Question:

What should I do about a Pre-Existing conditon?

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As of last November, I tried joining the Army. While going through a physical, the doctor discovered that I had a heart murmur and requested that I get all information concerning this from my doctor. My doctor sent me to a Cardiologist to have an echo done to be certain what the issue was. The Cardiologist found out that I actually have a rare birth defect called Hypertrophic-Obstructive Cardiomyopathy (HOCM for short). As far as I've been told, this is correctable through surgery but, I don't have insurance because I'm not in college and my current employer is insisting I work there at least a year before they might cover it because it's a pre-existing condition. The problem is that I can't. I'm currently working two jobs because my first one doesn't have insurance and the second one does, but doesn't pay enough for me to use just that job. I'm not at the point where surgery is necessary yet, but it is necessary if I want to join Army still, like I do. What should I do?

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  1. I had a pre-existing condition too, and I had no insurance at all. I contacted an insurance agency that helped me find an insurance that accepted me even without prior insurance.


  2. No company will accept you and cover that condition before your employer will cover it.  If you want the surgery you need to get it in writing from the Insurance Company your boss has his group health policy.  Not about your condition specifically but that pre-existing conditions will be covered after 12 months of coverage.  The other option is Risk Pool coverage.  You can call your department of insurance and get the number for your state's health insurance risk pool.

  3. Research, there are insurance co that will accept you.

  4. Well, I would go back to your employer and tell them they can't exclude this as pre-existing. Here is the federal guideline:

    "If you had a medical condition in the past, but have not received any medical advise, diagnosis, care or treatment within the 6 months prior to your enrollment date in the plan, your old condition is not a preexisting condition to which an exclusion can be applied. "

    From your question, I am assuming that you were on the insurance prior to finding out that you had a heart murmer and since you did not know about it, had never been diagnosed, recieved medical advise or treatment for it. Therefore, it cannot be considered pre-existing.

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