New job?

W

welshwitch

Guest
I just got offered an amazing opportunity at a promising start up! I have been verbally assured "The Cadillac of Health Insurance" by my prospective boss. However, since it is a start up they haven't decided on their health insurance yet, ie, what provider they'll be using.

I'm obviously not going to sign on the dotted line until I know that I am indeed getting health insurance, but I am a bit worried that I may need to change doctors should the new job have a provider that is different from my current job's benefits (I'm currently on Kaiser through my current job and they have a great CF center). I'm worried that even though I have "great" health insurance I won't be able to find a CF center.

Does this make sense? Maybe I'm stressing about leaving my current doctor, but in people's experience do most health insurance options cover CF? Ie if you have "full benefits" I shouldn't have a problem getting my meds covered? I'm just a little wary of getting new health insurance through a new employer, and I don't want to screw up my CF care.

Any ideas on how to handle this? This is a great opportunity and I don't want to pass it up; however, I don't want to be stupid about my health.

Happy New Year Everyone!
 
W

welshwitch

Guest
I just got offered an amazing opportunity at a promising start up! I have been verbally assured "The Cadillac of Health Insurance" by my prospective boss. However, since it is a start up they haven't decided on their health insurance yet, ie, what provider they'll be using.

I'm obviously not going to sign on the dotted line until I know that I am indeed getting health insurance, but I am a bit worried that I may need to change doctors should the new job have a provider that is different from my current job's benefits (I'm currently on Kaiser through my current job and they have a great CF center). I'm worried that even though I have "great" health insurance I won't be able to find a CF center.

Does this make sense? Maybe I'm stressing about leaving my current doctor, but in people's experience do most health insurance options cover CF? Ie if you have "full benefits" I shouldn't have a problem getting my meds covered? I'm just a little wary of getting new health insurance through a new employer, and I don't want to screw up my CF care.

Any ideas on how to handle this? This is a great opportunity and I don't want to pass it up; however, I don't want to be stupid about my health.

Happy New Year Everyone!
 
W

welshwitch

Guest
I just got offered an amazing opportunity at a promising start up! I have been verbally assured "The Cadillac of Health Insurance" by my prospective boss. However, since it is a start up they haven't decided on their health insurance yet, ie, what provider they'll be using.

I'm obviously not going to sign on the dotted line until I know that I am indeed getting health insurance, but I am a bit worried that I may need to change doctors should the new job have a provider that is different from my current job's benefits (I'm currently on Kaiser through my current job and they have a great CF center). I'm worried that even though I have "great" health insurance I won't be able to find a CF center.

Does this make sense? Maybe I'm stressing about leaving my current doctor, but in people's experience do most health insurance options cover CF? Ie if you have "full benefits" I shouldn't have a problem getting my meds covered? I'm just a little wary of getting new health insurance through a new employer, and I don't want to screw up my CF care.

Any ideas on how to handle this? This is a great opportunity and I don't want to pass it up; however, I don't want to be stupid about my health.

Happy New Year Everyone!
 
W

welshwitch

Guest
I just got offered an amazing opportunity at a promising start up! I have been verbally assured "The Cadillac of Health Insurance" by my prospective boss. However, since it is a start up they haven't decided on their health insurance yet, ie, what provider they'll be using.

I'm obviously not going to sign on the dotted line until I know that I am indeed getting health insurance, but I am a bit worried that I may need to change doctors should the new job have a provider that is different from my current job's benefits (I'm currently on Kaiser through my current job and they have a great CF center). I'm worried that even though I have "great" health insurance I won't be able to find a CF center.

Does this make sense? Maybe I'm stressing about leaving my current doctor, but in people's experience do most health insurance options cover CF? Ie if you have "full benefits" I shouldn't have a problem getting my meds covered? I'm just a little wary of getting new health insurance through a new employer, and I don't want to screw up my CF care.

Any ideas on how to handle this? This is a great opportunity and I don't want to pass it up; however, I don't want to be stupid about my health.

Happy New Year Everyone!
 
W

welshwitch

Guest
I just got offered an amazing opportunity at a promising start up! I have been verbally assured "The Cadillac of Health Insurance" by my prospective boss. However, since it is a start up they haven't decided on their health insurance yet, ie, what provider they'll be using.
<br />
<br />I'm obviously not going to sign on the dotted line until I know that I am indeed getting health insurance, but I am a bit worried that I may need to change doctors should the new job have a provider that is different from my current job's benefits (I'm currently on Kaiser through my current job and they have a great CF center). I'm worried that even though I have "great" health insurance I won't be able to find a CF center.
<br />
<br />Does this make sense? Maybe I'm stressing about leaving my current doctor, but in people's experience do most health insurance options cover CF? Ie if you have "full benefits" I shouldn't have a problem getting my meds covered? I'm just a little wary of getting new health insurance through a new employer, and I don't want to screw up my CF care.
<br />
<br />Any ideas on how to handle this? This is a great opportunity and I don't want to pass it up; however, I don't want to be stupid about my health.
<br />
<br />Happy New Year Everyone!
 
N

NYCLawGirl

New member
Things to look out for:

1) pre-existing conditions clauses (duh) -- would you be able to COBRA your old insurance during the exclusion period (normally 12 months)? could you afford to do so?

2) most health insurance companies are going to cover CF care at an approved center. you may, however, need a referral. it matters whether you get an HMO or a PPO plan. with an hmo plan, you can't go out of network, typically, but have often have great benefits within the network. with a PPO you normally get a division (e.g., 100% covered if doctor is in network, 80% covered if doctor is out of network). sometimes the networks are smaller at PPOs, however i believe they are safer bets for cfers. if, for example, you find yourself traveling and have to make an emergency visit to a cf center near you, the PPO will normally cover at least part of that cost. also you never get "stuck" without a cf center, you just might have to pay a bit more out of pocket. either way, know which option you have and what doctors are in network. also, know which referrals you need and how far in advance you need to obtain them.

3) kaiser is sort of the ultimate in HMOs -- you only get to see their doctors, and no other insurance plan is going to cover their doctors. sounds like you know this. but you can ask your doc at kaiser to recommend a cf doc outside of the kaiser group and then look up the various insurance plans accepted by that doctor. that will give you an idea of what plans are going to give you the best quality of cf care.

4) watch out for lifetime or yearly caps. seriously. you WILL meet a yearly cap with CF in almost every instance, esp if you get sick. also, of course watch the deductible.

5) know in advance the plan's policy w/ regards to generics and make sure your cf doc specifies when nothing but the brand name will do on the prescription.

6) final thought: don't disregard your plan's policy on DME (durable medical equipment). SO MUCH for cfers falls into this category -- from O2 concentrators to the VEST to compressors. know how often they'll allow for upgrades or replacements. know if they have yearly caps. just be aware. it's something most people don't even think about, but CFers need to.

you may also want to ask your employer if a flexible spending account will be available so that out of pocket expenses fr meds (copays, etc) can be paid for by pre-tax income. helps a lot when you're on as many meds as we are.
 
N

NYCLawGirl

New member
Things to look out for:

1) pre-existing conditions clauses (duh) -- would you be able to COBRA your old insurance during the exclusion period (normally 12 months)? could you afford to do so?

2) most health insurance companies are going to cover CF care at an approved center. you may, however, need a referral. it matters whether you get an HMO or a PPO plan. with an hmo plan, you can't go out of network, typically, but have often have great benefits within the network. with a PPO you normally get a division (e.g., 100% covered if doctor is in network, 80% covered if doctor is out of network). sometimes the networks are smaller at PPOs, however i believe they are safer bets for cfers. if, for example, you find yourself traveling and have to make an emergency visit to a cf center near you, the PPO will normally cover at least part of that cost. also you never get "stuck" without a cf center, you just might have to pay a bit more out of pocket. either way, know which option you have and what doctors are in network. also, know which referrals you need and how far in advance you need to obtain them.

3) kaiser is sort of the ultimate in HMOs -- you only get to see their doctors, and no other insurance plan is going to cover their doctors. sounds like you know this. but you can ask your doc at kaiser to recommend a cf doc outside of the kaiser group and then look up the various insurance plans accepted by that doctor. that will give you an idea of what plans are going to give you the best quality of cf care.

4) watch out for lifetime or yearly caps. seriously. you WILL meet a yearly cap with CF in almost every instance, esp if you get sick. also, of course watch the deductible.

5) know in advance the plan's policy w/ regards to generics and make sure your cf doc specifies when nothing but the brand name will do on the prescription.

6) final thought: don't disregard your plan's policy on DME (durable medical equipment). SO MUCH for cfers falls into this category -- from O2 concentrators to the VEST to compressors. know how often they'll allow for upgrades or replacements. know if they have yearly caps. just be aware. it's something most people don't even think about, but CFers need to.

you may also want to ask your employer if a flexible spending account will be available so that out of pocket expenses fr meds (copays, etc) can be paid for by pre-tax income. helps a lot when you're on as many meds as we are.
 
N

NYCLawGirl

New member
Things to look out for:

1) pre-existing conditions clauses (duh) -- would you be able to COBRA your old insurance during the exclusion period (normally 12 months)? could you afford to do so?

2) most health insurance companies are going to cover CF care at an approved center. you may, however, need a referral. it matters whether you get an HMO or a PPO plan. with an hmo plan, you can't go out of network, typically, but have often have great benefits within the network. with a PPO you normally get a division (e.g., 100% covered if doctor is in network, 80% covered if doctor is out of network). sometimes the networks are smaller at PPOs, however i believe they are safer bets for cfers. if, for example, you find yourself traveling and have to make an emergency visit to a cf center near you, the PPO will normally cover at least part of that cost. also you never get "stuck" without a cf center, you just might have to pay a bit more out of pocket. either way, know which option you have and what doctors are in network. also, know which referrals you need and how far in advance you need to obtain them.

3) kaiser is sort of the ultimate in HMOs -- you only get to see their doctors, and no other insurance plan is going to cover their doctors. sounds like you know this. but you can ask your doc at kaiser to recommend a cf doc outside of the kaiser group and then look up the various insurance plans accepted by that doctor. that will give you an idea of what plans are going to give you the best quality of cf care.

4) watch out for lifetime or yearly caps. seriously. you WILL meet a yearly cap with CF in almost every instance, esp if you get sick. also, of course watch the deductible.

5) know in advance the plan's policy w/ regards to generics and make sure your cf doc specifies when nothing but the brand name will do on the prescription.

6) final thought: don't disregard your plan's policy on DME (durable medical equipment). SO MUCH for cfers falls into this category -- from O2 concentrators to the VEST to compressors. know how often they'll allow for upgrades or replacements. know if they have yearly caps. just be aware. it's something most people don't even think about, but CFers need to.

you may also want to ask your employer if a flexible spending account will be available so that out of pocket expenses fr meds (copays, etc) can be paid for by pre-tax income. helps a lot when you're on as many meds as we are.
 
N

NYCLawGirl

New member
Things to look out for:

1) pre-existing conditions clauses (duh) -- would you be able to COBRA your old insurance during the exclusion period (normally 12 months)? could you afford to do so?

2) most health insurance companies are going to cover CF care at an approved center. you may, however, need a referral. it matters whether you get an HMO or a PPO plan. with an hmo plan, you can't go out of network, typically, but have often have great benefits within the network. with a PPO you normally get a division (e.g., 100% covered if doctor is in network, 80% covered if doctor is out of network). sometimes the networks are smaller at PPOs, however i believe they are safer bets for cfers. if, for example, you find yourself traveling and have to make an emergency visit to a cf center near you, the PPO will normally cover at least part of that cost. also you never get "stuck" without a cf center, you just might have to pay a bit more out of pocket. either way, know which option you have and what doctors are in network. also, know which referrals you need and how far in advance you need to obtain them.

3) kaiser is sort of the ultimate in HMOs -- you only get to see their doctors, and no other insurance plan is going to cover their doctors. sounds like you know this. but you can ask your doc at kaiser to recommend a cf doc outside of the kaiser group and then look up the various insurance plans accepted by that doctor. that will give you an idea of what plans are going to give you the best quality of cf care.

4) watch out for lifetime or yearly caps. seriously. you WILL meet a yearly cap with CF in almost every instance, esp if you get sick. also, of course watch the deductible.

5) know in advance the plan's policy w/ regards to generics and make sure your cf doc specifies when nothing but the brand name will do on the prescription.

6) final thought: don't disregard your plan's policy on DME (durable medical equipment). SO MUCH for cfers falls into this category -- from O2 concentrators to the VEST to compressors. know how often they'll allow for upgrades or replacements. know if they have yearly caps. just be aware. it's something most people don't even think about, but CFers need to.

you may also want to ask your employer if a flexible spending account will be available so that out of pocket expenses fr meds (copays, etc) can be paid for by pre-tax income. helps a lot when you're on as many meds as we are.
 
N

NYCLawGirl

New member
Things to look out for:
<br />
<br />1) pre-existing conditions clauses (duh) -- would you be able to COBRA your old insurance during the exclusion period (normally 12 months)? could you afford to do so?
<br />
<br />2) most health insurance companies are going to cover CF care at an approved center. you may, however, need a referral. it matters whether you get an HMO or a PPO plan. with an hmo plan, you can't go out of network, typically, but have often have great benefits within the network. with a PPO you normally get a division (e.g., 100% covered if doctor is in network, 80% covered if doctor is out of network). sometimes the networks are smaller at PPOs, however i believe they are safer bets for cfers. if, for example, you find yourself traveling and have to make an emergency visit to a cf center near you, the PPO will normally cover at least part of that cost. also you never get "stuck" without a cf center, you just might have to pay a bit more out of pocket. either way, know which option you have and what doctors are in network. also, know which referrals you need and how far in advance you need to obtain them.
<br />
<br />3) kaiser is sort of the ultimate in HMOs -- you only get to see their doctors, and no other insurance plan is going to cover their doctors. sounds like you know this. but you can ask your doc at kaiser to recommend a cf doc outside of the kaiser group and then look up the various insurance plans accepted by that doctor. that will give you an idea of what plans are going to give you the best quality of cf care.
<br />
<br />4) watch out for lifetime or yearly caps. seriously. you WILL meet a yearly cap with CF in almost every instance, esp if you get sick. also, of course watch the deductible.
<br />
<br />5) know in advance the plan's policy w/ regards to generics and make sure your cf doc specifies when nothing but the brand name will do on the prescription.
<br />
<br />6) final thought: don't disregard your plan's policy on DME (durable medical equipment). SO MUCH for cfers falls into this category -- from O2 concentrators to the VEST to compressors. know how often they'll allow for upgrades or replacements. know if they have yearly caps. just be aware. it's something most people don't even think about, but CFers need to.
<br />
<br />you may also want to ask your employer if a flexible spending account will be available so that out of pocket expenses fr meds (copays, etc) can be paid for by pre-tax income. helps a lot when you're on as many meds as we are.
 
W

welshwitch

Guest
Thanks for all the free legal advice, Piper! On a related note: Do you think it's a good idea to tell your employer about your CF when you get hired, or is it something that's more on a "need to know" basis?

Also: can I ask why I would COBRA my old insurance during the exclusion period? Would this be if the new insurance doesn't cover pre-existing conditions? Would I have to get this through my current employer before I quit? Could I just do COBRA for one month while the new insurance was kicking in?

Sorry for all the Qs--I just feel like with CF we're operating by a different set of rules.
 
W

welshwitch

Guest
Thanks for all the free legal advice, Piper! On a related note: Do you think it's a good idea to tell your employer about your CF when you get hired, or is it something that's more on a "need to know" basis?

Also: can I ask why I would COBRA my old insurance during the exclusion period? Would this be if the new insurance doesn't cover pre-existing conditions? Would I have to get this through my current employer before I quit? Could I just do COBRA for one month while the new insurance was kicking in?

Sorry for all the Qs--I just feel like with CF we're operating by a different set of rules.
 
W

welshwitch

Guest
Thanks for all the free legal advice, Piper! On a related note: Do you think it's a good idea to tell your employer about your CF when you get hired, or is it something that's more on a "need to know" basis?

Also: can I ask why I would COBRA my old insurance during the exclusion period? Would this be if the new insurance doesn't cover pre-existing conditions? Would I have to get this through my current employer before I quit? Could I just do COBRA for one month while the new insurance was kicking in?

Sorry for all the Qs--I just feel like with CF we're operating by a different set of rules.
 
W

welshwitch

Guest
Thanks for all the free legal advice, Piper! On a related note: Do you think it's a good idea to tell your employer about your CF when you get hired, or is it something that's more on a "need to know" basis?

Also: can I ask why I would COBRA my old insurance during the exclusion period? Would this be if the new insurance doesn't cover pre-existing conditions? Would I have to get this through my current employer before I quit? Could I just do COBRA for one month while the new insurance was kicking in?

Sorry for all the Qs--I just feel like with CF we're operating by a different set of rules.
 
W

welshwitch

Guest
Thanks for all the free legal advice, Piper! On a related note: Do you think it's a good idea to tell your employer about your CF when you get hired, or is it something that's more on a "need to know" basis?
<br />
<br />Also: can I ask why I would COBRA my old insurance during the exclusion period? Would this be if the new insurance doesn't cover pre-existing conditions? Would I have to get this through my current employer before I quit? Could I just do COBRA for one month while the new insurance was kicking in?
<br />
<br />Sorry for all the Qs--I just feel like with CF we're operating by a different set of rules.
 
N

NYCLawGirl

New member
I have to clear this up: it's not "legal advice" -- I'm not a licensed attorney in your state (I actually don't know what state you live in) and have no idea what the insurance laws are there (they're different state to state). This is just friendly, general advice from a CFer who has had to deal with insurance issues <img src="i/expressions/face-icon-small-smile.gif" border="0">

Okay, you would COBRA if your new insurance had a pre-existing conditions clause, meaning it wouldn't cover conditions present before the start of coverage for a certain time period (often 12 months). So eventually your new insurance would cover your CF, but it might not at the start. If your new policy has an exclusion period that lasts one month, then yes, after the month you could drop your COBRA. NOTE: not all insurance policies have pre-existing exclusions, and some states have made such practices illegal.

Your present employer will give you the option of COBRAing insurance at the time your employment ends. You will be responsible for 100% of your premiums under COBRA -- it can be expensive. You pay for COBRA each month and can drop it whenever you're ready to do so, though you won't be able to drop in the middle of the month and get a refund for that month, for example.

You can go online to see the federal COBRA guidelines.

Telling your employer is a personal choice. I was very upfront and honest with my employer, but my CF is (from what I gather) different from yours in terms of time missed and special needs. Most people would probably advise not telling until you actually have an offer/have accepted employment, but after that it's really up to you. I'm sure other people on this board can chime in with their personal experiences -- my personal thought is that it's easier to explain it all when you're healthy and working hard than to wait until you land in the hospital and are already taking time off/missing work.
 
N

NYCLawGirl

New member
I have to clear this up: it's not "legal advice" -- I'm not a licensed attorney in your state (I actually don't know what state you live in) and have no idea what the insurance laws are there (they're different state to state). This is just friendly, general advice from a CFer who has had to deal with insurance issues <img src="i/expressions/face-icon-small-smile.gif" border="0">

Okay, you would COBRA if your new insurance had a pre-existing conditions clause, meaning it wouldn't cover conditions present before the start of coverage for a certain time period (often 12 months). So eventually your new insurance would cover your CF, but it might not at the start. If your new policy has an exclusion period that lasts one month, then yes, after the month you could drop your COBRA. NOTE: not all insurance policies have pre-existing exclusions, and some states have made such practices illegal.

Your present employer will give you the option of COBRAing insurance at the time your employment ends. You will be responsible for 100% of your premiums under COBRA -- it can be expensive. You pay for COBRA each month and can drop it whenever you're ready to do so, though you won't be able to drop in the middle of the month and get a refund for that month, for example.

You can go online to see the federal COBRA guidelines.

Telling your employer is a personal choice. I was very upfront and honest with my employer, but my CF is (from what I gather) different from yours in terms of time missed and special needs. Most people would probably advise not telling until you actually have an offer/have accepted employment, but after that it's really up to you. I'm sure other people on this board can chime in with their personal experiences -- my personal thought is that it's easier to explain it all when you're healthy and working hard than to wait until you land in the hospital and are already taking time off/missing work.
 
N

NYCLawGirl

New member
I have to clear this up: it's not "legal advice" -- I'm not a licensed attorney in your state (I actually don't know what state you live in) and have no idea what the insurance laws are there (they're different state to state). This is just friendly, general advice from a CFer who has had to deal with insurance issues <img src="i/expressions/face-icon-small-smile.gif" border="0">

Okay, you would COBRA if your new insurance had a pre-existing conditions clause, meaning it wouldn't cover conditions present before the start of coverage for a certain time period (often 12 months). So eventually your new insurance would cover your CF, but it might not at the start. If your new policy has an exclusion period that lasts one month, then yes, after the month you could drop your COBRA. NOTE: not all insurance policies have pre-existing exclusions, and some states have made such practices illegal.

Your present employer will give you the option of COBRAing insurance at the time your employment ends. You will be responsible for 100% of your premiums under COBRA -- it can be expensive. You pay for COBRA each month and can drop it whenever you're ready to do so, though you won't be able to drop in the middle of the month and get a refund for that month, for example.

You can go online to see the federal COBRA guidelines.

Telling your employer is a personal choice. I was very upfront and honest with my employer, but my CF is (from what I gather) different from yours in terms of time missed and special needs. Most people would probably advise not telling until you actually have an offer/have accepted employment, but after that it's really up to you. I'm sure other people on this board can chime in with their personal experiences -- my personal thought is that it's easier to explain it all when you're healthy and working hard than to wait until you land in the hospital and are already taking time off/missing work.
 
N

NYCLawGirl

New member
I have to clear this up: it's not "legal advice" -- I'm not a licensed attorney in your state (I actually don't know what state you live in) and have no idea what the insurance laws are there (they're different state to state). This is just friendly, general advice from a CFer who has had to deal with insurance issues <img src="i/expressions/face-icon-small-smile.gif" border="0">

Okay, you would COBRA if your new insurance had a pre-existing conditions clause, meaning it wouldn't cover conditions present before the start of coverage for a certain time period (often 12 months). So eventually your new insurance would cover your CF, but it might not at the start. If your new policy has an exclusion period that lasts one month, then yes, after the month you could drop your COBRA. NOTE: not all insurance policies have pre-existing exclusions, and some states have made such practices illegal.

Your present employer will give you the option of COBRAing insurance at the time your employment ends. You will be responsible for 100% of your premiums under COBRA -- it can be expensive. You pay for COBRA each month and can drop it whenever you're ready to do so, though you won't be able to drop in the middle of the month and get a refund for that month, for example.

You can go online to see the federal COBRA guidelines.

Telling your employer is a personal choice. I was very upfront and honest with my employer, but my CF is (from what I gather) different from yours in terms of time missed and special needs. Most people would probably advise not telling until you actually have an offer/have accepted employment, but after that it's really up to you. I'm sure other people on this board can chime in with their personal experiences -- my personal thought is that it's easier to explain it all when you're healthy and working hard than to wait until you land in the hospital and are already taking time off/missing work.
 
N

NYCLawGirl

New member
I have to clear this up: it's not "legal advice" -- I'm not a licensed attorney in your state (I actually don't know what state you live in) and have no idea what the insurance laws are there (they're different state to state). This is just friendly, general advice from a CFer who has had to deal with insurance issues <img src="i/expressions/face-icon-small-smile.gif" border="0">
<br />
<br />Okay, you would COBRA if your new insurance had a pre-existing conditions clause, meaning it wouldn't cover conditions present before the start of coverage for a certain time period (often 12 months). So eventually your new insurance would cover your CF, but it might not at the start. If your new policy has an exclusion period that lasts one month, then yes, after the month you could drop your COBRA. NOTE: not all insurance policies have pre-existing exclusions, and some states have made such practices illegal.
<br />
<br />Your present employer will give you the option of COBRAing insurance at the time your employment ends. You will be responsible for 100% of your premiums under COBRA -- it can be expensive. You pay for COBRA each month and can drop it whenever you're ready to do so, though you won't be able to drop in the middle of the month and get a refund for that month, for example.
<br />
<br />You can go online to see the federal COBRA guidelines.
<br />
<br />Telling your employer is a personal choice. I was very upfront and honest with my employer, but my CF is (from what I gather) different from yours in terms of time missed and special needs. Most people would probably advise not telling until you actually have an offer/have accepted employment, but after that it's really up to you. I'm sure other people on this board can chime in with their personal experiences -- my personal thought is that it's easier to explain it all when you're healthy and working hard than to wait until you land in the hospital and are already taking time off/missing work.
 
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