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Ely
Ely, Counselor at Law
Category: Employment Law
Satisfied Customers: 101572
Experience:  Years of experience in running a medium sized law firm.
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My wife missed her Kaiser enrollment in Nov. 2015 (a

Customer Question

My wife missed her Kaiser enrollment in Nov. 2015 (a mistake), found out no more Kaiser after Jan. 1 2016, and was diagnosed with breast cancer in December 2015, had surgery on 12/22, and her appeal to Kaiser has just been denied. Can we appeal this denial, and if still denied what are other options. She is currently scheduled to begin chemo in early February.
Submitted: 1 year ago.
Category: Employment Law
Expert:  Ely replied 1 year ago.

Hello and welcome to JustAnswer. Please note: This is general information and is not legal advice. No specific course of action is proposed herein, and no attorney-client relationship or privilege is formed by speaking to an expert on this site. By continuing, you confirm that you understand and agree to these terms.

I am very sorry to hear about this whole situation. It is possible to appeal the decision, but this would have to be done on a court level. I am guessing your appeals so far have been via an administrative procedure. If so, then once that administrative procedure runs out, there is no more right to appeal per se "internally" but one can take the matter to a civil court and let the court decide.

Assuming this fails or assuming one feels that success is unlikely, there is insurance for individuals with preexisting conditions - under he new insurance laws, companies generally cannot deny her coverage based on her condition alone. However, she may have to get insurance elsewhere other than work. See HERE.

Good luck.

I hope this helps and clarifies. Gentle Reminder: Use the SEND or REPLY button to keep chatting, or please rate when finished. You may always ask follow ups at no charge after rating. Kindly rate my answer as one of the top three faces/stars and then SUBMIT, as this is how I get credit for my time with you. Rating my answer the bottom two faces/stars or failing to submit the rating does not give me credit and reflects poorly on me, even if my answer is correct. I work very hard to formulate an informative and honest answer for you; please reciprocate my good faith.

Expert:  Ely replied 1 year ago.
Hello again. I am checking in because you have not rated positively. To me this means you may have another question. Please let me know – I am simply touching base. Thanks!

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