Question
What is the name of your state? California
My boyfriend lives in California though I'm Canadian. For various reason I would have to move there to be with him. However, I've recently been diagnosed with CIS (the beginning stages of Multiple Sclerosis) and may require expensive medication as well as procedures like MRI's in the future. Are there any insurance companies in the US that might cover me if I gain US citizenship and find myself without the wonderful benefits of the Canadian health care system?
Any advice would be appreciated
Answer
Certainly there are. You might have to do a little research to find them and it might be expensive. But insurance plans with no pre-ex clauses certainly do exist.
BTW, if you at any time find yourself with access to an EMPLOYER SPONSORED GROUP PLAN (I emphasize because the law I am about to reference applies ONLY to such plans), US Federal law limits the length of time any condition can be considered pre-ex. The MAXIMUM length of time any condition can be considered pre-existing is 12 months (unless you fail to enroll for the coverage when you first become eligible, in which case it becomes 18 months); at the end of that time they MUST cover the pre-existing condition. Some states are even lower; in my state the maximum look-back time is 6 months (12 months for late enrollees). So do your research and take heart!
Good luck to you.
Answer
Now would that pertain to a condition like mine or only disability?
Answer
It pertains to ANY kind of pre-existing conditions, including conditions like yours.
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I'm not sure what types of things US insurance usually covers... would this be in relation to drugs (which need to be taken by syringe) or things like MRI's or even related relapses?
Sorry I'm getting so picky but this is my health as well as my happiness balancing opposite each other.
Answer
The specific terms would depend on the individual policy, but of the things you've named the only thing that I would think even MIGHT be restricted would be drugs, and even then it would be a question of being limited to certain choices. For example, if Rx drug A, B, and C are all used in the treatment of MS, the policy MIGHT choose to only cover A and C.
US insurance is not unlimited, but any half-way decent policy is going to cover standard treatment options for MS.
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I have to give you a really huge thank you for giving me hope. I was just talking to my own insurance broker this evening and he made the situation seem pretty desperate. I've been in tears for most of the rest of the evening. Wish me luck and I hope that happiness follows you wherever you go.
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I'm not trying to make it easy; if you're going to be buying an individual plan you may have to try quite a few before you find one, and it won't be cheap. And the law I referenced, I want to reiterate, ONLY covers group insurance - an individual policy can place a permanent restriction on it.
But the situation is NOT hopeless and if you plug away at it, you WILL be able to find insurance. Best of luck to you. P.S. Be sure you talk to a US broker.
Answer
State= North Carolina
Actually I am in Germany but I'd like to move back to North Carolina (US citizen) so I am in the same sort of situation. I am currently covered under an insurance plan here which my employer & I both contribute to. I wanted to get an individual insurance plan in NC but the insurers I talked to would not cover my pre-existing condition (back/neck/jawproblems that require chiro/therapy sorts of treatment). I'd like to study full time and that is why I am not looking into getting a plan through employment.
I read about HIPAA & contacted the NC insurance commission, and they told me that this would not apply to me since I was not covered by a program through which I could get COBRA. But I have indeed been fully covered by a plan in Germany for almost 3 years, so does this not count as continuous coverage so that I would be eligible anyway? I worry that the NC insurance commission is not used to dealing with international situations and I don't want to give up b/c I was told incorrectly.
Aromatherapy, did you manage to find a plan that would cover you and if so, which one? And is an insurance broker just an insurance company representative, and if not, how do I find a broker?
Many thanks for your help!
Answer
Versichert, it's generally considered bad form at the very least to attach your question onto someone else's. "Hijacking" a thread generally results in, at worst, your question being ignored and at best, your being told to start your own thread before you can get any answers. However, I'm feeling benevolent today so as long as you promise me you won't do it again, I'll answer your question here.
No, it is unlikely that coverage that was provided to you outside the United States is going to qualify as "creditable coverage" for purposes of HIPAA protection. Not even all coverage INSIDE the US is going to count towards that purpose. For the most part, only US, group employment-sponsored coverage counts. There are exceptions but this is not one of them.
Answer
If you are unable to obtain other coverage, check into this program:
The Major Risk Medical Insurance Program(MRMIP) provides health insurance for Californians who are unable to obtain coverage in the individual health insurance market. The majority of subscribers are between the ages of 40-64, and 58% are women. People enroll in the program because they have been rejected for coverage by an insurance carrier or health plan due to a pre-existing condition. After 36 consecutive months in the program, subscribers are required to leave MRMIP, but they leave with a guarantee of coverage from plans selling coverage in the individual insurance market. Services in the program are delivered through contracts with health insurance plans. Californians qualifying for the program, and for the guaranteed issue coverage that follows MRMIP coverage, participate in the cost of their coverage by paying premiums. The State of California supplements those premiums to cover the cost of care in MRMIP. The State shares the cost of post MRMIP coverage with health plans that provide the coverage. MRMIP's subsidy is funded from tobacco tax funds. For an application: call toll free 1-800-289-6574.