Question:
Can you still keep insurance on your own if husbands group is up 4 renewel?
I have bcbs fl ppo I am approved for surgery but they are giving me a hard time they verified that I dont have a pre-existing condition but they are still saying I have to wait unil Aug.1,2003 that is when I have 1 yr. w/ them the problem is that my husbands employer is up for renewel then and they might be changing insurance again would I be able to keep policy on my own w/ them if I made direct payments to them my husbands employer was only covering him and he has to pay each week for me they dont pay any percent for me.If anyone has an answer I appreciate it thank you.. — marie M. (posted on May 30, 2003)
May 29, 2003
NO... If your husband's company changes insurance.. you go along too.. EVEN
tho you are 'paying' for yourself you are still being covered under the
group plan.
— star .
May 29, 2003
Sure - however, you would have to convert the policy to an individual one,
possibly under COBRA. But you would have to pay for the entire premium
yourself -- plus they usually charge you an additional 2% fee.
— Nannette
May 30, 2003
I have to agree with Helen - your husband is part of a group plan, and just
because you pay the premiums yourself (I am betting the rates are
discounted, even though it may not seem like it) you probably won't be able
to conitinue to pay for that plan yourself. If it is a plan designed
specifically for his company, the policy may, in fact, cease to exist if
the company drops it.
— koogy
May 30, 2003
The first poster is right--if the group plan changes, then you have to go
along with the group. COBRA will not help you because the employer
switching plans is not a "qualifying event". You may be able to
convert to a personal policy, but it will be at considerably higher rates
thaan you pay now because there is no group discount. I chagned insurance
companies after having been approved by one, and had no trouble getting
approved under the new one. Also, pre-existing condition credit MUST be
given to you for the period of time you were covered under the previous
plan (one of the good provisions of HIPAA), so the new plan cannot make you
wait yet another year under them.
— Vespa R.
May 30, 2003
I agree with all the other posters. Only one more comment to add. Even if
you went out and got your "own" policy directly from BCBS it is
very possible that WLS might not be covered. BCBS has sooooooo many
different plans and I'm not sure if the ones offered to the individual
public include WLS coverage. My BCBS policy does but again it's part of a
group plan. I still think you need to be working with HR to see if there
was anything in writing that indicated pre-existing conditions would be
excluded. We have the opportunity to change plans every October and if we
change to a different plan there are no pre-existing condition clauses.
This should have been spelled out in the insurance booklet you would have
gotten. If it isn't then park your butt at the closest regional office
until at least a customer service supervisor will talk to you. Better yet
make an appointment to see the vice president of that branch and present
your case and ask to have it reviewed and quickly since time is of the
essence. I suspect your rights under the policy are being violated because
they are hoping the company changes plans and then they won't have to pay.
The just hope that people won't be savvy enough to push the issue and call
them on it.
<p>When I wanted BCBS to cover the cost of Redux they told me there
was no coverage. When I pointed them to the page in the exclusions section
that said weight loss treatment was covered for the MO as long as medical
necessity was met, they said OH. My request was approved and even extended
for an additional 6 months. So be absolutely sure that your policy
indicates what they are saying is right before giving up.
— zoedogcbr
May 30, 2003
Hi,thank you for all your help I am the original poster to this question I
have been trying for days to speak w/ a supervisor at ins. comp. and the
reps. keep telling me I have to have 1 call me back but they never do I
have been in contact w/1 rep. who seems to understand my problem and she
says she is going to try to help me w/ it and get medical review to change
the date on approval I called yesterday and they said her inquiry is still
pending I am so afraid they will have another excuse what can I do if I
cant speak to supervisor ?Thank you for everyones help...PS. I even filed
aa complaint w/ my states ins. commisioners office and the lady from their
keeps asking them for an answer but they dont have a straight answer from
them niether but I dont feel as though she is pushing it though she is
still working on it also..
— marie M.
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