Prior injuries and changing health insurance companies Posted: 06-19-08 01:17am
I was injured a little over one year ago
and had some reconstructive surgery done
for a trauma but did not have every
surgery I needed due to financial
difficulties.
Since then I had to cancel my health
insurance for a few months due to
unemployment. Now that I have a new
health insurance plan, will my current
plan cover my prior injuries if I wanted
to get the surgeries that I didn't get
before?
Thanks.
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ahsu7
New User, Becoming EHEALTHy
Joined: 20 Jun 2008 Posts: 1 Location: www.PacificPrime.com, www.PacificPrime.com
Posted: 06-20-08 02:34am
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!
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Coast Life and Health
New User, Becoming EHEALTHy
Joined: 12 Jul 2008 Posts: 5
Posted: 07-12-08 14:13pm
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.
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katherinek74
New User, Becoming EHEALTHy
Joined: 13 Jul 2008 Posts: 5
Prior Injuries Posted: 07-15-08 23:00pm
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
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dexy39
New User, Becoming EHEALTHy
Joined: 17 Jul 2008 Posts: 1
Posted: 07-17-08 19:24pm
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.
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roxgro
New User, Becoming EHEALTHy
Joined: 08 Aug 2008 Posts: 4
Break in coverage ..... Posted: 08-08-08 21:06pm
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.
