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Old 01-11-2012, 10:01 PM #1
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Question Would a new insurance deny battery replacement as 'pre-existing condition'

My first thought on this is yes they would deny....
Have any of you been faced with this, or know anything about it?

My current Ins is through my employer and the company pays the premiums (almost $700/mo!). Due to corporate greed, my company and my job may be desolving within a year or so and I would not be able to afford that kind of premium.
I don't want to have to feel 'stuck' with this Ins, but maybe I am. I hope I have a few yrs left with my battery life, but who knows. This is something I'll eventually have to face, be it next year or 5 yrs from now. Sure wouldn't want to be stuck paying for the whole thing out of pocket!

If anyone can chime in, I'd appreciate it

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Old 01-11-2012, 11:11 PM #2
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Heart Insurance

Yo, Rae-

Under insurance portability acts both federally and in state laws, assuming you obtain insurance under a new employment if that occurs, pre-existing conditions should be waived. Were you not to find replacement work with benefits resulting in your purchase of insurance personally, take a look at any pre-existing condition issues with an agent BEFORE signing any paperwork.

I know I did read every single page of the Bama Care legislation, and I have had so MUCH contract language under the bridge since then I frankly have forgotten. I can take a look at the language again, as upon full implementation it is surely to have something to say on point.

If your workplace knew how very hard you work, they would never in a million years elect to separate you from employment.

Remember, if you are within an employee base of sufficient numbers, COBRA should be part of the picture enabling continuation of the coverage another 18 months.

ARGHHHHHHHH,
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Old 01-12-2012, 12:56 AM #3
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Default That's rough

Boy, serving on active duty then and being an Air Force wife for 20 years was rough: low pay, substandard housing, lot of travel to remote locations away from my daughter and I, but we loved it at the time and really didn't know how much civilian jobs paid, so we didn't know (a lot if the time) what we were missing. Military medicine does have it's disadvantages but I always know that we have it to fall back on. It definitely would be a source of comfort in a situation like yours. I hope it all works out for you!
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Old 01-12-2012, 10:18 AM #4
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How about calling the ins. dept. of the company that made your implant (was it Boston Scientific??). They may have experience with this kind of thing because I'm sure you'd not be the only one to have to change jobs and then face needing a new battery implant. Just a thought! Sorry to hear about the possibility of having to find a new job...it's always something, isn't it...but then, it's always an opportunity for prayer and to watch God work things out!!
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Old 01-12-2012, 11:00 AM #5
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Default Affordable Health Care Act "Obama Care"

Starting in 2014, insurers cannot deny benefits based on preexisting conditions. Unfortunately, this doesn`t help much right now. But it`s a good reason not to repeal it.
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Old 01-12-2012, 07:27 PM #6
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Thumbs up Thanx my friends

Some very sound advice given here! You all rock

I'm only in year 2 of having my unit, so hopefully I've got several yrs left - without having to change the battery.

I like what Joan says regarding the Obama care. I hope it sticks. I can hold out til 2014 no problem! This would sure bring comfort in knowing this.......as long as the forces that be in government don't somehow screw this up.

Fiona has good point - check with Medtronic (in my case). They may have some hints.
Mark, thank you! If I'm face to face with a potential Ins agent and he says it would be covered.....I'd still need to get that down in writing, yes?

Wow, Eliza, I didn't know you were in the military.....no wonder you're so 'tough'

Last edited by Rrae; 01-12-2012 at 08:19 PM.
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Old 01-12-2012, 07:45 PM #7
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Rrae, I would have given you this link earlier, but was at work and using my Kindle and it was too hard (I don't want them knowing my personal health business, so don't come here on their network):

http://www.healthcare.gov/law/resour...eexisting.html

There is also a type of insurance available now that people with pre-existing conditions can get, which looks like it would be a little less expensive than the premium you're looking at now:

http://www.healthcare.gov/law/featur....html#benefits

Hope this helps.
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Old 01-12-2012, 08:18 PM #8
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Default Thank you Joan!

I'll put those links in my left pocket for safe keeping

Another thought that enters my mind...
If I remember correctly, I think these units technically fall under the category of DME (durable medical equipment) so maybe that in itself would not be considered as pre-existing.... The DME isn't a condition per se. The battery is a piece of equipment that needs maintenance.

I spose this could be looked at in several different ways.

This is something that could probably easily be looked into and maybe even the company (Medtronic) would advise on this.....or like Joan says, there might be some sort of legislation that has this covered.
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Old 01-12-2012, 09:10 PM #9
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Hey Rae, the important thing is to not have a break in coverage. As long as there is not a break in coverage, moving from your employer plan to either COBRA coverage (if eligible) or an individual plan, you will not be faced with a pre-existing condition clause. I know COBRA premiums are outrageous, but there are other more affordable individual plans you can get until you can get covered on a new employer plan (hopefully).
If there is a break in coverage of more than 63 days, then you could be faced with a pre-existing condition clause on a new plan...there is no way around it unless they are a large carrier and just do not have any clauses but most do.
Like others said, Obama care is doing away it....gradually.

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Old 01-12-2012, 11:47 PM #10
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Heart Joan and Nanc are on point

So, Rae, avoid breaks in coverage until legislation is fully effective. Speaking with any agent get language in writing to consider. Watch the premiums, language is key, speak about existing DME as an exceptoin to some lapse in coverage.

Don't let this overwhelm or overcome you. Take one day at a time.

All will be well,
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