Insurance and New Opportunities

[FloridaJen]

This is probably very premature, but I'm a planner and I'm trying to think through some decisions I may have to make soon. I am at the beginning stages of my DS denial because my current employer/3rd party administrator has indicated the DS is a denied code. I have no idea what the outcome is going to be or if it will happen before 2020, where my insurance will renew and I have yet to learn if bariatric will still be offered. I assume it will be, but who the hell knows.

Meanwhile, I have learned that with our current state of restructuring/integration with a bigger hospital system I will have to apply for a new position come spring. It's very likely that there will not be a position of interest for me or one that I will even qualify for. It's almost a certainty my current position goes away and even though they have said "everyone will have a position" I know that's crap if everyone doesn't have a position that fits their skills. So I have applied for a new job at a new organization and got called immediately for the preliminary assessment with HR and have an official phone interview Thursday. I live in a small area and jobs like this don't come around very often - it's a position made for me, working for an organization I am passionate about.

Of course, I haven't been offered the job yet, but I'm trying to get my ducks in a row IF they were to offer it to me. HR sent me their current benefits package and it's great, on the surface, but she did indicate it's changing come 2020 - hopefully for the better, but that's not guaranteed. I don't know if they have bariatric, and of course, it's not something I can ask at this stage of the game. The timing of all of this SUCKS so bad and if I could have just gotten my effin' surgery when I was supposed to this would be super easy. Do I risk changing jobs in the middle of this appeal without having any indication it will get approved? Do I risk losing this opportunity for a surgery that may never get approved? Do I risk not having surgery at all if I change now and no bariatric coverage later? It's really bad timing for me for so many reasons because right now I have the flexibility I desperately need to take care of personal matters I'm dealing with (including surgery stuff), but not having surgery OR a job come spring isn't ideal either.

Does anyone know how I can find out more about the benefits without asking? It says it's a national plan with Florida Blue?

Thanks for "listening"

Jen

 

[Spiky Bugger]

Above my pay grade, but I’m here to you on.

 

[JackieOnLine]

same here! but there are enough smart folks here, someone will have an idea I suspect.

 

[southernlady]

Maybe ask for a copy of the Evidence of Coverage. That is where it will be spelled out and won't give away why you are asking for it.

 

[Spiky Bugger]

Maybe ask for a copy of the Evidence of Coverage. That is where it will be spelled out and won't give away why you are asking for it.

That might frighten the employer? And concern them about upcoming time off?

 

[Spiky Bugger]

This is probably very premature, but I'm a planner and I'm trying to think through some decisions I may have to make soon. I am at the beginning stages of my DS denial because my current employer/3rd party administrator has indicated the DS is a denied code. I have no idea what the outcome is going to be or if it will happen before 2020, where my insurance will renew and I have yet to learn if bariatric will still be offered. I assume it will be, but who the hell knows.

Meanwhile, I have learned that with our current state of restructuring/integration with a bigger hospital system I will have to apply for a new position come spring. It's very likely that there will not be a position of interest for me or one that I will even qualify for. It's almost a certainty my current position goes away and even though they have said "everyone will have a position" I know that's crap if everyone doesn't have a position that fits their skills. So I have applied for a new job at a new organization and got called immediately for the preliminary assessment with HR and have an official phone interview Thursday. I live in a small area and jobs like this don't come around very often - it's a position made for me, working for an organization I am passionate about.

Of course, I haven't been offered the job yet, but I'm trying to get my ducks in a row IF they were to offer it to me. HR sent me their current benefits package and it's great, on the surface, but she did indicate it's changing come 2020 - hopefully for the better, but that's not guaranteed. I don't know if they have bariatric, and of course, it's not something I can ask at this stage of the game. The timing of all of this SUCKS so bad and if I could have just gotten my effin' surgery when I was supposed to this would be super easy. Do I risk changing jobs in the middle of this appeal without having any indication it will get approved? Do I risk losing this opportunity for a surgery that may never get approved? Do I risk not having surgery at all if I change now and no bariatric coverage later? It's really bad timing for me for so many reasons because right now I have the flexibility I desperately need to take care of personal matters I'm dealing with (including surgery stuff), but not having surgery OR a job come spring isn't ideal either.

Does anyone know how I can find out more about the benefits without asking? It says it's a national plan with Florida Blue?

Thanks for "listening"

Jen

Okay, so after pondering this, here I am engaging in sketchy behavior:

WHAT IF...
•You get offered and accept the new job.
•BUT, you ask them if it might be possible to hire you as an independant contractor, for the first year, with a slightly higher salary but no benefits (save them some money.). Or to replace your medical care benefit with something else for the first year—gas money allowance, parking allowance, child care allowance, SOMETHING but not medical that will give you cash to help pay for my next brilliant idea.
•THEN, continue your COBRA (you can carry it for 18 months) from the current job, out of pocket, the entire cost (yours and your employer’s plus 2%), so that...
•You can continue to pursue the surgery w/the coverage you have now.

My way of thinkng things out is usually brilliant, criminal, or a bit of both. Take ANY of my advice with a large serving of salt.

PS... southernlady may have to caution others, but I’m being careful here...there may be HUGE changes to everyone’s medical plans (WE CAN DISCUSS THIS IN RANTS AND RAVES, PEOPLE, NOT HERE) depending on what happens later in 2020.

 

[hilary1617]

I live in a small area and jobs like this don't come around very often - it's a position made for me, working for an organization I am passionate about.

^^^^^ This says it all for me. Go for the job.

Do you know anyone who works at that organization? Maybe they would be willing to share the plan group number so you could research plan-specific coverage on the Florida Blue site?

I do think once an offer is on the table it would be reasonable to ask for more detailed information on benefits including insurance - like a copy of the EOC.

If you do switch employers, research the Family Medical Leave Act protections. I think, but could be mistaken, that job protections only kick in after 12 months of service.

 

[JackieOnLine]

it sounds wonderful, I hope it works out for you.

 

[FloridaJen]

Ok, I didn't get any notification I had responses, sorry guys! thanks for all your great ideas.

I'm relieved to say I didn't get this job...or this position...but they want me for another position in a couple of months! They are working on fine-tuning the job description, so I may or may not want it, but thankfully it buys me some time. It's been about 3 weeks since BCBS received my appeal and they say they have to respond within 30 days. If I can get this surgery done in the next few months I could be free to explore other opportunities with this new organization. aaaahhhhhhh.