Insurance question...need some info

[Alphabetsoup]

Hi all... I'm in a quandry and need some information. I've tried to find out using the web but keep hitting dead-ends, so I figured I'd ask y'all.

Heres the situation...
Last year I was diagnosed with an enlarged thyroid with a nodule. We did a biopsy and it was clear, and followed up last fall and it hadn't grown any and seemed to be shrinking.

Fast forward to the last two weeks when I've been feeling like it is growing again (necklaces are tighter on that side).

Now here is my problem...(it is kind of complex, so please bear with me)
1. I've go a new job in PA starting in August (YAY!!)
2. Our plans to move out of our stupidly expensive apartment have fallen through (turns out we'd have to continue paying rent here anyway, so might as well stay here....but that means less money we have for the move in August).
3. I teach school and we are coming up on summer school...which pays me what I usually get in one month, over 4 months (sigh)...and we need that money to move.

Here is my issue...if I go to the doctor and they decide to take out part of my thyroid, I would be unable to fulfill my summer school teaching contracts (I could lose my voice for several months, or have it back immediately....). If I lose the summer contracts then we can't afford to move (no relocation funds from my new employer).

And now my question: if I go to the doctor and they find something that needs to be taken out, and we elect NOT to do it this summer, but to wait until we get settled in PA next fall (and do it prior to the Christmas break).... would it be excluded from my new insurance policy as a pre-existing condition?

Here is my other problem....my current insurance ends on August 9th, but my new job doesn't start until August 28th....will that 2 week gap in insurance cause problems? Do I really have to get Cobra coverage for just 2 weeks?

Thanks guys!

 

[Lisa loves Pooh]

My insurance coverage has changed for the third time in 5 months.

Each one has sent me pre-existing clause paperwork.

IIRC (I'd have to dig it out) for both companies ---the prexisting clause was 12, but only wanted info for the last 6 months as a reduced consideration. The Pre-existing condition clause would be reduced 1 month for every month of coverage you had before the new policy kicks in unless you had a gap of greater than 63 days.

I don't know how to interpret that latter part, but just wanted to share what my paperwork includes. So if you have already been to the doctor for treatement or consult...they might consider it pre-existing evne if you don't get teh surgery. But as long as you don't have a lapse in coverage, it shouldn't be an issue anyway. ETA: With your 2 week lapse, you should be fine--but you can always pay that retroactively--especially if you have a problem in that 2 week period requiring medical care.

My husband just got his cobra info from the cancellation of his last coverage (considered an employer switch when he went from a temp company to permanent hire)---our coverage on that policy had ended March 31 and we just got teh Cobra paperwork this week. Over 2 weeks later.

 

[luvmarypoppins]

1. On the thyroid issues I think sooner is better than waiting. How much of a gap will there be between your last day of reguular teaching and summer school classes? Could you squueze the surgery in then?

I had my whole thyroid out but if you dont have any problems you should have your voice back rather quickly. It might be a little low and hoarse but it does go away. Also if you put it off will you have to find a new dr. in Penn?

On the ins. as Lisa has said I am getting ins. for my ds as he is gong off our policy and the clause seems about the same 63 days if you had prior ins and the preixisting says if you ever consulted or were treated by a dr. for that condition in the last 6 months etc.

Best of luck.

 

[mamacatnv]

As long as you don't have a lapse in coverage of I believe more than 60 days then it should not be treated as a pre-existing condition. You should make sure you have no lapse when you change employers and if there is going to be a lapse then make sure you opt for the COBRA to keep yourself covered.

Former employers by law have 15 days to send you the COBRA election forms.

 

[Lisa loves Pooh]

So if I had no lapse in coverage, do I have to go through the effort of documenting all treatments for the past 6 months? The last insurance didn't make me--but I wonder if that is b/c they can't (that coverage was over 12 months).

 

[golfgal]

I you are going to a GROUP plan they can not exclude preexisting conditions under the insurance portability laws a couple years ago. If you are moving to an individual plan then they can exclude preexisting conditions.

As for COBRA, no, you don't have to pay for COBRA for those 2 weeks unless you use it. The plan is designed this way. You have 60 days to elect coverage and another 60 days to pay. If you are really worried I would suggest getting a gap plan from your current insurance carrier for a month. They are VERY inexpensive but only cover NEW conditions.

As for delaying the surgery, personally I would do it NOW if you have short and long term disability insurance through work. Look into what your plan covers and at what percentages--typically you will see short term coverage at 100% of your salary and long term at 60%. If you are union you may have some coverage through the union as well.

 

[Normangirls]

Your gap in coverage may be more than two weeks -- if your new employer has a 60 probationary period (waiting period) until you are eligible for benefits, your gap in coverage would be 74 days (60 + two weeks).

Like a PP said, if you are signing up for coverage with a group plan, you should not have to deal with pre-existing condition issues. But check with the provider of the new plan to make sure -- if there is an issue you can choose to pick up the COBRA to close the gap in coverage (but that will be expensive). And make sure you are going to be eligible for COBRA (sometimes, in some circumstances, COBRA does not have to be offered).

As to your health issues, something like that scares me and I would suggest you get seen and treated as soon as possible. But with the problems that creates with your summer employment, I know that's easier said than done, so all I have to offer is this: .

Also, if you decide to have the surgery (which you may or may not need) in the fall, first find out what your new employer says about your need for time off that soon after starting with them.