Private Health Insurance - Questions regarding 'Pre Existing Ailments'?

Question

1. What exactly is regarded as a 'pre existing ailment'? Do I just need to declare the more obvious ones such as blood disorders or viruses (such as AIDS/HIV), or even little ones such as a small cut on my forehead which I obtained when I was 2 years old?

2. Do I need to declare anything at all? What happens if I dont declare anything?

Answer 1

When you apply for insurance, it is very important you answer all questions truthfully.Failure to disclose known health problems can result in major cost to you.Let's say you have been diagnosed with a stomach ulcer for which you take OTC medicine and watch what you eat.You apply for insurance but do not list this problem.Policy is put into effect, you get a card, all is well. Six mos later you are rushed to ER vomiting blood. You aren't thinking about anything but getting better, as you explain your complete history to the ER doctor. Your claim is recvd by the new ins, they send for a copy of the ER visit (very common practice, especially for ER visits) and there it is: you lied on your application. Yes,omitting info is the same as.Now they refuse to pay ANY of these expenses, even though you have been paying premiums for 6 mos! And your future claims will certainly receive close scrutiny. Always be truthful. You don't have to list a 20 yr old minor injury, but give the names of your doctors, disclose any known health problems for which you have seen a doctor. Most companies will only exclude pre-existing conditions for 2 years, and in some cases (if you are stable) they may allow them sooner, ex: blood pressure controlled w/ meds x 5 yrs. Now the Good News: if you have been continuously covered by ins and lose/drop coverage, as long as the lapse in coverage is less than 45 days, pre-existing does not apply. At least not in Texas.(Not sure about all other states) Good luck.

Answer 2

your insurance company provides you with a handbook to explain the answers to your questions -contact them.