Denied coverage for wife's pre-existing eating disorder? Posted: 04-14-08 21:58pm
I recently received a letter from my HSA
plan wanting to know previous docs that
had treated my wife for bulimia and why it
wasn't disclosed to them, because they
just received a claim from her. The
answer is because I didn't know about it
then. Apparently she had been treated on
our previous insurance without my
knowledge, and I personally filled out the
application for our current HSA. She had
her previous insurance for years and it
even overlapped our current HSA coverage
for 1 month. Does that mean that she can
be denied coverage or is she protected
under the "Portability" in HIPAA?
What are our options at this point?
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JM1983
New User, Becoming EHEALTHy
Joined: 07 Apr 2008 Posts: 4
Posted: 04-16-08 12:00pm
How long ago was her last treatment for
the eating disorder? What state are you
in? Both of these variables are very
important.
In most cases, HIPAA portability only
applies to those who are coming off of a
group health insurance plan with an
employer. To be HIPAA eligible, youi must
have either not been offered COBRA, or
accepted COBRA and exhausted the 18 month
period.
Do you own your own business?
Once you answer these questions I might be
able to extend some advice to you.
Thanks!
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avppro
New User, Becoming EHEALTHy
Joined: 14 Apr 2008 Posts: 2
Posted: 04-16-08 12:49pm
Well I have since learned that portability
doesn't apply since it was an individual
plan and the current HSA is an individual
one. We live in CO and I would say that
previous treatment was over a year maybe 2
prior to changing insurance.
I do own my own business. Are you asking
because it might make sense to start a
group policy of my own?
Thanks!
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JM1983
New User, Becoming EHEALTHy
Joined: 07 Apr 2008 Posts: 4
Posted: 04-16-08 12:56pm
yes I would recommend starting your own
small group policy. As long as you have
between 2-50 employees working at least 24
hours a week (This could be yourself and
wife) , and you have been in business at
least a year, you can get small group
coverage. This is "guaranteed issue"
coverage. If you PM me, I can try and
help you find some rates on this
