Question:
How long before I can use new insurance?
My husband's insurance has an exclusion policy. I can get BCBS Highmark of PA from my company. How long do I have to wait to use the coverage after joining? It says in my handbook at work that it does cover WLS. I would rather join the BCBS and use them to cover WLS than self pay. Is there any policies for waiting? I mean-people can't join the insurance and use them for coverage and then quit, right?? I don't want to call and send up a red flag to them. Any replies will be gratefully appreciated! Sharon Brown — SharonBrown (posted on February 28, 2005)
February 28, 2005
From the moment your policy goes into effect, you can use it for whatever
you want to use it for. That is why we get health insurance. And yes,
people can join insurance, use them, and cancel it. As long as you paid
your premium, thats all that matters. <br><br>Now, if you are
speaking about pre-existing clauses, that's another story. AND, some self
funded, and I'm sure ones that are not, have a wait time for WLS because it
has become so mainstream as of late. By calling and asking you are doing
no harm. Even if it throws up red flags, they can not really do anything
about it. This is thru your employer and they can not pick and choose who
they insure based on intent. Besides, you can call with the group number
(get from insured co-worker) and ask anonymously. Best Wishes! ~~Rebecca
— RebeccaP
February 28, 2005
If the insurance is through your company, you might check to see when the
next enrollment period. Generally speaking, you can only enroll or change
your coverage during the enrollment period which is usually once per year.
If it's several months until your enrollment period, you might contact your
HR department and ask under what circumstances could you opt into the
companies insurance plan. The same rules applies for dropping insurance
coverage. Again, generally speaking, unless there has been a 'life
changing' event, most of the time you can only make changes during the
enrollment period. The handbook should tell you what the qualifications and
waiting periods are (if any) before you can begin to use your insurance.
Some companies have a 30-60 or 90-day waiting period, some do not. Some
insurances also have pre-existing condition clauses that may prevent you
from using the insurance for a specific condition until a certain period of
time has elapsed. Insurance can be tricky business! Best of luck to you!
— Shayna T.
February 28, 2005
I went ahead and called and called the company help line. You will want to
deal with your employer more so than the actual BCBS, because it all
depends on your plan. My husband works for the State of Michigan. Before
we switched, I called them (they have a department that deals with the
employees) and I asked them every question that I could think of. They
were wonderful with me. I am in a different state, but we switched during
open enrollment in august, and our coverage started on October 10th. I had
surgery January 5th of this year. Pretty quick as far as I am concerned.
You can also ask them what are their prequalifications. There are a LOT of
things that you can do to get your ducks in a row before even being covered
by them. So that once your coverage begins, you are ready to roll.
Such as (if you have switched doctors in the past) getting all of your
medical records at your current pcp. If you have joined different weight
loss places, such as WW's or LA weight loss, get paperwork from them
showing that you attended, etc. Go through all of your doctors records
looking for anything that will document your attempted weightloss through
the years. Look for signs of complications due to weight loss - such as
sleep apnea, knee joints aching, any bones aching, breathlessness, etc.
Anything that you can use, document it. Do you have trouble sleeping?
Make sure it is documented by your doctor.
Have you checked with a clinic that is covered by BCBS? You can find that
out by asking your employer who they work with. Find out what all that you
need for them to do, and what they need for you to do. They can also give
you a timeline. You will probably have to see a psychiatrist for a
specific set of testing.
Hope this helps some.
Junith
— [Deactivated Member]
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