor tell me he retired because he got tired of talking to a insurance rep, (possibly a former nurse), who would tell him why a procedure was not covered. He felt that as a doctor, he knew better what needed to be done than the insurance rep.

Wishing you and your wife all the best with your decisions so that your wife stays healthy.

[pauld315]

Thanks to all for your well wishes. We have been dealing with this since she was 38 and we never look at it as a liability or really even think about it all that much. We faced the possibilities of what could happen years ago and put it in God's hands. We always remain positive since we do believe that positive thinking will always help in your cure. We celebrate as each year passes. She is still a survivor after 13 years. That is all good.

I still haven't found out when, if ever, the insurance companies will remove you from "pre-existing condition" status. It affects health insurance and as mentioned above, procuring life insurance. I tried raising her life insurance once after she had cancer and that was also a no go. Do they ever drop that classification and actually consider you cured ?

It just doesn't seem right that the medical community considers you cured after a 5 year remission but the insurance companies really never consider you cured. Thanks to all for their advice.

[Vinny]

My wife and I are a group of two. The business was here for a few years but inactive. When I decided to move here we simply got insurance under the dormant Florida company. I do not know if there are any restrictions on new businesses though so best to check this out. They might have some rules in effect to prevent people from doing what you outlined above. Insurance companies do not like to pay out if you haven't heard.

[2 Oldcrabs]

Part of the new healthcare bill will eliminate the "pre-existing condition" clause. Insurance companies will not be able to deny or charge you more . Not sure what year it takes effect ( I think it is 2012). But there is movement to repeal the healthcare bill. We wish you the best.