Please help me understand insurance!

[littleenid]

I'm a Canadian marrying an American cfer, and I am having a horrible time trying to understand how insurance works. It is hard enough trying to figure out how insurance works in the US in general, but having to figure out how it works with CF just gives me a big headache.

I have been trying to read a lot about how copays and lifetime limits and pre-existing conditions stuff works but I still don't get it.

My guy is on COBRA right now. One thing I read made it sound like when he gets a new job he might have no insurance for a year because of his CF. Another thing I read made it sound like he would have it right away because he was never off of COBRA.

I'm also confused about whether he could ever go on my insurance through work. Would he have to wait another year for that to kick in as well?

If someone with CF goes without insurance for a period longer than a few months does it become impossible to ever get insurance again?! I heard that and it scared the crap out of me.

I know you guys all have a lot of experience with this stuff, so I hope someone can help me or direct me to a site that can (I have read some cf sites' insurance sections though). It is just really hard to wrap my head around coming from a place where I can go see my doctor and go home without ever worrying about a bill.

 

[littleenid]

I'm a Canadian marrying an American cfer, and I am having a horrible time trying to understand how insurance works. It is hard enough trying to figure out how insurance works in the US in general, but having to figure out how it works with CF just gives me a big headache.

I have been trying to read a lot about how copays and lifetime limits and pre-existing conditions stuff works but I still don't get it.

My guy is on COBRA right now. One thing I read made it sound like when he gets a new job he might have no insurance for a year because of his CF. Another thing I read made it sound like he would have it right away because he was never off of COBRA.

I'm also confused about whether he could ever go on my insurance through work. Would he have to wait another year for that to kick in as well?

If someone with CF goes without insurance for a period longer than a few months does it become impossible to ever get insurance again?! I heard that and it scared the crap out of me.

I know you guys all have a lot of experience with this stuff, so I hope someone can help me or direct me to a site that can (I have read some cf sites' insurance sections though). It is just really hard to wrap my head around coming from a place where I can go see my doctor and go home without ever worrying about a bill.

 

[littleenid]

I'm a Canadian marrying an American cfer, and I am having a horrible time trying to understand how insurance works. It is hard enough trying to figure out how insurance works in the US in general, but having to figure out how it works with CF just gives me a big headache.

I have been trying to read a lot about how copays and lifetime limits and pre-existing conditions stuff works but I still don't get it.

My guy is on COBRA right now. One thing I read made it sound like when he gets a new job he might have no insurance for a year because of his CF. Another thing I read made it sound like he would have it right away because he was never off of COBRA.

I'm also confused about whether he could ever go on my insurance through work. Would he have to wait another year for that to kick in as well?

If someone with CF goes without insurance for a period longer than a few months does it become impossible to ever get insurance again?! I heard that and it scared the crap out of me.

I know you guys all have a lot of experience with this stuff, so I hope someone can help me or direct me to a site that can (I have read some cf sites' insurance sections though). It is just really hard to wrap my head around coming from a place where I can go see my doctor and go home without ever worrying about a bill.

 

[littleenid]

I'm a Canadian marrying an American cfer, and I am having a horrible time trying to understand how insurance works. It is hard enough trying to figure out how insurance works in the US in general, but having to figure out how it works with CF just gives me a big headache.

I have been trying to read a lot about how copays and lifetime limits and pre-existing conditions stuff works but I still don't get it.

My guy is on COBRA right now. One thing I read made it sound like when he gets a new job he might have no insurance for a year because of his CF. Another thing I read made it sound like he would have it right away because he was never off of COBRA.

I'm also confused about whether he could ever go on my insurance through work. Would he have to wait another year for that to kick in as well?

If someone with CF goes without insurance for a period longer than a few months does it become impossible to ever get insurance again?! I heard that and it scared the crap out of me.

I know you guys all have a lot of experience with this stuff, so I hope someone can help me or direct me to a site that can (I have read some cf sites' insurance sections though). It is just really hard to wrap my head around coming from a place where I can go see my doctor and go home without ever worrying about a bill.

 

[littleenid]

I'm a Canadian marrying an American cfer, and I am having a horrible time trying to understand how insurance works. It is hard enough trying to figure out how insurance works in the US in general, but having to figure out how it works with CF just gives me a big headache.
<br />
<br />I have been trying to read a lot about how copays and lifetime limits and pre-existing conditions stuff works but I still don't get it.
<br />
<br />My guy is on COBRA right now. One thing I read made it sound like when he gets a new job he might have no insurance for a year because of his CF. Another thing I read made it sound like he would have it right away because he was never off of COBRA.
<br />
<br />I'm also confused about whether he could ever go on my insurance through work. Would he have to wait another year for that to kick in as well?
<br />
<br />If someone with CF goes without insurance for a period longer than a few months does it become impossible to ever get insurance again?! I heard that and it scared the crap out of me.
<br />
<br />I know you guys all have a lot of experience with this stuff, so I hope someone can help me or direct me to a site that can (I have read some cf sites' insurance sections though). It is just really hard to wrap my head around coming from a place where I can go see my doctor and go home without ever worrying about a bill.

 

[ReneeP]

Hi Kelly,

I can answer a couple of your questions... I know all to well how confusing insurance is in this country; however, I worked for Blue Cross for several years so I have a general understand of how it works. The problem is that because every policy is different, it can still be very confusing at times.

There are some rules that apply no matter what insurance you have. One of those is concerning the pre-existing condition clause you were referring to. Federal law states that as long as you have no greater than a 63 day lapse in medical insurance coverage, you cannot be put under a pre-existing condition clause. What that means is that if your boyfriend has any medical insurance, including COBRA, and switches to another insurance (yours at work or any other), they CANNOT exlude his CF claims for any period of time. The only way they can do that is if he goes completely uncovered for 64 or more days in a row. If that happens, they can refuse to cover any claims for a condition that he knew he had prior to getting the insurance for a certain period of time (usually one year).

There is a government website that explains this and several other insurance issues that may help you. The website is <a target=_blank class=ftalternatingbarlinklarge href="http://www.dol.gov/ebsa/publications/yhphipaa.html">HIPPA INFO LINK</a>

There is another website that I found to be pretty easy to follow and explains insurance terms and stuff. That side is <a target=_blank class=ftalternatingbarlinklarge href="http://www.foreignborn.com/self-help/health_insurance/5-ins_terms.htm">Understanding Medical Insurance Link</a>

I hope that helps some. If you have other specific questions, feel free to ask. Most of the people on this site have had more than their share of dealings with medical insurance companies and have a good understanding of how it all works.

Good luck!!!

 

[ReneeP]

Hi Kelly,

I can answer a couple of your questions... I know all to well how confusing insurance is in this country; however, I worked for Blue Cross for several years so I have a general understand of how it works. The problem is that because every policy is different, it can still be very confusing at times.

There are some rules that apply no matter what insurance you have. One of those is concerning the pre-existing condition clause you were referring to. Federal law states that as long as you have no greater than a 63 day lapse in medical insurance coverage, you cannot be put under a pre-existing condition clause. What that means is that if your boyfriend has any medical insurance, including COBRA, and switches to another insurance (yours at work or any other), they CANNOT exlude his CF claims for any period of time. The only way they can do that is if he goes completely uncovered for 64 or more days in a row. If that happens, they can refuse to cover any claims for a condition that he knew he had prior to getting the insurance for a certain period of time (usually one year).

There is a government website that explains this and several other insurance issues that may help you. The website is <a target=_blank class=ftalternatingbarlinklarge href="http://www.dol.gov/ebsa/publications/yhphipaa.html">HIPPA INFO LINK</a>

There is another website that I found to be pretty easy to follow and explains insurance terms and stuff. That side is <a target=_blank class=ftalternatingbarlinklarge href="http://www.foreignborn.com/self-help/health_insurance/5-ins_terms.htm">Understanding Medical Insurance Link</a>

I hope that helps some. If you have other specific questions, feel free to ask. Most of the people on this site have had more than their share of dealings with medical insurance companies and have a good understanding of how it all works.

Good luck!!!

 

[ReneeP]

Hi Kelly,

I can answer a couple of your questions... I know all to well how confusing insurance is in this country; however, I worked for Blue Cross for several years so I have a general understand of how it works. The problem is that because every policy is different, it can still be very confusing at times.

There are some rules that apply no matter what insurance you have. One of those is concerning the pre-existing condition clause you were referring to. Federal law states that as long as you have no greater than a 63 day lapse in medical insurance coverage, you cannot be put under a pre-existing condition clause. What that means is that if your boyfriend has any medical insurance, including COBRA, and switches to another insurance (yours at work or any other), they CANNOT exlude his CF claims for any period of time. The only way they can do that is if he goes completely uncovered for 64 or more days in a row. If that happens, they can refuse to cover any claims for a condition that he knew he had prior to getting the insurance for a certain period of time (usually one year).

There is a government website that explains this and several other insurance issues that may help you. The website is <a target=_blank class=ftalternatingbarlinklarge href="http://www.dol.gov/ebsa/publications/yhphipaa.html">HIPPA INFO LINK</a>

There is another website that I found to be pretty easy to follow and explains insurance terms and stuff. That side is <a target=_blank class=ftalternatingbarlinklarge href="http://www.foreignborn.com/self-help/health_insurance/5-ins_terms.htm">Understanding Medical Insurance Link</a>

I hope that helps some. If you have other specific questions, feel free to ask. Most of the people on this site have had more than their share of dealings with medical insurance companies and have a good understanding of how it all works.

Good luck!!!

 

[ReneeP]

Hi Kelly,

I can answer a couple of your questions... I know all to well how confusing insurance is in this country; however, I worked for Blue Cross for several years so I have a general understand of how it works. The problem is that because every policy is different, it can still be very confusing at times.

There are some rules that apply no matter what insurance you have. One of those is concerning the pre-existing condition clause you were referring to. Federal law states that as long as you have no greater than a 63 day lapse in medical insurance coverage, you cannot be put under a pre-existing condition clause. What that means is that if your boyfriend has any medical insurance, including COBRA, and switches to another insurance (yours at work or any other), they CANNOT exlude his CF claims for any period of time. The only way they can do that is if he goes completely uncovered for 64 or more days in a row. If that happens, they can refuse to cover any claims for a condition that he knew he had prior to getting the insurance for a certain period of time (usually one year).

There is a government website that explains this and several other insurance issues that may help you. The website is <a target=_blank class=ftalternatingbarlinklarge href="http://www.dol.gov/ebsa/publications/yhphipaa.html">HIPPA INFO LINK</a>

There is another website that I found to be pretty easy to follow and explains insurance terms and stuff. That side is <a target=_blank class=ftalternatingbarlinklarge href="http://www.foreignborn.com/self-help/health_insurance/5-ins_terms.htm">Understanding Medical Insurance Link</a>

I hope that helps some. If you have other specific questions, feel free to ask. Most of the people on this site have had more than their share of dealings with medical insurance companies and have a good understanding of how it all works.

Good luck!!!

 

[ReneeP]

Hi Kelly,
<br />
<br />I can answer a couple of your questions... I know all to well how confusing insurance is in this country; however, I worked for Blue Cross for several years so I have a general understand of how it works. The problem is that because every policy is different, it can still be very confusing at times.
<br />
<br />There are some rules that apply no matter what insurance you have. One of those is concerning the pre-existing condition clause you were referring to. Federal law states that as long as you have no greater than a 63 day lapse in medical insurance coverage, you cannot be put under a pre-existing condition clause. What that means is that if your boyfriend has any medical insurance, including COBRA, and switches to another insurance (yours at work or any other), they CANNOT exlude his CF claims for any period of time. The only way they can do that is if he goes completely uncovered for 64 or more days in a row. If that happens, they can refuse to cover any claims for a condition that he knew he had prior to getting the insurance for a certain period of time (usually one year).
<br />
<br />There is a government website that explains this and several other insurance issues that may help you. The website is <a target=_blank class=ftalternatingbarlinklarge href="http://www.dol.gov/ebsa/publications/yhphipaa.html">HIPPA INFO LINK</a>
<br />
<br />There is another website that I found to be pretty easy to follow and explains insurance terms and stuff. That side is <a target=_blank class=ftalternatingbarlinklarge href="http://www.foreignborn.com/self-help/health_insurance/5-ins_terms.htm">Understanding Medical Insurance Link</a>
<br />
<br />I hope that helps some. If you have other specific questions, feel free to ask. Most of the people on this site have had more than their share of dealings with medical insurance companies and have a good understanding of how it all works.
<br />
<br />Good luck!!!