Question:
How long before I can use new insurance?

My husband's insurance has an exclusion policy. I can get BCBS Highmark of PA from my company. How long do I have to wait to use the coverage after joining? It says in my handbook at work that it does cover WLS. I would rather join the BCBS and use them to cover WLS than self pay. Is there any policies for waiting? I mean-people can't join the insurance and use them for coverage and then quit, right?? I don't want to call and send up a red flag to them. Any replies will be gratefully appreciated! Sharon Brown    — SharonBrown (posted on February 28, 2005)

February 28, 2005
From the moment your policy goes into effect, you can use it for whatever you want to use it for. That is why we get health insurance. And yes, people can join insurance, use them, and cancel it. As long as you paid your premium, thats all that matters. <br><br>Now, if you are speaking about pre-existing clauses, that's another story. AND, some self funded, and I'm sure ones that are not, have a wait time for WLS because it has become so mainstream as of late. By calling and asking you are doing no harm. Even if it throws up red flags, they can not really do anything about it. This is thru your employer and they can not pick and choose who they insure based on intent. Besides, you can call with the group number (get from insured co-worker) and ask anonymously. Best Wishes! ~~Rebecca
   — RebeccaP

February 28, 2005
If the insurance is through your company, you might check to see when the next enrollment period. Generally speaking, you can only enroll or change your coverage during the enrollment period which is usually once per year. If it's several months until your enrollment period, you might contact your HR department and ask under what circumstances could you opt into the companies insurance plan. The same rules applies for dropping insurance coverage. Again, generally speaking, unless there has been a 'life changing' event, most of the time you can only make changes during the enrollment period. The handbook should tell you what the qualifications and waiting periods are (if any) before you can begin to use your insurance. Some companies have a 30-60 or 90-day waiting period, some do not. Some insurances also have pre-existing condition clauses that may prevent you from using the insurance for a specific condition until a certain period of time has elapsed. Insurance can be tricky business! Best of luck to you!
   — Shayna T.

February 28, 2005
I went ahead and called and called the company help line. You will want to deal with your employer more so than the actual BCBS, because it all depends on your plan. My husband works for the State of Michigan. Before we switched, I called them (they have a department that deals with the employees) and I asked them every question that I could think of. They were wonderful with me. I am in a different state, but we switched during open enrollment in august, and our coverage started on October 10th. I had surgery January 5th of this year. Pretty quick as far as I am concerned. You can also ask them what are their prequalifications. There are a LOT of things that you can do to get your ducks in a row before even being covered by them. So that once your coverage begins, you are ready to roll. Such as (if you have switched doctors in the past) getting all of your medical records at your current pcp. If you have joined different weight loss places, such as WW's or LA weight loss, get paperwork from them showing that you attended, etc. Go through all of your doctors records looking for anything that will document your attempted weightloss through the years. Look for signs of complications due to weight loss - such as sleep apnea, knee joints aching, any bones aching, breathlessness, etc. Anything that you can use, document it. Do you have trouble sleeping? Make sure it is documented by your doctor. Have you checked with a clinic that is covered by BCBS? You can find that out by asking your employer who they work with. Find out what all that you need for them to do, and what they need for you to do. They can also give you a timeline. You will probably have to see a psychiatrist for a specific set of testing. Hope this helps some. Junith
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