Heath Insurance question??

Question

I am in NC and need to know what exactly is continous coverage?We had coverage from a previous employer from 2-14-05 until 8-16-07. He left and we got insurance with another employer from 9-12-07 to 10-10-07 he left and started his current job on 10-15-07 and had a 90 day waiting period and insurance began on 1-13-08. His current insurance sent a letter stating they wanted creditable coverage letters that we had to have 18 month continous coverage from a previous employer OR previous health plan to avoid the pre-exisiting limitations.It stated they needed coverage letters for dates of 10-15-06 to 10-15-07.Said as long as we had no break of 63 days we would not be subject to the pre-exisiting limitations.SO is the insurance we had considered continous,we had no 63 day break ever?They sent us a letter stating we had over a 63 break in insurance and have1 year before any pre-exisiting conditions will be covered.This doesnt seem right to me and they are NOT helpful, it is Medcost Preferred

Answer 1

The 63 day rule is imposed by the federal government, not the insurance company. Here is a link for more information: http://www.dol.gov/ebsa/faqs/faq_consume...

Yes, as you can see by the website it is legal to deny coverage for pre-existing conditions if you've had a break in credible coverage over 63 days. It doesn't matter the reason. Many employers have a 3 or even a 6 month waiting period before you qualify for their health plan. This is one reason why COBRA or short term medical coverage plans are available.

Answer 2

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Answer 3

It sounds like a not easy cracking nut,have a look here,you should find something useful for you.

http://insurance.online-assistant.info

Answer 4

As long as you got certificates of coverage from each of these, there should not be a waiver for pre-existing. Contact your states insurance commissioner's office to see if you would qualify for the extended coverage period.

EDIT:It looks like they may be within their right's. But if he had an HMO under the COBRA from his previous employer, he may be eligible for a longer break. Check with the insurance commissioner's office in your state to be sure.

The key here is he did not have a 63 day break in employers, but he DID have a 63 day break in coverage (unless he continued it with the last employer.)