HIPPA and pre-existing conditions

[spidey07]

Doing some research on COBRA and why it's so important to never let your insurance lapse reveled something interesting about pre-existing conditions - insurance companies cannot deny claims based on pre-existing conditions if you've had continuous coverage for 12 months.

Makes sense. It's to not penalize you for switching jobs or policies or if you get laid off there are means to keep continuous coverage. At the same time prevent people from waiting until the get sick or diagnosed before they get health insurance. The HIP in HIPPA is "health insurance portability"

http://www.insure.com/articles...thinsurance/HIPAA.html

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more, a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."

 

[TruePaige]

The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

 

[ebaycj]

Originally posted by: spidey07
Doing some research on COBRA and why it's so important to never let your insurance lapse reveled something interesting about pre-existing conditions - insurance companies cannot deny claims based on pre-existing conditions if you've had continuous coverage for 12 months.

Makes sense. It's to not penalize you for switching jobs or policies or if you get laid off there are means to keep continuous coverage. At the same time prevent people from waiting until the get sick or diagnosed before they get health insurance. The HIP in HIPPA is "health insurance portability"

http://www.insure.com/articles...thinsurance/HIPAA.html

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more, a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."

Only valid for group health care plans. FAIL.

 

[spidey07]

Originally posted by: TruePaige
The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

You're just mad because I completely destroyed pre-existing conditions as a point. Already covered, signed into law by Clinton. COBRA costs subsidized and signed into law with ARRA by Obama. The point is dead.

 

[0marTheZealot]

ARRA is set to expire in a couple months. COBRA is prohibitively expensive regardless. Not a solution at all.

 

[spidey07]

Originally posted by: ebaycj

Only valid for group health care plans. FAIL.

A lot of states extend the concept requiring non-group plans to follow the HIPPA guarantees. Or you could always get a group plan, many state high-risk pools are also available and also included with HIPPA.

-edit-
Or you could go participate in a group plan. This is what insurance brokers are for.

 

[TruePaige]

Originally posted by: spidey07

Originally posted by: TruePaige
The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

You're just mad because I completely destroyed pre-existing conditions as a point. Already covered, signed into law by Clinton. COBRA costs subsidized and signed into law with ARRA by Obama. The point is dead.

Um..no you didn't.

COBRA and group plans immediately after is not a choice for everyone.

Hell most people couldn't ever HOPE to afford their COBRA.

You just can't live with yourself for being a murderer.

You hate everyone who isn't you, what was that quote of yours about gays and atheists?

 

[spidey07]

Originally posted by: TruePaige

Originally posted by: spidey07

Originally posted by: TruePaige
The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

You're just mad because I completely destroyed pre-existing conditions as a point. Already covered, signed into law by Clinton. COBRA costs subsidized and signed into law with ARRA by Obama. The point is dead.

Um..no you didn't.

COBRA and group plans immediately after is not a choice for everyone.

Hell most people couldn't ever HOPE to afford their COBRA.

You just can't live with yourself for being a murderer.

You hate everyone who isn't you, what was that quote of yours about gays and atheists?

Nonsense. They are absolutely a choice, they just choose not to do the work or pay for their insurance.

This looks appealing for anybody that truly thinks they have no choice or somehow prevented from getting health insurance. Never used it, but it's what google gives for the guaranteed-issue clause.
http://www.guaranteed-issue-health-insurance.com/

 

[SammyJr]

Originally posted by: spidey07

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more, a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."

Yeah, but it pretty well fucks those who do not have a group policy or can't afford COBRA.

 

[TruePaige]

Originally posted by: spidey07

Originally posted by: TruePaige

Originally posted by: spidey07

Originally posted by: TruePaige
The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

You're just mad because I completely destroyed pre-existing conditions as a point. Already covered, signed into law by Clinton. COBRA costs subsidized and signed into law with ARRA by Obama. The point is dead.

Um..no you didn't.

COBRA and group plans immediately after is not a choice for everyone.

Hell most people couldn't ever HOPE to afford their COBRA.

You just can't live with yourself for being a murderer.

You hate everyone who isn't you, what was that quote of yours about gays and atheists?

Nonsense. They are absolutely a choice, they just choose not to do the work or pay for their insurance.

This looks appealing for anybody that truly thinks they have no choice or somehow prevented from getting health insurance. Never used it, but it's what google gives for the guaranteed-issue clause.
http://www.guaranteed-issue-health-insurance.com/

That is just a site where you search for plans....which also exclude pre-existing conditions.

Sorry, total BS.

 

[TruePaige]

This reminds me of your idea of a health care plan.

http://news.bbc.co.uk/2/hi/1288230.stm

 

[spidey07]

Originally posted by: TruePaige


That is just a site where you search for plans....which also exclude pre-existing conditions.

Sorry, total BS.

Nope. Read the OP again and the link contained.

 

[Special K]

Originally posted by: ebaycj

Originally posted by: spidey07
Doing some research on COBRA and why it's so important to never let your insurance lapse reveled something interesting about pre-existing conditions - insurance companies cannot deny claims based on pre-existing conditions if you've had continuous coverage for 12 months.

Makes sense. It's to not penalize you for switching jobs or policies or if you get laid off there are means to keep continuous coverage. At the same time prevent people from waiting until the get sick or diagnosed before they get health insurance. The HIP in HIPPA is "health insurance portability"

http://www.insure.com/articles...thinsurance/HIPAA.html

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more, a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."

Only valid for group health care plans. FAIL.

So if I opt to buy an individual policy from an insurance company such as BCBS instead of taking COBRA coverage (or buy the individual policy after the ARRA subsidy runs out), does that count as a group plan for the purposes of pre-existing conditions or not?

Since it's called an individual plan I would assume not, but then again I figure they have to pool you in with some other group of people, right? Isn't that how they spread the risk around, at least in theory?

Also is anything that I see a doctor for considered a "pre-existing condition", no matter how trivial?

 

[JEDIYoda]

Originally posted by: spidey07

Originally posted by: TruePaige

Originally posted by: spidey07

Originally posted by: TruePaige
The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

You're just mad because I completely destroyed pre-existing conditions as a point. Already covered, signed into law by Clinton. COBRA costs subsidized and signed into law with ARRA by Obama. The point is dead.

Um..no you didn't.

COBRA and group plans immediately after is not a choice for everyone.

Hell most people couldn't ever HOPE to afford their COBRA.

You just can't live with yourself for being a murderer.

You hate everyone who isn't you, what was that quote of yours about gays and atheists?

Nonsense. They are absolutely a choice, they just choose not to do the work or pay for their insurance. -- thats BS!!!


This looks appealing for anybody that truly thinks they have no choice or somehow prevented from getting health insurance. Never used it, but it's what google gives for the guaranteed-issue clause.
http://www.guaranteed-issue-health-insurance.com/

Your a blooming idiot Spidey!!
I had some of the best health insurance in the world....
I worked for a hospital and I paid nothing practically to have my family covered.
I left my place of employment and the premiums for COBRA alone were over $700 a month just for me......there is no way i could afford to cover myself and my famliy......

 

[umbrella39]

Spidey, are you ever right about anything? You are so full of shit I can't even for a second think that you are buying in to it. So why even bother with the typing it out part? Find a different hobby.

 

[Turin39789]

Originally posted by: Special K

Originally posted by: ebaycj

Originally posted by: spidey07
Doing some research on COBRA and why it's so important to never let your insurance lapse reveled something interesting about pre-existing conditions - insurance companies cannot deny claims based on pre-existing conditions if you've had continuous coverage for 12 months.

Makes sense. It's to not penalize you for switching jobs or policies or if you get laid off there are means to keep continuous coverage. At the same time prevent people from waiting until the get sick or diagnosed before they get health insurance. The HIP in HIPPA is "health insurance portability"

http://www.insure.com/articles...thinsurance/HIPAA.html

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more, a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."

Only valid for group health care plans. FAIL.

So if I opt to buy an individual policy from an insurance company such as BCBS instead of taking COBRA coverage (or buy the individual policy after the ARRA subsidy runs out), does that count as a group plan for the purposes of pre-existing conditions or not?

Since it's called an individual plan I would assume not, but then again I figure they have to pool you in with some other group of people, right? Isn't that how they spread the risk around, at least in theory?

Also is anything that I see a doctor for considered a "pre-existing condition", no matter how trivial?

No it doesn't.

Any lapse in coverage means prex applies and we ain't paying.

 

[Athena]

Originally posted by: spidey07
A lot of states extend the concept requiring non-group plans to follow the HIPPA guarantees. Or you could always get a group plan, many state high-risk pools are also available and also included with HIPPA.

-edit-
Or you could go participate in a group plan. This is what insurance brokers are for.

So provide us with a link of the states that mandate guaranteed issue at competitive group rates.

And explain why,if it is so easy for anyone to participate in a group plan with "affordable" rates, Congressional hearings have been filled with so much testimony about denials, recissions, and poor coverage.

The take home message from this particular defense of the status quo is that it is misguided to think that the private insurance market in the US can somehow be regulated into something that will provide health and financial security for the nation. That's not its objective and we ought to be looking to a different financing model.

 

[ebaycj]

Originally posted by: Special K

Originally posted by: ebaycj

Originally posted by: spidey07
Doing some research on COBRA and why it's so important to never let your insurance lapse reveled something interesting about pre-existing conditions - insurance companies cannot deny claims based on pre-existing conditions if you've had continuous coverage for 12 months.

Makes sense. It's to not penalize you for switching jobs or policies or if you get laid off there are means to keep continuous coverage. At the same time prevent people from waiting until the get sick or diagnosed before they get health insurance. The HIP in HIPPA is "health insurance portability"

http://www.insure.com/articles...thinsurance/HIPAA.html

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more, a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."

Only valid for group health care plans. FAIL.

So if I opt to buy an individual policy from an insurance company such as BCBS instead of taking COBRA coverage (or buy the individual policy after the ARRA subsidy runs out), does that count as a group plan for the purposes of pre-existing conditions or not?

Since it's called an individual plan I would assume not, but then again I figure they have to pool you in with some other group of people, right? Isn't that how they spread the risk around, at least in theory?

Also is anything that I see a doctor for considered a "pre-existing condition", no matter how trivial?

This just happened to me. I was told over the phone by BCBS's CSR that EVERYTHING would be flagged pre-existing for the first year. Headache, flagged. Fever, flagged. Food poisoning, flagged. You get the point.

That is, until i told her i had previous (continuous) coverage through BCBS in the form of my COBRA. Then she switched to "nothing will be flagged as pre-existing".

 

[ebaycj]

Originally posted by: Turin39789

No it doesn't.

Any lapse in coverage means prex applies and we ain't paying.

Actually by law it has to be a lapse of 63 days or greater.

 

[Ausm]

Originally posted by: spidey07
Doing some research on COBRA and why it's so important to never let your insurance lapse reveled something interesting about pre-existing conditions - insurance companies cannot deny claims based on pre-existing conditions if you've had continuous coverage for 12 months.

Makes sense. It's to not penalize you for switching jobs or policies or if you get laid off there are means to keep continuous coverage. At the same time prevent people from waiting until the get sick or diagnosed before they get health insurance. The HIP in HIPPA is "health insurance portability"

http://www.insure.com/articles...thinsurance/HIPAA.html

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more, a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."

Well wouldn't that seem obvious because Cobra covers people who lost their job and I never had a job where the company insurance provided would not cover a pre-existing condition. This would make COBRA pretty useless if it was allowed to invoke a pre-existing condition clause.

Oh for the record I am diabetic which is considered a pre-existing condition.

 

[Athena]

Originally posted by: ebaycj
That is, until i told her i had previous (continuous) coverage through BCBS in the form of my COBRA. Then she switched to "nothing will be flagged as pre-existing".

I don't think you would have had the same experience had you switched to Aetna at the expiration of your COBRA benefits.

 

[ebaycj]

Originally posted by: Athena

Originally posted by: ebaycj
That is, until i told her i had previous (continuous) coverage through BCBS in the form of my COBRA. Then she switched to "nothing will be flagged as pre-existing".

I don't think you would have had the same experience had you switched to Aetna at the expiration of your COBRA benefits.

Likely not.

However, When I did switch from United Healthcare to BCBS a few years back, I had to fax BCBS a copy of my "exit letter" from United Healthcare before BCBS would waive pre-existing.

 

[heyheybooboo]

Summary: Insurers can't deny you for pre-existing conditions


Assuming, of course, you can afford their huge premium and riders.

 

[EagleKeeper]

Originally posted by: spidey07

Originally posted by: TruePaige

Originally posted by: spidey07

Originally posted by: TruePaige
The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

You're just mad because I completely destroyed pre-existing conditions as a point. Already covered, signed into law by Clinton. COBRA costs subsidized and signed into law with ARRA by Obama. The point is dead.

Um..no you didn't.

COBRA and group plans immediately after is not a choice for everyone.

Hell most people couldn't ever HOPE to afford their COBRA.

You just can't live with yourself for being a murderer.

You hate everyone who isn't you, what was that quote of yours about gays and atheists?

Nonsense. They are absolutely a choice, they just choose not to do the work or pay for their insurance.

This looks appealing for anybody that truly thinks they have no choice or somehow prevented from getting health insurance. Never used it, but it's what google gives for the guaranteed-issue clause.
http://www.guaranteed-issue-health-insurance.com/

When you are layed off, your salary is no more than 50% of your original income.
You still have your household expenses which are not cut - now CORBA comes in withan extra $300-500/month. That is at least 1 weeks unemployment check.

 

[Athena]

Originally posted by: ebaycj
However, When I did switch from United Healthcare to BCBS a few years back, I had to fax BCBS a copy of my "exit letter" from United Healthcare before BCBS would waive pre-existing.

You said that you converted from COBRA BCBS to an individual policy. Can we assume then, that the exit letter was to get full coverage at your new employer?

One of the many gotchas with HIPAA is that it only protects people who weren't paying for their own coverage in the first place. "Creditable" insurance means:

• A group health plan
• Medicare
• Medicaid
• A military-sponsored health care program such as TriCare
• Health plans offered by the Indian Health Service
• A state high-risk health insurance pool
• The federal Employees Health Benefit Program
• A public health plan established or maintained by a state or local government
• A health benefit plan provided for Peace Corps members

In other words, if you work for one of the 60% of small businesses that do not offer coverage and pay or self-employed and take responsibility for your family's well being by participating in the individual health insurance market, you are basically penalized if/when you go to work for a company with better benefits.