Switching Occupations - Insurance Concerns | Arthritis Information
I just found out a couple weeks ago that the company that I've worked for, for the past (11) years is going out of business and closing the doors permanently. I had a good position that paid fairly well. However, the downside was that the company provided absolutely "zero" benefits. That said, I've been searching for a new job. I've found some interesting prospects which as an added plus, have decent benefits (medical, dental & vision). However, I have some concerns with regards to how a career switch would all play out with regards to insurance.
I currently am on a insurance plan that is sponsored by the state of Illinois due to the fact that nobody else will insure me due to my pre-existing conditions. It is basically a "high risk pool" of insurance offered by the state of Illinois in conjunction with BlueCross BlueSheild. I've had this insurance for over (7) years and I have to pay premiums with this policy out of my own pocket. While this insurance is very pricey, at least they do provide good coverage. The stipulation with this high risk state insurance is that, should you ever secure employment that provides health insurance or are ever able to secure health insurance through a "normal" provider on your own, you must leave the state plan. As we all know RA related expenses add up quickly. I can't afford not to be covered, especially since it appears that I may have to take a cut in salary. I'd really hate to be forced to leave the high risk state plan due to an employer providing insurance and then have the insurance through the company not cover any RA related expenses. First off, does anybody know if I could be denied group health insurance due to my RA? Could the company group health insurance put a "writer" on me saying they would not cover any pre-existing conditions? Also, if they will cover me would I have a waiting period before my group insurance would kick in?
Also, am I obligated to tell a future employer about my RA or any other pre-existing conditions that I have? I'm afraid that if I inform a future employer about my RA that they may not hire me. I'm not sure if this information has to be disclosed to them for company group health insurance or not.
Ta2d2008-09-05 11:30:48I believe under the HIPAA laws, your existing insurance coverage will qualify as pre-existing coverage and so long as you've had it for a year or more your new employer-provided coverage cannot deny benefits due to any pre-existing condition that they offer coverage for and that your current insurance currently covers.
Call a plan administrator for the high-risk state insurance and ask him/her. They should have answers.
as JR said call the plan. State run plans may have different rules
and no you do not have to tell your employer about the RA..and its against the law for them to ask. All they can ask...is if you have any limitations that would prevent you from fulfulling the essential job duties of the position.
It is safest to call your plan. But I think you have nothing to worry about with accepting a group plan from your new employer - your pre-existing cond will continue to be covered because you have had continous health insurance.
I would never tell a future employer about my RA. It is not a good idea to tell any employer ever...unless you have too and even then it is better to say arthritis than ra. In big companies your current boss may be OK but things can change fast with little notice.
marian2008-09-05 14:07:31Access to affordable health care is an increasing concern for more and more Americans, and especially for those of us with RA or other chronic conditions as having a pre existing condition can affect the cost of or access to health insurance.
Laws vary from state to state, so its difficulty to offer advice, but generally large group employers provide health coverage to all their employees regardless if they have a preexisting condition. In some cases, a group plan can make you wait before it will cover care for a pre-existing condition (sometimes 6 months). I don't know about small group employers, but in the individual health insurance market, an insurer can refuse to cover you or decide to charge you more if you have a pre-existing condition.
I don't think you have to disclose having RA in an interview to a potential employer, you might check with a state disability or advocate office, but I believe you must disclose it to an insurance company.
Something to consider when looking at insurance plans -- the prescription benefits coverage. Many of the RA drugs, like the biologics, enbrel, humira, etc., are very expensive. Some plans may have reasonable copays, some may charge a percentage of the drug cost which could monthly be several hundred dollars, and some may not cover such RA drugs at all. And, not to add to your anxiety, drug formularies (list of drugs covered under a plan) can change within a few months notice.
In today's news, a survey reported that 59% of employers intend to keep down rising health care costs in 2009 by raising workers' deductibles, copays or out-of-pocket spending limits. So in addition to premium and drug costs, you should also consider out of pocket expenses, deductibles and copays.
Finding affordable, adequate health insurance coverage can be overwhelming for folks like us with RA. Controlling and managing a chronic condition like RA, enabling people to stay in the workforce, take care of their families and themselves, be productive members of society can only be possible if we have access to affordable health care. The next Administration's health care reforms must prohibit insurers from denying coverage based on pre-existing conditions.
Finding a good job and good, affordable health insurance, is tough in these times -- good luck and take care, wishing you success in these endeavors.
Thank you for all of the advice. I, myself figured that it would not be wise to mention that I had RA at an interview for a potential employer. While it would be against the law for them to discriminate due to the RA, I'm sure they could/would potentially mask the decision on not hiring with some other issue.
I did call my state plan and they stated that since I've had my current insurance plan for many years, this counts as "appreciable" coverage and that if going to a group plan through an employer I should not have a wait period for coverage of pre-existing illness.
My main issue now is trying to find a position that I believe I can effectively perform without too much trouble due to my RA. I'm currently a product designer and work on a computer all day long every day. Since my RA is also in my hands, fingers and wrists I do have some difficulty at times due to the pain of typing every day. However, I haven't let this difficulty interfere with my job too much. After almost (11) years at my current position there is a big part of me that would like a career change. However, with my RA I'm somewhat afraid that my best bet is to stay in an office position. I'm not sure I could go back to a "physically demanding job" or a position out in the weather with the uncertainty of not knowing how my RA will be from day to day.
I mentioned earlier in the thread that my place of business is shutting down and that I was going to be looking for work. The good news is that I just found out that I'm going to be getting a job offer from another company doing the same type of work (CAD Design). When I go in for my final interview I don't plan to tell them about my RA. However, I'm concerned about what is going to happen the first time I have to go in to work with my wrist or finger splints on because I'm in a bad flare. I'm in the middle of a flare right now that has me in excruciating pain to move my right wrist and the fingers on my right hand are very stiff. At the moment I have to type with one hand and I can't use a mouse with my right hand. This has lasted for over two weeks now and I've got to wonder how I'm going to explain this to them once hired if I'm not up front with them when I get hired.
I still don't think it's in my best interest to tell them up front. However, I'm concerned that if they find out afterwards that they might let me go. Any advice?
Ta2D
If you have to wear the splints then wear them. Its a risk you are going to have to take enventually at any job. Just make sure that you do not leave yourself open to silly reprimands. Make sure you document any conversation you and any co worker or superior have about your RA
buckeye is right.. catalog everything said to you.. and though you're braced at times... try to show that it does not hinder your performance... it potentially could mean going some extra miles than anyone else... but we all do what we have to as a survival plan...
For me when I switched insurance groups left mine and went on my husbands the Insurance company had to cover me...At the time I was only dx with MS..since then I have been dx with RA. but they had to cover my MS and my meds, very costly. The way my agent explained if you go from one policy to the next they have to accept you. This is in Ohio so I don't know if it is a state thing.
Good Luck! Nothing seems easy anymore.
InflamedOnline
I am an ex-insurance agent in NYS but have been out of it for sometime. If you take the health insurance at the time you are hired, no problem. If you wait and decide you want it later--you would have a waiting period for a pre-existing condition. In the case of a spouse that looses a job and wants coverage on the other spouses' insurance, that is a change in circumstance, and they would have to cover them. This may be different from state to state.
Don't mention the RA to any future employer, do not mention the splints. In fact, I would not wear the splints to work under any circumstance unless my clothes cover them. If they do show on your hands--a lot of typists or a lot of people on computers wear splints from time to time due to carpel tunnel. I would deal with it when it is necessary. I would not give any information. If some asks, I would just say oh, my wrists are a bit achy today and these keep them warm and drop the conversation.
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