insurance question

[Guest guest]

,

I would contact Tucker at Magic. I think she is still

handling the insurance questions, or call MAGIC and ask who to talk

to.

We recently switched jobs so here is what we were told. Your son

needs to be continuously insured. When you get the next job, if you

have had a break in insurance, they can deny the growth hormone

since he hasn't been continuously covered. Something to do with a

preexisting condition clause. I think generally the " condition " has

to have been treated for the last 18 months in order for it to NOT

count as a preexisting, but again, check with Magic.

We looked into COBRA. Basically it is the same plan you are on now,

but you pay all the premium - what you and your employer together

use to pay. So that is nice in that all the stuff stays the same

until you find a new job.

The only way to know about the next job is to ask. After my husband

got the new offer, but before we accepted, he asked to see the Human

Resource policy book and insurance information. Then, we asked the

HR person to verify that Matt's growth hormone would be covered.

THe best they could do was to say that they thought it would, and we

had a verbal assurance from his new boss that they would do what

ever they could. FYI - we had BCBS with the old job and the new one

(although in a different state). I was told that once " one of the

Blues covers it, the rest usually do " .

Someone at Magic can help and it is totally worth the call (and

joining if you haven't already)

Beth H.

> My son, Jay, has been on Humatrope for a year (currently .44 ml

> 1x/day - 6days per week)and has had great results - 10.5 cm growth

> (and the pain finally TOTALLY disapated with the shot when we

> switched to a bacteriastatic solution - fyi) He also takes Peri

> (6.9ml 2x/day).

>

> Anyway, I have group coverage - we live in Missouri - but my

> company is downsizing - so we are eligible for Cobra (very costly

> and a min 18 mos. - I think I can just cover my son on it, too).

> My concern is insurability/timing. Who knows the ans. to this

> stuff -

>

> 1)if I stay on the benefit plan for a month or two and then switch

> to another group - can he/we get coverage?

> 2) Is there anyway to do the above and get coverage on an

individual

> policy - it seems slim - is their any indivdual / self employed

> group plan?

> 3) If we go on Cobra - will that continuity of coverage carry

over

> to the next policy - group or individual?

>

> Any other insights or ideas would be greatly appreciated.

>

> Dave, and Jay 5 1/2 44 " and 39#

[Guest guest]

,

I am going to take Beth and 's advice as well and call MAGIC

as well. We are curently struggeling with the same situation, except

my husband opened his own company and we are trying to get indvidual

coverage. I have hit a brick wall. I can't not get coverage on Coby

through an individual play. I can get a state coverage but the

premium would cost me $1,100 a month. We are looking into putting me

on the pay roll so that my husband and I can each take 2 kids and get

2 policies so that we can get group plans to cover Coby.

However, Coby just started Humatrope this week. Lilly is paying for

his growth hormone until they find us insurance or we find it.

If I can help in any other way, please feel free to write to me.

le, mom to :

Shye 9, Brock 7, and Coby(rss) & Carlee 1

[Guest guest]

Hi,

We are likely to go out on our own for insurance soon and don't know

if my daughter's club foot will be viewed as a pre-existing condition

and either preclude us from insurance or jack our rates up. Anybody

have any info?

Thanks,

Liz

[Guest guest]

That's a very interesting question. Because it is a congenital deformity

and the person in question is a minor, they may have an exception for it, or

it may be that they have to cover it. I was just reading my coverage book

tonight, and there are alot of things that fall under exception (allowed

coverage where normally there is no benefit) when it pertains to a child

under the age of 7 or under age 19 and it is either a condition from birth

or an ongoing condition.

An example is that Kai recieves coverage for speech therapy - even tho

speech therapy is listed as a non-covered item - because he is under 7 and

it is considered a neurodevelopmental issue. By the same token, were he to

need reconstructive surgery on his foot (not likely, but lets say) it would

be covered - even tho reconstructive surgery, even for function, is excluded

- because there is an exclusion to the exclusion stating that a minor (18 or

under) with a congenital deformation may have reconstructive surgery.

Another good example is that pregnancy is excluded from being subject to

pre-existing conditions - and I believe that is a federal ruling. Seems our

book says something about pre-existing conditions that are in the middle of

on-going treatment are not to be excluded, as well.

I also dont believe they can (or usually do) raise premiums for something

that is simple-congenital like clubfoot. It is not a lifelong treatment,

and the expenses related to it, while more than a child without, are

relatively low (especially using the Ponseti Method) in comparison with

other conditions. I would say when you are insurance shopping just ask up

front about these things.

Angel

Caitlen 8/29/97

Arica 8/22/01

Kai 12/31/02

----Original Message Follows----

Reply-To: nosurgery4clubfoot

To: nosurgery4clubfoot

Subject: insurance question

Date: Fri, 22 Jul 2005 02:16:42 -0000