| | Joined: May 2010 Posts: 61 Supporting Member (50+ posts) | OP  Supporting Member (50+ posts)
Joined: May 2010 Posts: 61 | So, if I have major medical insurance, and I change jobs, does the pre-existing condition exclusion last for one year only?
Survivor. 55yr male. Dx 07/09 SqCCa Stage IV, Rt Tonsil, Lt&Rt Lymph Nodes. Aborted tonsilectomy 07/09. Chemo port 07/09. PEG 09/09. Chemo - 3xCisplatin 6xErbitux. RTx35. Tx ended 11/09. CAT scan (clean) 01/10. PET scan (clean) 02/10. Port & PEG removed 04/10.
| | | | | Joined: Sep 2009 Posts: 96 Supporting Member (50+ posts) | | Supporting Member (50+ posts)
Joined: Sep 2009 Posts: 96 | The preexisting time is usually waived if you have had insurance without a lapse. The amount of time decreased depends on how long you had your old insurance for.
31 at dx 9/06
SCC T4N0M0 with bone invasion upper maxillary
Surgery 10/06
CT's clear for 2 years
2nd recurrence - Laser surgery 1/09 dx
Tumor board - No surgery to invasive for QOL
35 IMRT 3/30/09 Completed 5/15/09
8 tx Erbitux 3/24/09 Completed 5/6/09
HBO for ORN March & April 2010
Fibula flap 5/10
| | | | | Joined: Sep 2009 Posts: 96 Supporting Member (50+ posts) | | Supporting Member (50+ posts)
Joined: Sep 2009 Posts: 96 | Sorry, hit it button to soon. You will get a paper from your old insurance called continuation of coverage or something like that. You will need to fax it over or get it to your new insurance to know how much time they will take off. You get killed on the pre-existing when you have had a lapse in coverage for too long.
31 at dx 9/06
SCC T4N0M0 with bone invasion upper maxillary
Surgery 10/06
CT's clear for 2 years
2nd recurrence - Laser surgery 1/09 dx
Tumor board - No surgery to invasive for QOL
35 IMRT 3/30/09 Completed 5/15/09
8 tx Erbitux 3/24/09 Completed 5/6/09
HBO for ORN March & April 2010
Fibula flap 5/10
| | | | | Joined: Jul 2007 Posts: 939 "Above & Beyond" Member (500+ posts) | | "Above & Beyond" Member (500+ posts)
Joined: Jul 2007 Posts: 939 | I think it is called "Certificate of Credible Coverage"..just shows the new insurance company that you have not had a lapse of coverage. Your old insurance company will know what you need.
Every policy is different but most will honor this and not force a waiting period.
Deb..caregiver to husband, age 63 at diagnosis, former smoker who quit in 1997.
DIAGNOSIS: 6/26/07 SCC right tonsil/BOT T4N0M0
TREATMENT START: 8/9/07 cisplatin/taxol X 7..IMRT twice daily X 31.5.
TREATMENT END: 10/1/07
PEG OUT: 1/08
PORT OUT: 4/09
FOLLOWUP: Now only annual exams. ALL CLEAR!
Passed away 1/7/17 RIP Bill
| | | | | Joined: May 2010 Posts: 61 Supporting Member (50+ posts) | | OP Supporting Member (50+ posts)
Joined: May 2010 Posts: 61 | Do I understand all of you to be saying moving from one major medical policy to another, there is no pre-existing condition clause?
Survivor. 55yr male. Dx 07/09 SqCCa Stage IV, Rt Tonsil, Lt&Rt Lymph Nodes. Aborted tonsilectomy 07/09. Chemo port 07/09. PEG 09/09. Chemo - 3xCisplatin 6xErbitux. RTx35. Tx ended 11/09. CAT scan (clean) 01/10. PET scan (clean) 02/10. Port & PEG removed 04/10.
| | | | | Joined: Aug 2005 Posts: 307 Platinum Member (300+ posts) | | Platinum Member (300+ posts)
Joined: Aug 2005 Posts: 307 | That is correct Mike. As long as there is no lapse in coverage, they don't consider it a pre-existing condition. My husband Ron had Kaiser when he went through treatment. When we got married I added him on to my insurance which is Blue Cross. Kaiser gave us the Certificate of Coverage which I in turn gave to Blue Cross. We never had a problem.
Hope this helps,
Shelley
Caregiver to husband Ron. Throat Cancer. Finished 35 radiation treatments on 11/21/04. 8/2/11 small lesion on lower gum, laser Procedure to remove. 3/6/12 Doc. removed another lesion on outside of his neck. Did a skin graft from his chest to replace the skin on his neck. Went to Heaven on 6/24/12.
| | | | | Joined: Dec 2003 Posts: 2,606 Likes: 2 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Dec 2003 Posts: 2,606 Likes: 2 | "Certificate of Continued Coverage" in most states shows the insurance company if you had continuous coverage or a lapse in coverage. Many policies invoke the "pre-existing condition clause" for any periods of no coverage or do not pay for the amount of time you had no coverage. I hope this helps.
Last edited by Uptown; 02-09-2011 01:02 PM. Reason: typo
SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
| | | | | Joined: Sep 2009 Posts: 96 Supporting Member (50+ posts) | | Supporting Member (50+ posts)
Joined: Sep 2009 Posts: 96 | By law you can have up to like 63 days of non coverage, if I remember right. Some companies policies don't start for like 90 days but insurance companies are not allowed to count that as a lapse if I remember the timing right. Sounds like you should be good to go.
31 at dx 9/06
SCC T4N0M0 with bone invasion upper maxillary
Surgery 10/06
CT's clear for 2 years
2nd recurrence - Laser surgery 1/09 dx
Tumor board - No surgery to invasive for QOL
35 IMRT 3/30/09 Completed 5/15/09
8 tx Erbitux 3/24/09 Completed 5/6/09
HBO for ORN March & April 2010
Fibula flap 5/10
| | | | | Joined: Mar 2011 Posts: 20 Member | | Member
Joined: Mar 2011 Posts: 20 | That all applies to individual covrage after group ins. If you just changed jobs and have new group coverage, you are under guaranteed coverage depending on size of group. (Here in Calif, it is groups of two or more. in a lot of states it is 3 or more , some 5 or more. Talk to an agent in your state to be sure.
Regards,
Chris
Stage 4 squamous cell tonsil cancer. Two lymph nodes involved surgically removed before source found to be tonsil. Implant radiation right on tonsil, regular mask radiation therapy for two months and a final Implant radiation. All clear confirmed by PET scans for 6 years.
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