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• Reputation: 4209 Q&A: 121 4 6 1581 87 19 Classifieds: 0 0 what's this? Follow Following 5 Russ Campbell, NWEBS

  5 0 Certainly the best information is to query the insurance provider of your prospective new employer. I don't think you really tip you hand by doing this because the issues will come clear if you take employment there anyway. I would urge you to get their responses in writing so you have something to use for evidence of this stance if they change their story later. The best resource for general information is to contact the Office of the Insurance Commissioner of the State of Washington, your consumer protection agency for insurance matters here. You can peruse some general posted information that exists on the site here for health insurance FAQs, and here for the 2011 open-enrollment periods for children (for public plans). No, this does not directly apply to your full situation but is the best info I found on the subject on the public website. Really the best thing is to contact the Insurance Commissioner's Office and get a specialist on the phone to answer your questions. Many things will change (for the better) on this front as the full implementation of the new health care law comes into effect in 2014. Also remember that many services are available to you through your school district. I speak from the experience of being an occupational therapist who has primarily worked in the public school setting. Your public school district is responsible for provision of educational services from age Zero through the age of 21 for children with special needs and that includes many of the services to address the developmental delays you mention in your description.   Russ Campbell, NWEBS answered in Health Insurance 4 months ago | Report 5 comments by kashakesh, Russ Campbell, NWEBS, and kashakesh… 2 0 Russ - thank you! Your link to the office of the insurance commissioner was great and led me to find the answer here. I'll back it up with a call to make sure. Thanks again! Matthew kashakesh commented 4 months ago | Report 0 0 If you can make a generalized statement of what you learn in getting an answer for your specific situation (or recommend a particular webpage) then please return and post it. Someone in the future may find your question and the later discussion/postings here on Qland and having that elaboration may just provide the right direction or answer for them. Russ Campbell, NWEBS commented 4 months ago | Report 2 0 Russ, good point. Here's what I found out. There are two worlds when talking about switching insurance. There is an individual plan and group coverage. Group coverage is typically something that you would get when going through an employer and the individual plan is what one purchases on one's own (just to have, or if you are self-employed). For group coverage, an employer (according to the lady I spoke with at the insurance commission) cannot deny coverage, however there are possible complications. It comes down to waiting periods. Any waiting period (the time that it takes until one eligible for coverage) greater than 90 days subjects the person to the pre-existing condition clause. So, if there is a gap in coverage of greater than 90 days, my son would be subjected to the clause. If switching jobs, research with the new employer how long this waiting period will be and who is eligible for coverage (dependents, spouse, etc.). Signing up for COBRA (Consolidated Omnibus Budget Reconciliation Act) insurance coverage is one way to ensure that the gap in coverage is non-existent or is minimized, however this typically comes at a greater cost (high deductibles, higher co-pays, high co-insurance costs). According to the federal health care site, it is not legal for insurance companies to deny coverage to children who have pre-existing conditions at all, ever. This came into effect in 2010 (see: http://www.healthcare.gov/law/features/rights/childrens-pre-existing-conditions/index.html) So, all in all I believe that in my situation, my child will be covered and will not be denied coverage. Remember that in 2014, all of these shenanigans go away anyway. kashakesh commented 4 months ago | Report 0 0 Great report, thanks for elaborating the results of your research. Again, I urge you to include your local school district in securing appropriate services for your son. He is eligible there even if he is not a public school student (services are available for private school students, but you will usually have to provide transportation and the services are typically available during normal school hours). If he qualifies by their testing using his performance skills as it impacts his ability to learn (educational performance standards), then those services are provided in addition to any private services you may be accessing. Contact your local school district for information. Russ Campbell, NWEBS commented 4 months ago | Report 0 0 We have our son in a developmental pre-school through the district and are aware of the theoretical resources. He receives services integrated into his normal class and goes for what is called extended day services as well. Unfortunately, the district (SPS) is streched beyond its means, so to get him to the level needed, we use our insurance. Of course, there is never enough to go around. What we need is insurance reform with regard to what is and is not covered. I am actually lucky to have any neurodevelopmental benefit at all, as quite a few plans do not have the coverage. Everything else is private-pay as fortunately / unfortunately we make too much to qualify for assistance (but of course, too little to get everything that is needed). A number of other states mandate that there be coverage for neurodevelopmental services. Perhaps one day our collective heads will be removed from our collective rectums in realization that early and full intervention costs so much less than adult care. Thank you for the info and banter. Matthew kashakesh commented 4 months ago | Report Enter your comment or ask a new question preview THIS IS A PREVIEW: Click "Post" to submit it or "Edit" to make changes. edit Please wait… This could take a minute if the tubes are clogged.

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