Extension of Benefits

[mrklaig1]

A friend had private medical insurance through his employer. About one year ago he started having bladder problems.... Twice he sought help over a few months. He was told it was an infection, etc.

He then quit his job and three months later found out the problems were cancer of the bladder. It was obvious from the size of the tumors that he had the cancer while insured
with his previous employer.

He is now uninsured as he did not purchase private health insurance after he left.

Question: Would he have coverage under his previous policy since he had the cancer while covered?

Thank you,

[ecmst12]

If the policy is no longer in force, then he is not covered. It may not be too late for him to sign up for Cobra though, if he quit his job 3 months ago. He will have to pay premiums back to the termination but that would be a small price to pay.

[cbg]

In a VERY few, VERY specific situations, DEPENDING ON THE EXACT WORDING OF THE POLICY there MAY be a limited extension of benefits for a matter of a few weeks or months. Outside of those VERY limited situations, the fact that he had the cancer while the policy was still in force does NOT require the existing policy to continue coverage. He will have to read the policy to be certain, but to my knowledge bladder cancer is not one of the situations in which he would be entitled to an extension of benefits. He should not anticipate such coverage.

If he has been gone for three months he has either already passed the deadline to elect COBRA or is sitting right on top of it, so he needs to inquire NOW.

If the deadline to elect COBRA has passed, his only option is to purchase a high risk policy or to find another job that offers health insurance.

[lkc15507]

Agreed, he must act now to see if he has ANY options from the previous employer. Having quit his job 3 months ago, he is also in jeopardy of having the bladder cancer excluded as a pre-existing condition by any new insurer as 3 months would exceed the 63 day break in coverage.

[momm2500]

as previously noted: not all policies have an extension of benefits. IF a plan does have that clause, it is normally that the individual must be in a period of limited activity. meaning your insurance ends while you are in patient in a hospital. in this case the prior health insurance plan will not be liable. if you did not elect cobra, see if you can get state insurance aid