Question about health insurance in the USA

Last time I had a doctors appointment my doctor mentioned he thought I may have heart disease and he wanted me to setup an appointment to have it checked out. I have delayed setting up an appointment mainly because I am under employed at the moment. I’m only making about half the money I was making last year and the job is a dead end. I am lucky enough to have insurance.

My question is if I get diagnosed with heart disease does that mean I have stay at this job until 2014, when healthcare reform fully kicks in, or find another job and have to pay an outrageous amount for cobra?

It depends.

If the heart disease was caused by the job, you might qualify for Worker’s Compensation insurance.

If you are immediately hospitalized (without leaving the job first) you will qualify for Temporary Disability Insurance.

If you leave this job, you will lose your insurance, and any new insurance may not cover pre-existing conditions.

Thats about what I thought. On one hand it makes me want to postpone this appointment, but on the other hand he may have already put something in my file and it may already be considered pre-existing.

I wasn’t aware group health plans excluded pre-existing conditions, just delay coverage for 6 months to a year.

Obama’s Affordable Care Act establishes temporary “high-risk” pools in each state that will cover people with pre-existing conditions until 2014, when, as you say, all insurers will be required to cover such conditions themselves. The pools are in the process of being set up at the moment but will be up and running in July. I don’t know the exact details, and some pundits like this one are sceptical of the benefits, but it’s certainly one of the options you can consider.

Furthermore, many plans cannot exclude such conditions, as long as you’ve had continuous coverage prior to joining the plan.

So if the OP find a new job, and has had continuous insurance, the new job’s insurance should cover it.

There are some restrictions on that - e.g. smaller companies, companies which are self-insured (I think)… but in general it shouldn’t be an issue.

I don’t know about the temporary-disability insurance that **Superhal **mentions - that may be a state-by-state thing.

“CARSON CITY – Gov. Jim Gibbons announced Wednesday that Nevada will not operate a health insurance pool for people with high-risk pre-existing medical conditions because the national health care reform bill provides only a fraction of the money needed to run it properly.”

So it seems, that in practice, nothing will change.

This is a real problem for expat Americans now… new local laws make it such that my UK-issued insurance is no longer recognized here by the government (tho hospitals accept it), but it means I can no longer get a visa for residency. Also, many banks are no longer allowing Americans to keep accounts because of IRS hassles.

Looks like I am on the road again, moving to a new country every 90 days just to stay legal and insured. :mad:

Here’s an article about the high-risk pools. Note that this says that you have to have been uninsured for six months.

I had a similar situation pop up a few years ago. About 4 months into a new job, I was found to have heart disease & the cardiologist wanted to do a catheterization with possible angioplasty. The new job’s insurance carrier balked, but once I showed them a “continuity of coverage” statement from my old job’s insurance carrier, showing that I had coverage before taking the new job, they signed off – they were thinking that I might have not had any kind of insurance, and then waited until I got into a cushy new job with good insurance before seeking treatment.

Once the new job’s insurer was satisfied, I then had the cath, during which they found a 90% blockage of the LAD and placed a stent.

As far as I’m aware, when they say “Nevada will not operate a health insurance pool …”, they mean the state won’t be operating the pool directly, it’ll be a federal initiative instead. My understanding is that, either way, there will be high-risk pools available to people in every state. This LA Times article explains it a bit.

You’re right that it’s sad though. These high-risk pools were actually a major part of many of the alternative Republican plans for health care reform, yet a lot of those same Republicans who supported them when they were a “Republican” idea are now refusing to administer them now they’re a “Democratic” one.

That seems like false economy to me. Either it is nothing or easier to treat now than later or won’t need to be treated later…

… false dichotomy

In all my 30 years of working I’ve only seen one job that did that. And that was a small company with 5 full time and about 100 part time employees (no coverage).

What they did was make you wait a year to get covered for any condition you saw a doctor for, one year prior to getting hired.