MI Question - PreExisting Condition

[markandpatti96]

What is the name of your state? Michigan.

My husband has worked for the same employer for 15 years. His employer has never offered health care benefits, so he has always been under my employer's policy. He is considering taking a new job, a job that offers health care benefits. Over the past couple of years, he has been treated for Leukemia - all of which was covered with my health care benefits...

(1) Could his new employer's health insurance deny coverage for his Leukemia care?

and

(2) Can I legally keep him on my insurance and he deny health care coverage from his new employer? My employer requires me to sign an affidavit every year stating insurance is not available through his employer.

 

[cbg]

Since he has been covered under a group health insurance policy (yours) HIPAA applies, which means that they CANNOT consider any condition pre-existing. They CANNOT deny coverage for any condition that has been covered on another group insurance plan. This assumes that he stays on your coverage until he is eligible for the benefits at the new employer and there is no gap in coverage.

HIPAA (the original HIPAA, not the privacy amendment mess that was enacted last year) was put into place SPECIFICALLY so that employees could change jobs and health insurance without losing coverage for pre-existing conditions.

There is nothing in Michigan law (or the law of any other state) that says you cannot keep him on your plan. However, as I stated in your other question, there may be something in the contract that says you can't. The fact that your employer asks for an affidavit each year indicates that their contract with the insurance carrier may say that they will only cover dependents who do not have access to other coverage. The law does not require them to do this, but the law permits them to do this. You should check with your employer before making the decision to keep him on the plan. If you find that by contract, he must pick up the insurance with his own employer, that coverage CANNOT decline him coverage and CANNOT deny coverage for the leukemia on the basis that it's pre-existing, as long as he 1.) stays on your plan until he is eligible for the new benefits and 2.) elects the new benefits as soon as he is eligible. If he lets the initial eligibility date go by without electing coverage, it's a whole new ball game.