Re: TX insurance agency said...

[Guest guest]

Okay folks..Just in case anyone else is in this position I thought I would post what the TX state agency of insurance said to me. I called them regarding Mike's possible job change. They said since he had been with his present company and is still covered by them, for 9 years he has built up enough credit to have the 6 month pre-existing condition period waved with the new insurance company by showing them the certificate of creditable coverage from his present insurance. That is according to the HIPPO federal law, allowing those with pre-ex conditions to change jobs with no laps in insurance.

Do any of you have experience with this?

Thank you for helping through this- You all are wonderful!

MINDY

randy -- re: INSURANCE

i have to say, randy is very, very blessed to have the coverage he has, and to be at the mayo out in AZ (20 minutes from daughter jillian and SIL aaron, who live in peoria, AZ). and i am personally thrilled that it looks like jillian's insurance will allow for a "mayo" baby, because everything i've learned about mayo is that everyone & every department... top notch, all the way.

by comparison, jim's transplant coverage? randy, you got reimbursement traveling over 50 miles... and here we are out in CA, a 2-3 hour drive from north coastal san diego county to USC up in los angeles, sometimes more, depending on traffic. and no reimbursements as randy described, not a penny toward food, gas, lodging, uprooting for the post-tx time that you must remain within close proximity to the tx center. zip. nada. zilch. the big goose-egg. california blue cross "used" to do a bit of reimbursing, but they updated their policies, which totally eliminated that benefit for us mere weeks before we needed it... because they considered north san diego to be within close-enough proximity to east los angeles. which is utter poppycock!!! it was quite an uprooting for our entire family, from december 5th to just days before Christmas (and USC shocked us, saying jim was doing so well, we could all just go home)!

because we could find no "safe" place to stay in east la... and the closest place we found was 20 minutes away from the tx center (if you avoided peak freeway traffic times, that is). where? in beverly hills, of all places! i explained the nature of the son-to-father living related transplant to save jim's life... was ballsy enough to negotiate with "residence inn" ...negotiate HARD! ...for a medical emergency rate, and corporate eventually did grant us one. i kept insisting we weren't their average clientele... we weren't there for plastic surgery or elective surgery, for instance, but we were there because jim was dying. i appealed to corporate's humanitarian side, and invited them to do the right thing and give us every discount they possibly could extend. (it never hurts to ask, right? all they could say was no...)

but even with the discounts (like 75% off forced-valet parking costs), our extended-stay-residence bill (of a couple weeks) still came to over $5K. and that was our family of five staying in TWO rooms, folks. we didn't go out-of-pocket because when jim wasn't looking, his mother paid the bill for us. and i (who was looking) LET her! and she was blessed beyond measure that i did. ;-)

so randy, all that to say, you are indeed fortunate you got to do things "the mayo way." and yes, i pray that your place of employment never ever changes their insurance company.

maureen - (wife/medical advocate to jim: UC '84 [good results w/probiotics!]; "small-duct" unstentable PSC '96; LRLTx 12/7/01 thanks to our son & living donor [right lobe, 60% hepatectomy] jason, who's doing great, now 26 & yes, folks, he finally has a girlfriend; jim on colonoscopy recall every 6 months, tx center recall every 8 weeks, & full body dermatology *and* oncology recall every 8-12 weeks -- because we're diligent about his colon & skin cancer risks!); empty nesters as of 5/1/04... expectant first-time grandparents (spring 2005) ...and loving it :-)

[Guest guest]

Okay folks..Just in case anyone else is in this position I thought I would post what the TX state agency of insurance said to me. I called them regarding Mike's possible job change. They said since he had been with his present company and is still covered by them, for 9 years he has built up enough credit to have the 6 month pre-existing condition period waved with the new insurance company by showing them the certificate of creditable coverage from his present insurance. That is according to the HIPPO federal law, allowing those with pre-ex conditions to change jobs with no laps in insurance.

Do any of you have experience with this?

Thank you for helping through this- You all are wonderful!

MINDY

randy -- re: INSURANCE

i have to say, randy is very, very blessed to have the coverage he has, and to be at the mayo out in AZ (20 minutes from daughter jillian and SIL aaron, who live in peoria, AZ). and i am personally thrilled that it looks like jillian's insurance will allow for a "mayo" baby, because everything i've learned about mayo is that everyone & every department... top notch, all the way.

by comparison, jim's transplant coverage? randy, you got reimbursement traveling over 50 miles... and here we are out in CA, a 2-3 hour drive from north coastal san diego county to USC up in los angeles, sometimes more, depending on traffic. and no reimbursements as randy described, not a penny toward food, gas, lodging, uprooting for the post-tx time that you must remain within close proximity to the tx center. zip. nada. zilch. the big goose-egg. california blue cross "used" to do a bit of reimbursing, but they updated their policies, which totally eliminated that benefit for us mere weeks before we needed it... because they considered north san diego to be within close-enough proximity to east los angeles. which is utter poppycock!!! it was quite an uprooting for our entire family, from december 5th to just days before Christmas (and USC shocked us, saying jim was doing so well, we could all just go home)!

because we could find no "safe" place to stay in east la... and the closest place we found was 20 minutes away from the tx center (if you avoided peak freeway traffic times, that is). where? in beverly hills, of all places! i explained the nature of the son-to-father living related transplant to save jim's life... was ballsy enough to negotiate with "residence inn" ...negotiate HARD! ...for a medical emergency rate, and corporate eventually did grant us one. i kept insisting we weren't their average clientele... we weren't there for plastic surgery or elective surgery, for instance, but we were there because jim was dying. i appealed to corporate's humanitarian side, and invited them to do the right thing and give us every discount they possibly could extend. (it never hurts to ask, right? all they could say was no...)

but even with the discounts (like 75% off forced-valet parking costs), our extended-stay-residence bill (of a couple weeks) still came to over $5K. and that was our family of five staying in TWO rooms, folks. we didn't go out-of-pocket because when jim wasn't looking, his mother paid the bill for us. and i (who was looking) LET her! and she was blessed beyond measure that i did. ;-)

so randy, all that to say, you are indeed fortunate you got to do things "the mayo way." and yes, i pray that your place of employment never ever changes their insurance company.

maureen - (wife/medical advocate to jim: UC '84 [good results w/probiotics!]; "small-duct" unstentable PSC '96; LRLTx 12/7/01 thanks to our son & living donor [right lobe, 60% hepatectomy] jason, who's doing great, now 26 & yes, folks, he finally has a girlfriend; jim on colonoscopy recall every 6 months, tx center recall every 8 weeks, & full body dermatology *and* oncology recall every 8-12 weeks -- because we're diligent about his colon & skin cancer risks!); empty nesters as of 5/1/04... expectant first-time grandparents (spring 2005) ...and loving it :-)

[Guest guest]

The 6 month waiting period would apply to someone coming into a job

with no previous coverage either because they were not working or

their previous employer did not provide insurance. If you are going

from one company to another and currently have medical coverage you

do not need to worry about pre-existing conditions. A certificate of

coverage is a standard deal that any company should be able to

provide. The only thing you need to worry about and you have already

covered these bases is 1) Is there a period before benefits are

provided by the company (which you stated there is not) 2) The

comparability of old medical covergae to that provided by the new

employer (which you have also checked out). Therfore if these

conditions check out ok and he wants to make a job change he should

proceed. Pre-existing conditions will not be an obstacle for you.

What you were told by the TX agency is correct except that HIPAA not

HIPPO.

in Seattle

[Guest guest]

Hey thanks for the message .....and maybe I just made up the HIPPO thingy hehe Sounds better though I think !!Mindy

Therfore if these conditions check out ok and he wants to make a job change he should proceed. Pre-existing conditions will not be an obstacle for you. What you were told by the TX agency is correct except that HIPAA not HIPPO. in Seattle