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General Forum Topics > Health Insurance Forum > "pre-exisiting Conditions" Question.....
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Q: "pre-exisiting Conditions" Question.....
asked by: MarcusV1 on August 17th, 2007
New User
Does company policy vary from company to company regarding the number of months after the initial activation of the policy (ie E 12 months, 24 months, Zero months...etc) that a claim can be made for a condition not originally made known on the application? I live in Indiana.

I'ver heard about an "incontestible period" (Federal Law(?) where-as an applicant can make a claim for a pre-exisiting condition after 12/24(?) months of coverage even though it wasn't listed on the original application or made known to the insurer.

Is there any truth (or variations) to the above? Does it vary from company to company or is it all just considered insurance fraud?

Please advise?

Thanks!
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DoorIn
replied on August 23rd, 2007
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With Health Insurance, a policy is always contestable.

That being said, each company handles pre-existing conditions differently. It also depends if you have a group policy, individual policy, and if you had credible coverage before.

With some, you may not be eligible, with others, they may excluded, or rider that conditions. There are some that will have you wait 12 months before it is covered and some that may cover that condition right away.

That's why honesty is truly the best policy.

Your thinking of Life insurance, where the contestable period is 2 years, after which the policy can not be rescinded other than for non-payment.
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frank123
replied on August 28th, 2007
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Hi ..i am new to this.
Basically, I had good Blue Cross Blue Shield Group coverage for 9 years and then I lost my job. Was on Cobra (from Jan to end June this year- for six months) as it was free for me for 6 months only (did not want to go full 18 months as its expensive after the first 6 months of COBRA). Got on Goldenrule.com's short term policy for July and Aug and about to sign up for Blue Cross individual policy which is like $425 per month for me and wife (with maternity coverage). They said that cataract surgery I had before will not be covered for at least 2 more years. How come? I have certficate of pre-existing coverage from my former group plan? But then they exclude me for this?!! Is it because I am moving from a group policy to a individual one even though I am with the same company? Dont know much about health insurance so please advise!! Thanks !
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Carifairy
replied on August 28th, 2007
Extremely eHealthy
Usually pre existing conditions do not count when you switch from one plan to another..

It can vary though, I am sure.
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DoorIn
replied on August 28th, 2007
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Private Health Insurance plans are much more affordable than group plans. That's because they handle pre-existing conditions differently.

With group, as long as you have a continuation of coverage, your pre-existing conditions will most likely be covered.

With Individual, it doesn't matter in most cases. They don't generally cover pre-existing conditions and can therefore charge significantly less.

Think of it like you would auto insurance. If an Insurance Company had to cover and pay for the repairs on an automobile that already had banged up fenders before the insurance policy’s inception, that insurance policy and everyone else’s insurance policy would have to cost a lot more than if they just excluded those fenders. Make sense?
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