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My 5 year old daughter was diagnosed with IDDM about 3 years ago. I am now about to accept a job at another company. This new company has a pre-existing condition clause in the medical coverage plan. A pre-existing condition will be covered in the first 12 months of employment only up to a set dollar amount. The amount will not even cover routine supplies for a year. I am concerned about not having coverage for hospitalizations that might happen. Our daughter has been hospitalized several times in the last 3 years, usually due to a flu or stomach virus where she can't keep any food or liquid down.

I would appreciate any info on how to get medical coverage for pre-existing conditions for a year. I am looking into COBRA but I was wondering if there is any other way to get coverage.

Besides COBRA, where you'd be paying the premiums, there's no easy way around this situation, unless there's a state law that's being ignored or overlooked. Check with your state's insurance commissioner.

If you were considered a "key employee" of your company, you might have enough clout to persuade "the boss" to dicker with your employer's insurance company and make a deal to cover situations like this (but your company would probably be forced to pay higher premiums for the additional coverage).

Definitely, write your Congressmen, and insist that Congress pass Senate Bill 1028, which would prohibit insurance companies from using "preexisting conditions" as a way to screw up employment transfers: the concept is to make insurance "portable" from one job to the next.

And remember to ask the doctors and hospitals for a discount if your daughter needs hospitalization at a time when there's a gap in insurance coverage: most physicians will be compassionate, and many hospitals also, if there's a temporary lapse of coverage: they want to "keep the customer satisfied" and if they accept a discount from managed care insurance companies, they might accept a similar discount in your case.

Additional Information: 1 Sep 96

The Health Insurance Reform Act of 1995 will finally allow U.S. citizens to have health insurance despite "preexisting conditions." The implementation date for these insurance reforms is January 1, 1997.

Original posting 1 Sep 96


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