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Re: [IP] Health Insurance in the States

It depends on the size of the company.  Big companies probably.  Under 100
employees probably but good chance there will be a wait period and they will
cover far less of the cost of medical care.  Under 50 and again under 25
employees, you will tend to see reductions in coverage, longer wait periods,
etc.  Most companies cover test strips, insulin, pump supplies but the co-pays
and terms of the coverage will vary.  Your biggest problem may be bureacracy.
The two biggest variations will be:

    state -- some states have the HMO itized coverage (like California), some
have old-fashioned fee-for service 80/20 coverage (I think New Mexico is still
this way mostly), some have mixture (New Jersey is moving this way).   This
will effect how much time you spend trying to get things you need and how much
you will spend on them and the hoops you have to jump through to get around

    company policy -- some companies negotiate for extra coverage.  Others take
the basic plans.  Basic plans tend to try to deter you from using all but
specific brands of test strips, limit the number, control amounts of insulin
and supplies, and have less accomodating service for getting pump supplies.

In theory, you should be covered.  In fact, you will have to learn to work the
telephone to get what you need when you need it.  Some of the most troublesome
plans will cost you the least so it may be a trade off $$ for time.

Last suggestion:  establish before you sign up for the policy (with a doctor)
that you are a pumper (not a new pumper) so that it is ongoing treatment.
Getting a new pump or coverage for new pump treatment is slower and harder than
getting authorization to continue treatment and they can't actually say no.
However, once you are already pumping they tend to take longer to get the
supplies covered and to you.  Don't spend $$ to be reimbursed if you can at all
help it (most policies guaratee repayment within a calendar year but there is
no guaratee they have to cover what they didn't pre-authorize) and order things
well in advance -- 2-3 months before you need them.

Good luck,


Eddie Hart (and Tony Milne) wrote:

> Now I know there is probably a great deal of variation within Insurance
> companies, but my questions are.
> In the profession I am training for there are job opportunities in the
> States.
> If I come to the States to live and work (for a couple of years), it looks
> likely that the company that will hire me will also provide medical
> insurance.
> In this case, will the insurance company accept my diabetes?(being a
> pre-existing condition)
> If not will they cover me for everything else but diabetic related illness?
> Cheers in advance,
> Tony (soon to be pumping thanks to Steve) Milne.
> ----------------------------------------------------------
> Insulin-Pumpers website http://www.insulin-pumpers.org/

Insulin-Pumpers website http://www.insulin-pumpers.org/