Employer Health Benefits and Pre-existing Conditions...?

Question

Does anyone have ANY ideas on what I should do next?

s it true that in the state of Califonia that an employer can not deny health benefits to an employee because they have a pre-existing condition?

I was told by my husband's HR gal, (They don't have a department), that Blue Cross would not cover his pre-existing condition even if he signed up through his employer's health plan/contract.

Then I was told by someone else that he can get benefits, but that Blue Cross might raise the employer's contracted premium if someone comes on board with a pre-existing condition and this is why they are discouraging him from signing up.

Bleh! I can't get a straight answer from these people and I don't know who to call.

Labor Commissioner is for pay related issues only, not health benefits.

Sorry, but what is BCBS?

SlowPoke: Thanks so much!

Thanks everyone! I don't feel so stuck now. I have a few things I can do. And silly me! It never occurred to me that I should just call Blue Cross directly. :-/

Thanks!

Answer 1

There is a Federal law that says they can't exclude him from their insurance. What they are doing is against both Federal and state law for California. Here is a link.

http://www.calpatientguide.org/v.html

ps- I would get all your facts straight and in front of you before you go to HR or contact Blue Cross. You are much more likely to get what you want without as much hassle that way :-)

Answer 2

BCBS=Blue Cross Blue Shield.

The way I understand it, if he is getting a group contract, they can not deny a pre-existing condition. The best thing to do is call the insurance company and get the person's name and something in writing if possible. Another idea is to call the Insurance Commission in the state. They would have a better idea than the labor commissioner

Answer 3

BCBS = Blue Cross Blue Shield.

I believe the answer to your question is that the employer can't deny the benefits, but the insurance company can.

I am not aware of any insurance company that covers pre-existing conditions, as sad as that statement is.

I'm not an expert, though, so I definitely recommend looking for more info. Have you checked with the state insurance commissioner?

Answer 4

I have BSBC and we had to wait until my husband had not been treat for 18 month for his arthritis before BCBS would cover it. To find out what is covered and when contact BCBS. That in it self will be frustrating because of the new vioce recognition system they use, just FYI. Ask about how your policy covers pre exhisting illnesses. I don't think your husband's employeer can refuse him benifits over a pre ex illness. Contact your state's labor board or ask an attorney. Refusal to provide benifits may be illegal. Good luck!

Answer 5

He can get coverage but it will not cover his pre-existing for one year. After one-year the insurance will pick up on whatever they have deemend to be "pre-existing". With my husband it was his allergies they would not cover for one year but after that one year, they started covering it.

Answer 6

i have blue cross/ blue shield....my plan says that you can have pre exsisting condions except pregnancy before you get your insurance but it depends on your condition it should just make your premium go up just a bit....good luck

Answer 7

call BCBS .