Job Change - INSURANCE NIGHTMARE CONTINUES

My surgery auth is in appeal. We have HR also helping us to hopefully speed it up. NOW, my husband might change jobs at the beginning of Feb. He has been in the recruitment process since Oct. We thought I would be having surgery last year, so it was not on our minds that the surgery would bump into the job change. If the appeal takes the full thirty days (the denial took five weeks!!!) I will likely have to start a completely new authorization and delay my surgery even more. On the other hand, if I get scheduled quickly, I may have to pay five grand out of pocket. My friends think that what I pay on the current insurance will not transfer to the new policy. I can't imagine practically paying for a used car and then starting over the next month. Anyone familiar with the current insurance rules? I'm anxious to get my surgery because of pain, but don't want to run us into bankruptcy!

Ok I've actually found some answers...don't know why I couldn't find out the other day when I googled. The deductible would reset. I don't know if that still holds true if we went from a PPO to HSA or just PPO to PPO. Oh what fun.

PPO and HSA are two totally different things. A PPO is a type of insurance, one where you usually don't need referrals and can go to any doctor you wish. HSA is a deduction taken out of your paycheck pre tax that you can use to help pay for medical expenses.

And yes, if you change insurance, deductible would start over.

Agreeing with Kim, and adding that a policy that has an HSA option is a high deductible health plan (HDHP) - usually higher copays, higher deductibles, higher total out-of-pocket expenses.

With the job change, you are supposed to be offered COBRA which will allow you to continue on your previous plan for up to 18 months. The caveat there is that you would be responsible for the premium in full if your employer had partially paid it while you were employed.

Deductibles also reset at the beginning of the plan year. For most of us, that coincides with the calendar year, unless you're employer's insurance contract starts at a different time.

Yep. It looks like I will have to wait until the new job and start completely over. Totally expecting another denial and appeal process. I mean it's possible the new carrier will cover it, but not likely from the different medical professionals I have spoken with. Sounds like usually the appeal will work, it just adds even more delay. I remember reading someone on here saying she had to wait eight months the for her surgery. I thought, I don't know what I would do with myself! Now,it's looking like mine will be at least six months out from when I decided to go ahead. My goal was before Christmas. Then January. I'm guessing it will be March. That gives me about six weeks or less before my kids are done with school. REALLY wanted to be 12 weeks out from surgery by summer. So disappointing!

New job, new insurance means starting from scratch. Could be a good thing though. I started a new job with new insurance and only after a year they approved my surgery first time doctor asked. Could be a good thing. Maybe lower deductible and out of pocket max.

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Originally Posted by lynn.erika New job, new insurance means starting from scratch. Could be a good thing though. I started a new job with new insurance and only after a year they approved my surgery first time doctor asked. Could be a good thing. Maybe lower deductible and out of pocket max.

Agreed, with minimal to zero information, I wouldn't speculate.

Thanks! We have choices of plans to choose from. So I do know the carrier. And the doctor didn't sound super excited. Haha. But we can pick a lower deductible and out of pocket max than we have now. We also will pay a little more each month. But maybe it will be better coverage.

Lynn.erika...Are you saying that your previous insurance took a year and your new insurance approved right away?

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Originally Posted by Tulip81 Thanks! We have choices of plans to choose from. So I do know the carrier. And the doctor didn't sound super excited. Haha. But we can pick a lower deductible and out of pocket max than we have now. We also will pay a little more each month. But maybe it will be better coverage. Lynn.erika...Are you saying that your previous insurance took a year and your new insurance approved right away?

I never asked my previous insurance for a hysterectomy since the coverage was so poor i couldn't afford my $3,000 deductible. About 8 months after getting coverage with new company, i asked my doctor for a hysterectomy and new insurance said yes in less than 2 weeks. No appeals, no fight, nothing. I was expecting it to be a hassle but it wasn't. My doctor said some insurance companies are easier to work with then others.

Gotcha!