Question:

Changing Health Insurance companies?

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I've had my existing policy for 3yrs & I'm currently in the process of switching companies for cost reasons. This policy states:1) A pre-existing condition exists if a covered person received medical advice,diagnosis,care or treatment within 6 months prior to their enrollment date.

I have not received medical care of any kind in the last 25yrs, so this is not a problem.

2) Duration of Limitation - The pre-existing condition limit will not exceed 12 months from the effective date of the covered person.

Huh? So, my policy is set to start Aug.1st. What if i need medical treatment 6,8,11 months down the road & let's say(hypothetically) I'm diagnosed with some sort of cancer & the doctor reports that this cancer has been with me for over 2 yrs. Now what? Will this be considered a "Pre-existing" illness and my coverage will be null & void? Thanks in advance for any assistance.

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7 ANSWERS


  1. I don't want to be condescending  but if you have recently purchased a policy from an agent and that agent is not willing or able to answer this type of question or questions for you then maybe you need to seek a new agent.  My agent is great I had simular problems in a different way and he answered my questions by calling a Texas Health Insurance underwriter with Blue Cross and found out how I would be treated by underwriting before we even completed the application.  If your agent can't do that.  I suggest you get an agent like mine.  The company he works for is http://www.lvhealthins.com


  2. Maybe You should try to google it first ,nonetheless, if you prefer some direct resource ,here might be helpful.http://health-insurance.expert-tip.info/...

  3. Here is a typical definition of a pre-existing condition:

    A pre-existing condition is a sickness or an injury for which, within the 12-month period before the effective date of coverage, medical advice, consultation, or treatment was recommended or received, or symptoms existed that would ordinarily cause a prudent person to seek diagnosis, care, or treatment.

    You do not have a have pre-existing condition.  

    Don

    http://mtnhealthinsurance.com

  4. ~~As long as it was not a diagnosed and/or treated medical condition, then it is not a pre-existing medical condition. Then it also is stating your pre-existing will be treated no matter 12 month after your effective date. However, if you have no medical condition, or treatment, or diagnoses for the past 25 years, you will be covered upon your effective date.~~

  5. A pre-existing condition exists if a covered person received medical advice,diagnosis,care or treatment within 6 months prior to their enrollment date....that's pretty clear.  Something you don't know about would not have received advice, diagnosis, treatment or care....

  6. It won't matter if your doctor finds cancer and says that he thinks you've had it for two years. What matters is if you saw a doctor two years ago, and were diagnosed and/or treated for cancer two years ago. This is where the pre-existing limitations clause comes in.  If you had cancer and then have to get treatment for it  after the twelve month period, the company cannot deny coverage even though it was pre-existing. They didn't find it at the time of application. You didn't know that you had it, and they cannot deny coverage.

  7. Keep in mind that this condition, if undiscovered, would had to have been noticed and treated by a "prudent" individual.

    So, you should be fine.

    Ed Harris

    http://majormedicalhealth.com/

    http://www.ohioquotes.com

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