Has anyone run into insurance coverage provided by their employer which has pre-existing conditions clauses? I hadn't run into that in over 20 years, and just hit it with my husband's insurance. That should end next year.
Hello.A preexisting condition can only be classified as a condition that was in effect six months prior to the effective date of the policy, and, further, it can only be excluded for one year after the effective date of the insurance policy.Basically it means that when one completes an application for health insurance that provides full coverage, they are asked medical questions pertaining to their medical history. If a person is honest and lists a preexisting condition then it will simply follow the policy guidelines as to execution, however, if a person does not list a condition, through an admitted and “permission-sought” procedure, the insurance company can check a virtual medical bureau of people’s health called The Medical Information Bureau and through information seeking methods locate said medical history.Gook luck!
Source: www.boltinsurance.com/
Source: www.boltinsurance.com/
Typically it is when you didn't have credible coverage within 61 days (depending on plan and state laws). When you can't provide proof of credible coverage then the plan will exclude treatment for the pre-existing condition. The healthcare reform pre-existing condition change for adults doesn't change until 2013 or 2014. In 2011 insurnace companies will not be able to deny care for a child under the age of 19 for a pre-existing condition.
Generally the preexisting clause applies to two situations, the first being the group health company needs to have a Certificate of Credible Coverage submitted to them from your prior health coverage provider or the second reason is an individual does not have any record of having coverage. There is usually a time period where there cannot be any lapse in coverage such as 90 days but that may depend on the resident state, but it seems to me that is a federal law but please do not quote me on that statement. What I would suggest is contacting your husband's HR department and or the person within the company who is responsible for employee benefits and ask them what needs to be done especially if you have had prior coverage, which I assume you did. Oh one other thing is it seems to me there was recently a federal law passed that was to effectively get rid of the preexisting clause statement but I cannot recall when it is to go into effect. Again, please do not quote me on that because I have not searched to verify it. If I have a chance I will do some digging to see if that is indeed the case or if it was something Washington was trying to get included in the National Health Plan. Take care, Dave
I had forgotten about the Cert. Of Cred. Coverage, which I received a copy of just the other day from my HR dept. I think you're right, and that would override the preexisting conditions clause in any new coverage. The new federal law should take precedence and prevent preexisting conditions as a disqualifier of coverage - which I think takes effect on Jan 1. by Chapps 2 years ago
I was once denied meds due to a pre-existing conditions because the meds were very expensive. It was a interfuron treatment for my liver. I went to my HR Manger and she bullied them into giving me the meds. When I was laid off my husbands company picked me up on his insurance when mine ran out. I have not had any problem with pre-existing condition. In fact someone else with the company has had a cancer relapse after starting and he has been covered. I should mention that my husbands company is self-insured.

