Advice on US Health Insurance
A copy of a September 2005 post from Jeff Horton
I have seen several responses to your post, which provide various perspectives
to your question.
Several posts reference HIPPA. In regard to issues regarding new or existing
employment the Americans
with Disabilities Act (also known as the "ADA") is something I recommend you
also become familiar with.
ADA applies to firms with at least 15 employees. In accordance with ADA, an
employer may not ask
questions about a prospective hire's medical condition or require an applicant
to have a medical
examination before it makes a conditional job offer.
After you are extended a job offer, an employer may ask questions about your
medical history and may
require a medical examination as long as it treats all applicants for the same
type of position in the
same manner. Even if you disclose you have cancer in an interview, an employer
has no right under ADA to
ask about your condition, treatment, or prognosis, (doesn't mean they won't ask
anyway). An employer has every right and expectation to know about any medical
issues you have after making an offer, since it must determine whether you may
require some accommodation (this is a legal term under ADA) due to your
condition. ADA does not require employers to provide health insurance; however,
ADA does require a fairness standard and an employer who denies you health
insurance when there are other employees with jobs similar to yours who have it
may be engaging in discriminatory practices under ADA.
You need to educate yourself, because in addition to federal laws, employment
and insurance issues vary by
state. For example, for HIPPA to apply you must be HIPPA eligible and states
vary in how HIPPA is implemented. Time limits may apply in some cases for
certain actions you may want to consider, so you need get up to speed quickly.
Here are some resources you and others dealing with these issues may be well
served to consider:
The National Coalition for Cancer Survivorship links on employment rights
(http://www.cansearch.org/resources/essential/employment.aspx) and health
insurance (http://www.cansearch.org/resources/essential/insurance.aspx).
Note that The Leukemia and Lymphoma Society references this same material on
their web site
regarding these issues.
The Georgetown University Health Policy Institute has written Consumer Guide for
Getting and Keeping
Health Insurance for each state and D.C. (http://www.healthinsuranceinfo.net).
Get the guides for the state you live in now and any states you may be
considering relocating to.
The U.S. Equal Employment Opportunity Commission (EEOC) website link titled
Questions and Answers About Cancer in the Workplace and the Americans with
Disabilities Act (ADA) (http://www.eeoc.gov/facts/cancer.html).
The NCCS and Georgetown sites have additional resource links, so I will stop
here.
As a closing point, I understand your concerns very well. I have a small
consulting business and have
been in management in the Fortune 500 world. As confusing and challenging
employment and insurance
issues are consumer, they are in many ways more so for business and often just
as important financially (especially for small business). Although, it is often
easy to recognize all the legitimate horror stories there are out there for
individuals seeking healthcare benefits, there are many examples of where the
system works and companies do the right thing by their employees (and not just
because they have to). In my own case, I returned to the corporate world late
year after being diagnosed with CLL (stage 0, with all the good indicators for
slow/no progression. Although, I had significant concerns about getting
employment and insurance due to my diagnosis, I did not encounter any problems.
The company I work for simply followed the appropriate protocols. Your chances
of things going smoothly in the private sector are probably going to be greater
with a large publicly traded company than a smaller company or a privately held
company.
Educate yourself and best of luck.
Jeff
Richmond VA
Stage 0, w&w