introduction and questions

[acmarano]

Our names are Adam Marano and Dawn White. Our daughter's name is Alexndra. She is almost 19 months old and we just returned from TCH for her third surgery. Everything seemed to go really well.
My problem is this: When we returned home on Thursday, I received a notice from my work saying that they will not be covering the insurance that we use for Alexandra. They are offering different insurance, but I noticed in the past that no other insurances seem to cover previous injuries. Shouldn't another insurance company cover the same as our current insurance? We are not the ones discontinuing the insurance. I don't feel that we should be held responsible for something that my company is doing to us. Will someone please help me if they know anything about what I am talking about.
Thank you and I look forward to talking with many people about all situations,

Adam, Dawn, and Alexandra

[Julie]

I live in NY and was checking about switching health insurance companies. I was told by all the ones that I contacted that as long as there is no lapse in coverage it is against the law to deny someone coverage due to an existing condition. Not sure if the law is the same in all states but it would seem that it should be.

[crystal]

just don't let your coverage lapse. you should be fine. when we switched insurances we had several days that we had both insurances. this will make sure that everything is ok. still look at you policy though, it may not cover it becouse of being out of state or something differnt like that.

[Kathleen]

Julie

I live in New York too and I have never been challenged on insurance needs.
We now have our insurance based in NJ and it is against the law to refuse to cover previous conditions.

I just completed over 30 visits for my obpi.
Kath

[admin]

The first surgery was the primary surgery. C5, C6, and C7 were all torn in half. C8 and T1 were pulled from the spine. Alexandra had Erb's palsy and Klumpke's palsy. I think that is the name of the second, please forgive me if I am wrong. She was completely paralyzed from the shoulder down. No movement in her arm or hand. Dr. Laurent took care of the c5, 6, and 7 and grafted them. He made 7 incisions in her calves and used those nerves to use to graph into the damaged nerves. The second surgery was to be a c7 transfer, but we just couldn't that because Dr. Nath said that there was a chance that there could do damage to the left arm (which is her good arm). We didn't want to take that risk. He went in and just cleaned the scar tissue and check the nerves to see how they were coming. All the nerves from the first surgery had good function in them. Also, the other two nerves grew into the working nerves and they too had function in them. That was great. This past surgery, Dr. Nath cut four tendons and put Alexandra in a splint with her arm raised for 8 weeks. He said that the surgery went great and we should expect to see some good results. We saw a little girl at TCH and she had the same damage done to her arm and she had the same procedures done at the same age as my daughter and her arm was doing great. We all got real excited when we saw her. So hopefully Alexandra will have the same great results.
This is my first day in here and it's real nice to talk to people that are going through the same thing as us. Please feel free to ask more questions.
Adam

[acmarano]

Thank you for replying. I hope that I don't have any problem with my insurance.

Adam

[acmarano]

Thank you for replying about the insurance. I will make sure there is no lapse and to check the laws for Michigan.
Adam

[acmarano]

The first surgery was the primary surgery. C5, C6, and C7 were all torn in half. C8 and T1 were pulled from the spine. Alexandra had Erb's palsy and Klumpke's palsy. I think that is the name of the second, please forgive me if I am wrong. She was completely paralyzed from the shoulder down. No movement in her arm or hand. Dr. Laurent took care of the c5, 6, and 7 and grafted them. He made 7 incisions in her calves and used those nerves to use to graph into the damaged nerves. The second surgery was to be a c7 transfer, but we just couldn't that because Dr. Nath said that there was a chance that there could do damage to the left arm (which is her good arm). We didn't want to take that risk. He went in and just cleaned the scar tissue and check the nerves to see how they were coming. All the nerves from the first surgery had good function in them. Also, the other two nerves grew into the working nerves and they too had function in them. That was great. This past surgery, Dr. Nath cut four tendons and put Alexandra in a splint with her arm raised for 8 weeks. He said that the surgery went great and we should expect to see some good results. We saw a little girl at TCH and she had the same damage done to her arm and she had the same procedures done at the same age as my daughter and her arm was doing great. We all got real excited when we saw her. So hopefully Alexandra will have the same great results.
This is my first day in here and it's real nice to talk to people that are going through the same thing as us. Please feel free to ask more questions.
Adam






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[francine]

Hi - just recently Ryan posted something about the same problem he is having at his work...so I went back to his post and found this link...hope it helps you...



I found this site:
http://www.insure.com/health/hipaa.html

It contains the following...

HIPAA imposes limits on the extent to which some health plans can exclude coverage for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 straight months, with no lapse in coverage of 63 days or more, and you switch to a new group health plan, it cannot invoke the pre-existing condition exclusion at all. It must cover your medical problems as soon as you enroll in the plan. (Newborns and adopted children who are covered within 30 days are not subject to the 12-month waiting period.)

if you have any further questions about this - email ryan at ryan@ubpn.org

good luck,
francine

[admin]

Adam and family,
We met while you were at TCH. I am so glad that you were able to find this site it is a great resource. WELCOME I will be contacting you regarding the Special Children's Fund that you and your wife told me about. So glad to hear that Alexandra is doing well with her recovery.
Best Wishes!
Stephanie