Pre-existing conditions are typically not covered by insurance plans, so my initial thought on this is that you will not be covered should you want to get surgery for a condition in the past. Please let me know if you find otherwise!

Do you have a group policy or individual? If you have group and you joined during open enrollment you are probably safe. If you have individual were you honest on your ap? If so and they did not add any riders excluding these conditions your probably safe.

Hello there,

Typically, pre-exisiting condition clauses in policies are generally for specific periods of time, usually 6 months.

As what other people have said, if you have an individual insurance policy, they would need to be aware of the condition during the application process. It's so important to disclose everything while you're applying for coverage.

The other issue with reconstructive surgery is that they will most likely require specific documentation advising that this surgery is not cosmetic and is actually medically necessary.


Kathy K

Pre-existing conditions only apply if you have had a break in coverage longer than 65 days. If you did have a break longer than that then the insurance company will do a pre-existing investigation which entails sending you a letter asking for the name and address of each provider you have seen in the past 6 months and a copy of your prescription records from the pharmacy you use. When you send that info in the insurance company will then send letters to each provider requesting office treatment notes. As long as you have not been treated for anything chronic you will be fine. If it is found that you do have a chronic condition then you will not have coverage for that condition for the length of your waiting period which is typically 1 year.

I just canceled my existing policy as I moved out of state, and it followed me to AZ where it was costing $850/month. I applied for AZ coverage online, THEN canceled my old policy. I got a letter telling me I had to submit records to them based on my previous doctor visits. This is scary...I didn't consider I might be denied when I canceled. Do they HAVE to cover anything they might consider pre-existing considering I applied (although not accepted yet) BEFORE I canceled my old policy? Thanks for you knowledge of this and advice.