Insurance question

[Dave-n-Oksana 49]

My Fiancee's daughter is a type 1 diabetic and has had this condition for about 6 years. Every 2 years she has to have a medical examination (next one is this month) to verify this so she can get her medication at no cost as well as her disability stipend.

Will this qualify as having coverage for a preexisting condition for medical insurance purposes? Is this Ukraine's Social Insurance? Any idea what documentation she will need to provide to show this?

Thanks in advance,

Dave

[Gary and Alla 3,694]

My Fiancee's daughter is a type 1 diabetic and has had this condition for about 6 years. Every 2 years she has to have a medical examination (next one is this month) to verify this so she can get her medication at no cost as well as her disability stipend.

Will this qualify as having coverage for a preexisting condition for medical insurance purposes? Is this Ukraine's Social Insurance? Any idea what documentation she will need to provide to show this?

Thanks in advance,

Dave

I cannot comment on your policy without seeing it...BUT it is typical (not required) that subsequent to a marriage the spouse and children are added to the policy under an "open enrollment" condition and pre-existing conditions are waived. It was this case in my insurance. So get the enrolled right away after the marriage, we had to provide a copy of the marriage certificate and the chidrens birth certificates (translated) to show they were Alla's children. This is typical with any "change of life" situation, including marriage, birth, adoption, etc.

Yes, her previous coverage was Ukraine's social insurance.

[mendeleev 68]

In order to avoid this hassle, we got my wife onto my medical insurance coverage about 8 months before she entered the USA. There was a 6 month pre-existing condition exclusion. So, since she'd been covered 8 months before US entry, no problem.

It was an advantage that my insurance company does not require SSN of its customers.

The sweetest part was that I talked my employer into paying the premium.

[Rob_Lesya 4]

In order to avoid this hassle, we got my wife onto my medical insurance coverage about 8 months before she entered the USA. There was a 6 month pre-existing condition exclusion. So, since she'd been covered 8 months before US entry, no problem.

It was an advantage that my insurance company does not require SSN of its customers.

The sweetest part was that I talked my employer into paying the premium.

Of course, the OP needs to know that your wife had a K-3 visa, which means that the two of you were married before she entered the US.

What you are suggesting generally would not be possible for a fiancee on a K-1 visa. Generally, you would not be able to add someone to your insurance until after you are married-- which means that the K-1 fiancee (and any derivative K-2 children) could not be added until AFTER they have entered the US and the marriage has taken place.

[mendeleev 68]

In order to avoid this hassle, we got my wife onto my medical insurance coverage about 8 months before she entered the USA. There was a 6 month pre-existing condition exclusion. So, since she'd been covered 8 months before US entry, no problem.

It was an advantage that my insurance company does not require SSN of its customers.

The sweetest part was that I talked my employer into paying the premium.

Of course, the OP needs to know that your wife had a K-3 visa, which means that the two of you were married before she entered the US.

What you are suggesting generally would not be possible for a fiancee on a K-1 visa. Generally, you would not be able to add someone to your insurance until after you are married-- which means that the K-1 fiancee (and any derivative K-2 children) could not be added until AFTER they have entered the US and the marriage has taken place.

That's true. For the K1, I bought a short-term policy for the period before we got married (or she returned home, as it turned out.) My employer, at that time, would have allowed me to bring her on just after marriage without a pre-existing condition issue.

[Dave-n-Oksana 49]

In order to avoid this hassle, we got my wife onto my medical insurance coverage about 8 months before she entered the USA. There was a 6 month pre-existing condition exclusion. So, since she'd been covered 8 months before US entry, no problem.

It was an advantage that my insurance company does not require SSN of its customers.

The sweetest part was that I talked my employer into paying the premium.

Of course, the OP needs to know that your wife had a K-3 visa, which means that the two of you were married before she entered the US.

What you are suggesting generally would not be possible for a fiancee on a K-1 visa. Generally, you would not be able to add someone to your insurance until after you are married-- which means that the K-1 fiancee (and any derivative K-2 children) could not be added until AFTER they have entered the US and the marriage has taken place.

That's true. For the K1, I bought a short-term policy for the period before we got married (or she returned home, as it turned out.) My employer, at that time, would have allowed me to bring her on just after marriage without a pre-existing condition issue.

Thanks for the information but the problem is not for my fiancee but for her daughter. My insurance policy at work does not cover children over 19 unless they are a full time student. The time frame we are expecting for their arrival is in the middle of the current semester.

I have also been told because of her pre-existing diabetes, that she will not be insurable unless I can prove that she had previous coverage before moving here.

[payxibka 10,045]

get familiar with HIPAA.... See if you can get her designated as a "special" enrollee...

What is a special enrollment opportunity?

Special enrollment allows individuals who previously declined health coverage to enroll for coverage. Special enrollment rights arise regardless of a plan's open enrollment period.

There are two types of special enrollment - upon loss of eligibility for other coverage and upon certain life events. Under the first, employees and dependents who decline coverage due to other health coverage and then lose eligibility or lose employer contributions have special enrollment rights. For instance, an employee turns down health benefits for herself and her family because the family already has coverage through her spouse's plan. Coverage under the spouse's plan ceases. That employee then can request enrollment in her own company's plan for herself and her dependents.

Under the second, employees, spouses, and new dependents are permitted to special enroll because of marriage, birth, adoption, or placement for adoption.

For both types, the employee must request enrollment within 30 days of the loss of coverage or life event triggering the special enrollment.

http://www.dol.gov/ebsa/faqs/faq_consumer_...ditableCoverage

[Neonred 3,562]

In order to avoid this hassle, we got my wife onto my medical insurance coverage about 8 months before she entered the USA. There was a 6 month pre-existing condition exclusion. So, since she'd been covered 8 months before US entry, no problem.

It was an advantage that my insurance company does not require SSN of its customers.

The sweetest part was that I talked my employer into paying the premium.

Of course, the OP needs to know that your wife had a K-3 visa, which means that the two of you were married before she entered the US.

What you are suggesting generally would not be possible for a fiancee on a K-1 visa. Generally, you would not be able to add someone to your insurance until after you are married-- which means that the K-1 fiancee (and any derivative K-2 children) could not be added until AFTER they have entered the US and the marriage has taken place.

That's true. For the K1, I bought a short-term policy for the period before we got married (or she returned home, as it turned out.) My employer, at that time, would have allowed me to bring her on just after marriage without a pre-existing condition issue.

Thanks for the information but the problem is not for my fiancee but for her daughter. My insurance policy at work does not cover children over 19 unless they are a full time student. The time frame we are expecting for their arrival is in the middle of the current semester.

I have also been told because of her pre-existing diabetes, that she will not be insurable unless I can prove that she had previous coverage before moving here.

The daughter is over 19? How old is she? If she is 20, then I would be even more concerned that she will NOT be able to get a green card. If she turns 21 before the green card interview, she will be denied and face deportation. It's called aging out and pops up often on VJ. There is a current case right now.

http://www.visajourney.com/forums/index.php?showtopic=212265

Edited August 12, 2009 by Neonred

[Dave-n-Oksana 49]

get familiar with HIPAA.... See if you can get her designated as a "special" enrollee...

What is a special enrollment opportunity?

Special enrollment allows individuals who previously declined health coverage to enroll for coverage. Special enrollment rights arise regardless of a plan's open enrollment period.

There are two types of special enrollment - upon loss of eligibility for other coverage and upon certain life events. Under the first, employees and dependents who decline coverage due to other health coverage and then lose eligibility or lose employer contributions have special enrollment rights. For instance, an employee turns down health benefits for herself and her family because the family already has coverage through her spouse's plan. Coverage under the spouse's plan ceases. That employee then can request enrollment in her own company's plan for herself and her dependents.

Under the second, employees, spouses, and new dependents are permitted to special enroll because of marriage, birth, adoption, or placement for adoption.

For both types, the employee must request enrollment within 30 days of the loss of coverage or life event triggering the special enrollment.

http://www.dol.gov/ebsa/faqs/faq_consumer_...ditableCoverage

Thanks for the information. My sister, who is a claims manager at an insurance company, has said the same. It was why I was asking about if my fiancee's daughter was covered under Ukraine's social insurance.

[Dave-n-Oksana 49]

In order to avoid this hassle, we got my wife onto my medical insurance coverage about 8 months before she entered the USA. There was a 6 month pre-existing condition exclusion. So, since she'd been covered 8 months before US entry, no problem.

It was an advantage that my insurance company does not require SSN of its customers.

The sweetest part was that I talked my employer into paying the premium.

Of course, the OP needs to know that your wife had a K-3 visa, which means that the two of you were married before she entered the US.

What you are suggesting generally would not be possible for a fiancee on a K-1 visa. Generally, you would not be able to add someone to your insurance until after you are married-- which means that the K-1 fiancee (and any derivative K-2 children) could not be added until AFTER they have entered the US and the marriage has taken place.

That's true. For the K1, I bought a short-term policy for the period before we got married (or she returned home, as it turned out.) My employer, at that time, would have allowed me to bring her on just after marriage without a pre-existing condition issue.

Thanks for the information but the problem is not for my fiancee but for her daughter. My insurance policy at work does not cover children over 19 unless they are a full time student. The time frame we are expecting for their arrival is in the middle of the current semester.

I have also been told because of her pre-existing diabetes, that she will not be insurable unless I can prove that she had previous coverage before moving here.

The daughter is over 19? How old is she? If she is 20, then I would be even more concerned that she will NOT be able to get a green card. If she turns 21 before the green card interview, she will be denied and face deportation. It's called aging out and pops up often on VJ. There is a current case right now.

http://www.visajourney.com/forums/index.php?showtopic=212265

She does not turn 20 until next month and we are hoping to have the visa by mid october. We are aware of the threat of aging out and planning to file the AOS as quickly after the wedding as possible. We will be wed within 2 weeks of their arrival.

[payxibka 10,045]

get familiar with HIPAA.... See if you can get her designated as a "special" enrollee...

What is a special enrollment opportunity?

Special enrollment allows individuals who previously declined health coverage to enroll for coverage. Special enrollment rights arise regardless of a plan's open enrollment period.

There are two types of special enrollment - upon loss of eligibility for other coverage and upon certain life events. Under the first, employees and dependents who decline coverage due to other health coverage and then lose eligibility or lose employer contributions have special enrollment rights. For instance, an employee turns down health benefits for herself and her family because the family already has coverage through her spouse's plan. Coverage under the spouse's plan ceases. That employee then can request enrollment in her own company's plan for herself and her dependents.

Under the second, employees, spouses, and new dependents are permitted to special enroll because of marriage, birth, adoption, or placement for adoption.

For both types, the employee must request enrollment within 30 days of the loss of coverage or life event triggering the special enrollment.

http://www.dol.gov/ebsa/faqs/faq_consumer_...ditableCoverage

Thanks for the information. My sister, who is a claims manager at an insurance company, has said the same. It was why I was asking about if my fiancee's daughter was covered under Ukraine's social insurance.

Ukraine's social insurance I do not think qualifies under pre-existing condition exemption based on previous helath insurance coverage... for that to "kick" you need a certificate from the previous plan.... It is my understanding that the "special" enrollee exception does not require this "certificate" of previous coverage.