Moving to California from the UK

[Jeanette40]

Hi again, I have just thought of another question, is there a big deal about pre-existing conditions? Will I even be allowed insurance or will it cost tons more, or if it is a group insurance attached to the company will me having CF not even matter?
<br />Thank you again
<br />Jeanette x

 

[julie]

If it is an employer based insurance they are NOT allowed to exclude for pre-existing conditions if you've had previous coverage with NO gap in coverage. I'm not sure however how this applies to the medical system in the UK... I'll see if I can find any info.

Also, CA has a program called Genetically Handicapped Persons Program (GHPP). it helps cover meds, travel and stuff for peolple with genetic conditions, CF being one of the ones that is covered. It's been since 2005 that I lived in CA, but we had my ex-husband on it and it picked up the copays and things that ins. didn't cover, or covered at a low %. That being said though, I've heard a lot of complaints about the functionality of the program lately, the applicaiton process I hear is VERY long and takes forever...

 

[julie]

If it is an employer based insurance they are NOT allowed to exclude for pre-existing conditions if you've had previous coverage with NO gap in coverage. I'm not sure however how this applies to the medical system in the UK... I'll see if I can find any info.

Also, CA has a program called Genetically Handicapped Persons Program (GHPP). it helps cover meds, travel and stuff for peolple with genetic conditions, CF being one of the ones that is covered. It's been since 2005 that I lived in CA, but we had my ex-husband on it and it picked up the copays and things that ins. didn't cover, or covered at a low %. That being said though, I've heard a lot of complaints about the functionality of the program lately, the applicaiton process I hear is VERY long and takes forever...

 

[julie]

If it is an employer based insurance they are NOT allowed to exclude for pre-existing conditions if you've had previous coverage with NO gap in coverage. I'm not sure however how this applies to the medical system in the UK... I'll see if I can find any info.
<br />
<br />Also, CA has a program called Genetically Handicapped Persons Program (GHPP). it helps cover meds, travel and stuff for peolple with genetic conditions, CF being one of the ones that is covered. It's been since 2005 that I lived in CA, but we had my ex-husband on it and it picked up the copays and things that ins. didn't cover, or covered at a low %. That being said though, I've heard a lot of complaints about the functionality of the program lately, the applicaiton process I hear is VERY long and takes forever...

 

[2005CFmom]

Jeanette,

Yes, a deductible means you pay the full cost of healthcare until you have paid that amount. So January can be a very expensive month...we just save up knowing it is coming.

Most plans I believe do have an out of pocket max, but the range varies widely. My husbands employer offers a few medical plans to choose from. There is one that has an out of pocket max of $5,500 per individual or $16,500 per family! And remember the cost of your prescription medications are normally NOT included in this amount. So you would have to pay this amount, PLUS the cost of medications.

As far as the i-neb...I'm not familiar with this, but you normally only get an e-flow if you are on inhaled antibiotics. My daughter nebs: albuterol, hypertonic saline & pulmozyme - and we use a "mobileaire" compressor with a "pari lc plus" nebulizers. If you only neb saline then most likely you will get whatever "brand" your insurance has contracted with. If you start nebbing something like pulmozyme, there are certain compressor/nebulizer combos that are recommended for using that drug.

Julie will probably be the best person to answer your question about pre-existing conditions. But generally, pre-existing conditions are not a problem with an employers group plan. My husband changed jobs a few years ago and we had no problem with the getting coverage under the new plan. But we had no gap in coverage...so that may be something to look into.

Feel free to ask anything that comes to mind. I'll do what I can to help.

 

[2005CFmom]

Jeanette,

Yes, a deductible means you pay the full cost of healthcare until you have paid that amount. So January can be a very expensive month...we just save up knowing it is coming.

Most plans I believe do have an out of pocket max, but the range varies widely. My husbands employer offers a few medical plans to choose from. There is one that has an out of pocket max of $5,500 per individual or $16,500 per family! And remember the cost of your prescription medications are normally NOT included in this amount. So you would have to pay this amount, PLUS the cost of medications.

As far as the i-neb...I'm not familiar with this, but you normally only get an e-flow if you are on inhaled antibiotics. My daughter nebs: albuterol, hypertonic saline & pulmozyme - and we use a "mobileaire" compressor with a "pari lc plus" nebulizers. If you only neb saline then most likely you will get whatever "brand" your insurance has contracted with. If you start nebbing something like pulmozyme, there are certain compressor/nebulizer combos that are recommended for using that drug.

Julie will probably be the best person to answer your question about pre-existing conditions. But generally, pre-existing conditions are not a problem with an employers group plan. My husband changed jobs a few years ago and we had no problem with the getting coverage under the new plan. But we had no gap in coverage...so that may be something to look into.

Feel free to ask anything that comes to mind. I'll do what I can to help.

 

[2005CFmom]

Jeanette,
<br />
<br />Yes, a deductible means you pay the full cost of healthcare until you have paid that amount. So January can be a very expensive month...we just save up knowing it is coming.
<br />
<br />Most plans I believe do have an out of pocket max, but the range varies widely. My husbands employer offers a few medical plans to choose from. There is one that has an out of pocket max of $5,500 per individual or $16,500 per family! And remember the cost of your prescription medications are normally NOT included in this amount. So you would have to pay this amount, PLUS the cost of medications.
<br />
<br />As far as the i-neb...I'm not familiar with this, but you normally only get an e-flow if you are on inhaled antibiotics. My daughter nebs: albuterol, hypertonic saline & pulmozyme - and we use a "mobileaire" compressor with a "pari lc plus" nebulizers. If you only neb saline then most likely you will get whatever "brand" your insurance has contracted with. If you start nebbing something like pulmozyme, there are certain compressor/nebulizer combos that are recommended for using that drug.
<br />
<br />Julie will probably be the best person to answer your question about pre-existing conditions. But generally, pre-existing conditions are not a problem with an employers group plan. My husband changed jobs a few years ago and we had no problem with the getting coverage under the new plan. But we had no gap in coverage...so that may be something to look into.
<br />
<br />Feel free to ask anything that comes to mind. I'll do what I can to help.
<br />
<br />
<br />

 

[Jeanette40]

Thank you Julie and Teri, really helpful as ever x I am still waiting to hear what insurance package we will be in so will know more then, and then possibly more questions for you, sorry!! Not sure a "no gap in coverage" applies to me though as I have never had cover as it's all free in England, apart from prescriptions, so never get insurance.

Teri - the i-neb is a great little device which delivers the drug pretty fast, and works with your normal pattern of breathing so it only puff out drug when you breathe in, thus not much wastage of drugs, be a shame if I can't use it in CA as I am really used to that one!

Thanks again, will be back to haunt you with more questions very soon!

Jeanette x

 

[Jeanette40]

Thank you Julie and Teri, really helpful as ever x I am still waiting to hear what insurance package we will be in so will know more then, and then possibly more questions for you, sorry!! Not sure a "no gap in coverage" applies to me though as I have never had cover as it's all free in England, apart from prescriptions, so never get insurance.

Teri - the i-neb is a great little device which delivers the drug pretty fast, and works with your normal pattern of breathing so it only puff out drug when you breathe in, thus not much wastage of drugs, be a shame if I can't use it in CA as I am really used to that one!

Thanks again, will be back to haunt you with more questions very soon!

Jeanette x

 

[Jeanette40]

Thank you Julie and Teri, really helpful as ever x I am still waiting to hear what insurance package we will be in so will know more then, and then possibly more questions for you, sorry!! Not sure a "no gap in coverage" applies to me though as I have never had cover as it's all free in England, apart from prescriptions, so never get insurance.
<br />
<br />Teri - the i-neb is a great little device which delivers the drug pretty fast, and works with your normal pattern of breathing so it only puff out drug when you breathe in, thus not much wastage of drugs, be a shame if I can't use it in CA as I am really used to that one!
<br />
<br />Thanks again, will be back to haunt you with more questions very soon!
<br />
<br />Jeanette x