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Health insurance discoveries
Jun. 19th, 2014 02:52 pmSome interesting facts have come to light that definitely influence my top surgery plans.
The plan I'll be getting through school after I transfer won't be announced until 30 June. Though the current version covers 90% the costs in-network and 60% the costs out-of-network, I don't know their process for designating in/out-of-network providers and the plan is subject to change in the next school year. Essentially, until the benefits are announced, I can't count on any coverage for top surgery. That mysterious plan will take effect 21 August.
The plan I currently have through school covers 100% of the costs of top surgery with a surgeon of my choice but ends on 9 August. I thought this meant I really had to schedule surgery before 21 July or thenabouts. Since I'd otherwise be uninsured from 9 August until 21 August and possibly still be at a higher risk of complications, I inquired about continuing coverage with my current plan so I won't be uninsured for the two weeks in between. I just found out I can continue coverage until 9 September with the same benefits for $384. So, I'll definitely be doing that because being uninsured for any amount of time is beyond my risk tolerance. As a bonus, it would buy me a little more time to decide. I could potentially schedule surgery as late as 15 August without having to take time off from my new job.
My partner's insurance begins 1 October, and it won't cost him a cent for me to be enrolled. Since it looks like neither his plan nor the one I'll be getting through school in the fall prohibits secondary insurance, I can be doubly insured through him. He finally heard back from HR, and they said his plan is administrated (administered?) in California even though it's the plan for out of state employees. That means the transition-related treatment exclusion they had is now forbidden, so top surgery would be covered to the same level as any other medically necessary surgery. The current version of his plan would cover 100% of in-network costs and 70% of out-of-network costs, but the details may change in the new plan that won't be announced until 1 September, and I still don't know how the in/out-of-network designation is made.
So, it looks like I have some more options. My hard deadline for guaranteed 100% coverage is now a month later than I thought, and I'll be able to decide after the plan for my new school is announced. Woohoo! I owe the universe some serious gratitude right now.
The plan I'll be getting through school after I transfer won't be announced until 30 June. Though the current version covers 90% the costs in-network and 60% the costs out-of-network, I don't know their process for designating in/out-of-network providers and the plan is subject to change in the next school year. Essentially, until the benefits are announced, I can't count on any coverage for top surgery. That mysterious plan will take effect 21 August.
The plan I currently have through school covers 100% of the costs of top surgery with a surgeon of my choice but ends on 9 August. I thought this meant I really had to schedule surgery before 21 July or thenabouts. Since I'd otherwise be uninsured from 9 August until 21 August and possibly still be at a higher risk of complications, I inquired about continuing coverage with my current plan so I won't be uninsured for the two weeks in between. I just found out I can continue coverage until 9 September with the same benefits for $384. So, I'll definitely be doing that because being uninsured for any amount of time is beyond my risk tolerance. As a bonus, it would buy me a little more time to decide. I could potentially schedule surgery as late as 15 August without having to take time off from my new job.
My partner's insurance begins 1 October, and it won't cost him a cent for me to be enrolled. Since it looks like neither his plan nor the one I'll be getting through school in the fall prohibits secondary insurance, I can be doubly insured through him. He finally heard back from HR, and they said his plan is administrated (administered?) in California even though it's the plan for out of state employees. That means the transition-related treatment exclusion they had is now forbidden, so top surgery would be covered to the same level as any other medically necessary surgery. The current version of his plan would cover 100% of in-network costs and 70% of out-of-network costs, but the details may change in the new plan that won't be announced until 1 September, and I still don't know how the in/out-of-network designation is made.
So, it looks like I have some more options. My hard deadline for guaranteed 100% coverage is now a month later than I thought, and I'll be able to decide after the plan for my new school is announced. Woohoo! I owe the universe some serious gratitude right now.
