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Member
Member Since Dec 2010
Posts: 26
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Dec 19, 2010 at 10:04 PM
#1
i have medical insurance but they say there is a preexisting clause on it. we got it in april and my husband went to an IOP program. i am bipolar and have been on charity care for the past year. it just resently ended. i want to go see a doctor with our health insurance but im scared that they wont cover it since i have seen a doctor within the last year. im not to sure what to do i call the insurnce company and it seems like they wont cover it. but the hospital said they also called them and they said they would. im not to sure what to do.
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Legendary
Member Since Aug 2007
Location: West of Tampa Bay, East of the Gulf of Mexico
Posts: 14,352
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Dec 19, 2010 at 10:57 PM
#2
The pre-existing condition exclusion clause has a time limit. The condition is not covered for a certain period of time. Check your insurance policy/coverage information to read about the pre-existing condition exclusion. If it is not clear, call the insurance company and ask specifically when the condition will be covered--the exact date.
If, for example, the exclusion is for 6 months, then the condition would now be covered since the insurance began in April. I wonder if the visit would be able to be covered under the charity program if the insurance doesn't pay. |
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Pandita-in-training
Member Since Sep 2006
Location: Maryland
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Dec 20, 2010 at 03:16 PM
#3
If your charity care has been your primary care-giver until recently, the pre-existing clause time limit might just be starting for you as you didn't use/have the April insurance coverage until now?
I would call the insurance company back and ask them specifically about your April insurance, how long it's pre-existing clause time limit is, what it covers, and when you, specifically, started primary coverage with that insurance and check that, "So I am now completely covered, even for pre-existing conditions?". But it sounds like you most need to know when you were covered by this insurance and then add how many months to that date, not the date you bought the policy to know when pre-existing conditions were and/or the exact month you had care last versus whether that would count during the period (i.e., if it's a six month pre-existing clause and you had care eight months ago, you should be clear). __________________ "Never give a sword to a man who can't dance." ~Confucius |
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Dec 23, 2010 at 08:10 PM
#4
Hello, chiggins. If you live in the United States, you would benefit from talking to someone at your state's department of insurance:
http://www.naic.org/documents/consum...e_contacts.pdf http://en.wikipedia.org/wiki/Pre-existing_condition Good luck. |
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