We are not COBRA. For specific contract details about your current company policy, contact your health plan administrator.
In Reply to: Forced to be "Out of Network" posted by Fin Keegan on July 14, 2003 at 16:39:03:
Sorry: my EMail below is incorrect: it should be "fjk4@columbia.edu"not "fjk4@columbia.edi" /Fin
: My wife and I discovered shortly after moving to Nevada from New York that she was pregnant. Since we have access to COBRA and, now, a "pre-existing condition" (the pregnancy) no local insurer will touch us. So, we are forced to use COBRA.
: However, since my former employer in New York pays for a NY-NJ-Connecticut Network POS plan we are deemed "out of network" every time we incur medical costs.
: There is a provision in the POS plan paid for by my employer that allows for "guesting" of family members on networks elsewhere in the country e.g. the Nevada network.
: However the insurance company refuses to allow my wife to guest on their Nevada network because we are on COBRA. As a result we stand to incur several thousand dollars worth of out-of-network (coinsurance and deductible) expenses when my wife has her scheduled C-section in August. This is on top of the $1000 per month we are paying the insurance company through COBRA.
: My question in this: apart from any humanitarian or common-sense considerations (which I know are immaterial to the corporate parties in these situations--I merely mention them because we happen to be human beings not money-trees) surely we are being discriminated against by virtue of the fact that we pay through COBRA?
: If so, does not this run counter to the very principle of COBRA, which is the guaranteed right of consumers, once they pay up, to continue the same coverage? But I am being denied that coverage if my wife cannot "guest" on another network.
: Your thoughts and experience about this matter would be very welcome.
: Thanks
:
: /Fin