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Case Management Agencies/Worth It?
Jul 25, 2000

I'm not sure if i'm in the right forum to ask this so feel free to advise me somewhere else. I'm currently employed and have full medical coverage, they pay for my medication which just passed the 2 year mark. So I'm thinking about changing jobs, which means new company and new insurance. I'm familiar with the HIPAA of 1996, I actually had my insurance company send me a copy of my creditable coverage form,just in case I get a new job and the Plan Admin. needs this to prove that I have been covered. This is my question...If I take this new position it will be a sizeable salary cut for the fist two years. It's a large company so I'm sure I wouldn't be the only one who works there with HIV, I just didn't want to be suspicious submitting my creditable coverage letter 30 days after I start,(that's when your insurance takes effect).So what I'm wondering is should I try to enroll with a case management agency where they help people with low incomes get their meds, even sometimes at no charge. I have read a lot about them but I wanted your opinion because you've given me some knowledgeable advice in the past. If you know any more about this please let me know. Thanks.

Response from Ms. Breuer

Please don't worry about giving the employer your certificate of creditable coverage. This certificate says nothing about your health status. It is only used by the new employer if he has a pre-existing condition clause in his health plan. If he does and the new employee has a certificate of creditable coverage that shows that he has had continuous coverage for at least 12 months without a break in coverage of greater than 63 days, then the new employer must waive the pre-existing condition clause for that employee. If the employee has less than 12 months of creditable coverage, the employer will use whatever months he does have to apply to the pre-existing condition limitation period. If the new plan doesn't have a pre-existing condition clause, the certificate is unnecessary.



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