Pre existing condition - epilepsy
 

Hey everyone. I was jsut readin gon the thread about how hearing aids are not covered in most insurance schemes and I found my heart skipping a beat.

My daughter has epilepsy (Rolandic Epilepsy in case you know anything about eplipsey). She is not seivure free by a long way and tends to have them about every 6 months even on meds (Carbamazipine).

Her form of epilepse is actually life threating if she is not on meds, but is quite controlled when medicated.

What happens with insurance? Any tips? Anyone been here before?

Thanks a million!

PS We fly out aprox 30 Oct so the countdown is on!!!

Re: Pre existing condition - epilepsy
 

A lot depends on how you are planning on obtaining health insurance.

Is your family coming to the US for a job already lined up where health insurance is provided for the family through work? If so, enquire of new employer right now, obtain Insurance coverage info through them.

If your family is coming to the US, and finding the Ins cover is up to you through individual plans...... some problems coming up.

Re: Pre existing condition - epilepsy
 

Just checked for you - at least the med is on the Walmart pharmacy generic list - $10 for 90 day supply. Target and Fred Meyer have a similar program.

http://i.walmart.com/i/if/hmp/fusion..._drug_list.pdf

Re: Pre existing condition - epilepsy
 

Wow thank you for checking that for me. My mum (who lives there) told me it might be on the list but I had no idea how to check!

We are in the middle of lining up a job. Hubby has a greencard and we are in the middle of finalising (Do we use 's' or 'z' on this forum?!) a job. Final inter is the forst week of Oct and hopefully a start date of when we move! He is a minister of Religion and the church has a health policy so I will ask for details of that asap.

Thanks again!

Re: Pre existing condition - epilepsy
 

if you can get the job coverage then your likely in a much better position that getting it as individuals as they often dont worry about preexisting conditions on group work provided policies.

Re: Pre existing condition - epilepsy
 

If the med is on one of the generic bargain lists then you won't go through insurance so you won't need it. The only other cost involved will be going to the doctor to get a prescription. To safeguard yourself you will need to get group insurance that starts within 63 days of you leaving the UK. Doing so you should be able to use you NHS coverage to show continuous creditable coverage which would mean pre-existing conditions would be covered. Once the 63 days expires, pre-existing conditions will almost certainly not be covered for a period of 12 months. Remember that a pre-existing condition blackout isn't just related to medications. Claims can and will be denied for anything that stems from the pre-existing condition. Eg, if something bad happens and she has a seizure, falls onto something and breaks her arm. The ER trip, the costs for the doctors, the costs for x-rays, the cost for setting the break and all follow up costs would almost certainly not be covered and you would be liable 100%. Health insurance is complicated and insurance companies don't make it easy to understand. They, and the people billing the companies make mistakes too so don't take anything as face value. If you get a claim come back denied, contact the insurance company and the biller if needed. A lot of the time a mistake has been made and you can get the claim resubmitted and paid.

You should also try to get hold of all your daughters medical records, or at least the ones dealing with the epilepsy, to give to your new doctor when you get here. It will be much, much easier for both you and the doctor to get on the same page if you have the previous records as opposed to starting completely fresh.

Re: Pre existing condition - epilepsy
 

Just curious because I can't think.. what visa will you get to come on?

Re: Pre existing condition - epilepsy
 

OP is a US citizen ......betcha...

Re: Pre existing condition - epilepsy
 

d'oh!
Post #1, I should've been thinking today. :)

Re: Pre existing condition - epilepsy
 

Where you moving to? There might be local or state schemes to help out?

Definitely ask the employer what the insurance plan is and get the details of the plan as insurance is often the deal breaker.

Re: Pre existing condition - epilepsy
 

You guys are all star! Thanks a million. TO fill in afew gaps (we do have some clever people on this forum) I am a US/uk Citizen and DH (Darling Husband) is UK citizen, kids just got duel. DH travelling on a greencard and we are moving to Indania.

Indiana does have a scheme that would cover us and they have a special coverage for children so that is all good but would rather be covered with DH work if at all possible, so just waitin g acouple more weeks to hear from them.

Thanks, esp to the chappy with the big long email about coverage/going to the Dr to get the meds etc. I have a family Dr (3 generations there so they know us well) who my son is already registered with and I can get my daughter in no problems.

I will also read and reread all that is covered!

Re: Pre existing condition - epilepsy
 

It might be useful for you to get a letter from a NHS doctor saying you have all been covered by the NHS for the past years - or even download a certificate of creditable coverage online and see if they'll fill that out.

Many insurance programs, and even perhaps the state program, will not cover pre-existing conditions right away without proof of creditable coverage.

The NHS is supposed to count - but they may ask some proof that you were covered by it.