Help with Bluecross

[redbeanss]

My employer carries Bluecross for the employees. I have been working here for years and I now have decided to join in on the policy. I have to wait until October to sign on. The representative told our office manager that my psoriasis may not be covered for the first year. I was on Enbrel for about two years. I was in the Encourage program. I began making too much money to qualify for the program so I have been without Enbrel for 7 or 8 months. It is a constant battle without the shots. I need to get back on Enbrel or something soon. I don't think I can wait another year! Can anyone give some advice as to if the insurance company can refuse to cover me because of a pre-existing condition and if so what can I do to recieve treatment. I am beginning to see signs of arthritis also.

[Kimbercat]

Unfortunately, if there is a gap in insurance coverage, most insurance companies will designate anything you have had treated in the past as a pre-existing condition, and establish a waiting period for coverage. This is one reason that it's important to try to keep continuous coverage whenever you can. As long as there is no break in coverage, the HIPPA laws will provide for any past illnesses or conditions to be covered with no waiting period. You might check with the new insurance company if your coverage under the Encourage Foundation can qualify you under this law. It sounds like you've been without coverage even from them though, so that may not help. Another suggestion would be to try calling the patient advocacy department at the NPF to see if they have any suggestions to help you. You're right that you should not be waiting a year for treatment if you are seeing signs of pa. Maybe you can seek treatment for the pa without a waiting period if you haven't seen anyone for it yet. Good luck, and I hope you can get some good answers to your questions.