Generally by asking about a pre-existing condition, the insurance company is looking for you to disclose any medical condition which you already have been diagnosed with and have been having treatment or are receiving some kind of care for. That's my understanding of it.
You need to check the individual insurer's guidelines though as it can vary from company to company and state to state. Some have a more stringent definition than others, for example it could mean any medical condition that's been dealt with in some way within six months prior to your application.
Please, always ask for clarification of what the terminology represents exactly from the company before signing up if you're unsure. Once you try to claim and find out your plan doesn't cover you after all because you misunderstood what it meant, it's too late.
The importance of that cannot be stressed enough or too many times. A few minutes invested can save a lot of heartache further down the line.
Hope that helps! :)
Posted: Fri Dec 14, 2007 09:22 am Post Subject:
In simple terms, the pre-existing condition is the medical condition that you are aware of at the time of enrolling for the health plan or may have been treated in the recent past. You need to disclose all your health related facts that's in your knowledge whenever you apply for the health plan.
There is a certain time limit that you need to wait, normally 12 to 18 months, before your policy coverage begins. This time limit is known as the pre-existing condition exclusion period. Within this waiting period the insurer may deny all the claims that are arising form the pre-existing conditions mentioned in the policy doc.
Rupert
Posted: Fri Dec 14, 2007 09:47 am Post Subject:
Lemme assure you that normal cough and cold isn't considered as the pre-existing condition.
Whenever, the insurers say pre-existing condition they normally refer to serious and terminal illnesses, which may require extensive medical care and may end up costing them hundreds and thousands.
There may be a huge list of diseases available with the insurers, if you are diagnosed with any of those prior to apply for the policy, you may even be denied of the coverage. Chronic cancer, cirrhosis if liver, type ‘A' diabetes, severe heart problems are few from the list. However, the range may very widely among the private insurers.
Posted: Fri Jun 11, 2010 09:23 pm Post Subject: strattera
My husband lost his job and doesnt qualify for cobra because his company has less than 20 employees. Is my daughter use of strattera for adhd covered with the new insurance or is it considered a prexisting condition. The school wont accept her without the medication.. What do I do?/
Posted: Sat Jun 12, 2010 05:44 am Post Subject:
My husband lost his job and doesnt qualify for cobra because his company has less than 20 employees. Is my daughter use of strattera for adhd covered with the new insurance or is it considered a prexisting condition. The school won't accept her without the medication.. What do I do?/
Depending on the state you reside in, you likely have the ability to secure coverage through a state mechanism specifically designed for small employer group that aren't COBRA qualified.
Depending on a number of things, which I'll get to in a minute, you should be able to secure guaranteed issue coverage without any pre-existing conditions exclusions for your daughter.
I need to know a few things to help you out:
1. What state do you live in?
2. How long was your family enrolled in the group plan from your husband's work?
3. How long has the coverage been terminated? This is REALLY IMPORTANT and I need to know SPECIFICS on this...it can't be a guess as to how long. I need the exact length of time the group coverage has been out of force.
Any missing info won't allow anyone to answer your questions... it's that specific. There are federal and state laws that are in place for exactly these situations, and your husband likely should have been informed of these options upon his separation from work.
Let us know the above and we'll see what we can do.
InsTeacher 8)
Posted: Sat Jun 12, 2010 07:35 pm Post Subject: insurance
(Thinking outloud here..)I thought alot of states consider ADHD a 'pre-existing' medical condition. I DO know someone who moved to another state (..from PA. I think she moved to Virginia) and she tried to get medical coverage for her teenage daughter. Her daughter had ADHD. She has looked into several Insurance companies...she's been denied by every one of them (I think 5 or 6, she said) because the companies are telling her that ADHD is a 'pre-exising' condition. :cry:
Posted: Fri Dec 14, 2007 12:32 am Post Subject:
what is pre-existing condition?
Generally by asking about a pre-existing condition, the insurance company is looking for you to disclose any medical condition which you already have been diagnosed with and have been having treatment or are receiving some kind of care for. That's my understanding of it.
You need to check the individual insurer's guidelines though as it can vary from company to company and state to state. Some have a more stringent definition than others, for example it could mean any medical condition that's been dealt with in some way within six months prior to your application.
Please, always ask for clarification of what the terminology represents exactly from the company before signing up if you're unsure. Once you try to claim and find out your plan doesn't cover you after all because you misunderstood what it meant, it's too late.
The importance of that cannot be stressed enough or too many times. A few minutes invested can save a lot of heartache further down the line.
Hope that helps! :)
Posted: Fri Dec 14, 2007 09:22 am Post Subject:
In simple terms, the pre-existing condition is the medical condition that you are aware of at the time of enrolling for the health plan or may have been treated in the recent past. You need to disclose all your health related facts that's in your knowledge whenever you apply for the health plan.
There is a certain time limit that you need to wait, normally 12 to 18 months, before your policy coverage begins. This time limit is known as the pre-existing condition exclusion period. Within this waiting period the insurer may deny all the claims that are arising form the pre-existing conditions mentioned in the policy doc.
Rupert
Posted: Fri Dec 14, 2007 09:47 am Post Subject:
Lemme assure you that normal cough and cold isn't considered as the pre-existing condition.
Whenever, the insurers say pre-existing condition they normally refer to serious and terminal illnesses, which may require extensive medical care and may end up costing them hundreds and thousands.
There may be a huge list of diseases available with the insurers, if you are diagnosed with any of those prior to apply for the policy, you may even be denied of the coverage. Chronic cancer, cirrhosis if liver, type ‘A' diabetes, severe heart problems are few from the list. However, the range may very widely among the private insurers.
Posted: Fri Jun 11, 2010 09:23 pm Post Subject: strattera
My husband lost his job and doesnt qualify for cobra because his company has less than 20 employees. Is my daughter use of strattera for adhd covered with the new insurance or is it considered a prexisting condition. The school wont accept her without the medication.. What do I do?/
Posted: Sat Jun 12, 2010 05:44 am Post Subject:
My husband lost his job and doesnt qualify for cobra because his company has less than 20 employees. Is my daughter use of strattera for adhd covered with the new insurance or is it considered a prexisting condition. The school won't accept her without the medication.. What do I do?/
Depending on the state you reside in, you likely have the ability to secure coverage through a state mechanism specifically designed for small employer group that aren't COBRA qualified.
Depending on a number of things, which I'll get to in a minute, you should be able to secure guaranteed issue coverage without any pre-existing conditions exclusions for your daughter.
I need to know a few things to help you out:
1. What state do you live in?
2. How long was your family enrolled in the group plan from your husband's work?
3. How long has the coverage been terminated? This is REALLY IMPORTANT and I need to know SPECIFICS on this...it can't be a guess as to how long. I need the exact length of time the group coverage has been out of force.
Any missing info won't allow anyone to answer your questions... it's that specific. There are federal and state laws that are in place for exactly these situations, and your husband likely should have been informed of these options upon his separation from work.
Let us know the above and we'll see what we can do.
InsTeacher 8)
Posted: Sat Jun 12, 2010 07:35 pm Post Subject: insurance
(Thinking outloud here..)I thought alot of states consider ADHD a 'pre-existing' medical condition. I DO know someone who moved to another state (..from PA. I think she moved to Virginia) and she tried to get medical coverage for her teenage daughter. Her daughter had ADHD. She has looked into several Insurance companies...she's been denied by every one of them (I think 5 or 6, she said) because the companies are telling her that ADHD is a 'pre-exising' condition. :cry:
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