Will health insurance cover a serious pre-existing condition?

Question

I believe I may have a serious medical condition. I know I should go to the doctor ASAP but I have a concern about my health insurance. My coverage is ok but not the greatest. I may or may not be changing jobs and the new job has much better insurance. Also, I am currently on my wife's health insurance policy and she may be changing jobs in March. How do I know if my possible medical condition would be covered by any new insurance policy? If it turns out to be serious, I may not be able to afford to pay my medical bills if my new insurance carrier chooses not to cover it. What are my options?

Answer 1

(This answer assumes you are a U.S. resident.)

There is good news for you: the Health Insurance Portability and Accountability Act (HIPAA) will provide you with protection in this situation. There is not enough information to conclusively tell you whether the plan through your or your wife's new insurer will completely extinguish your pre-existing condition exclusionary period, but if you've been covered at least 18 months under a group plan, it definately will. Go here to read more:

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

If your or your wife's new plan has a "waiting period," all you have to do is elect COBRA during that period of time. Even if you choose not to elect COBRA, the waiting period cannot be counted as a period of lapse; therefore, it isn't counted against the 63-day period you'll read about in the link above.

p.s. -- I have expert knowledge regarding HIPAA provisions and there's alot of misinformation here about this issue. If you have any questions, please send me a message through Yahoo Answers.

Answer 2

Usually if you're moving from one employer-sponsored health plan to another the new carrier is required to cover your pre-existing condition immediately. But be careful, most health insurance laws are state-based and there are major differences between the states.

Your best best is to contact a local insurance agent. He or she should know the answer to your question off the top of their head. If you need help finding a local agent, you can visit the site of their national trade association at http://www.NAHU.org. Click on the consumer resources tab and the the "find an agent" link.

One caveat: if your're changing employers you might face a waiting period in your new job. So you may need to take advantage of COBRA or any state-required continuation of benefits priviledges available to you for a few months until your new coverage kicks in).

The bottom line: there's a good chance everything will be fine. Contact a good agent and find out for sure.

Answer 3

As long as you are continuously covered under medical insurance changing insurance companies will not matter. If, however, you had no insurance for more than 3 months and then you get insurance the company could choose not to cover the pre-existing condition. You should go ahead and change jobs now. By the time your wife changes jobs you should be eligible for insurance with your new job and can switch your coverage from your wife's to yours. Then you can cover your wife when she switches jobs for the period of time she won't be covered until she becomes eligible at her new job.

Good luck.

Answer 4

First things first, if you become terminally ill because you didn't go to the doctor, ask yourself this: will insurance cover me now or does it matter now? You need to go to the doctor if you seriously think you have a "serious medical condition". Insurance companies are mostly known to have rejected any applicants with any pre-existing conditions.

What you can do is find out from your "future employer" (if you are still going to change jobs) the insurance comapny the use and do a little searching yourself. Call them up and inquire. Won't hurt if they don't know you; will hurt if what you have is serious and you don't tend to it ASAP.

Answer 5

You ask a good question. If your or your wife`s new employer is a large company, their group policy will probably take you both the day of your or her employment, provided you sign up. No health questions ask.

By the same token the day you walk out the door that coverage may fall off. Then you get in to cobra

Ask questions and read all information. Each proposed employer could have a different contract.

Answer 6

You are right to be concerned about pre-existing conditions. Insurance is very crappy these days. Don't go to a doctor until you or your wife change jobs. that way, there will not be any record of a pre-existing condition. Usually the new insurance will not cover any condition existing 6 months prior to obtaining your new insurance.

Answer 7

You have to check with your state insurance commissioner. In most states if you change insurance within 30 days you are covered. The thing is that you can't go over 30 days without insurance, then your preexisting condition won't be covered

Answer 8

Hmo's will cover even after diagnosis. Go to the Dr.

The most important thing is to get medical attention asap. You can't wait what if you are waiting until it's too late and no amount of insurance will help you?

That being said. Just enroll in the co HMO. they pay the most for health care at the best price to you.

Answer 9

A lot of times, if you have a certificate that shows you were insured (evidence of insurability), and the previous condition was covered under the prior insurer, a new insurer will pick up the preexisting condition because there was no lapse in coverage.

You will have to make that a condition of new employment - or of your wife's new employment.

Answer 10

If it is serious, go to the doctor now.

You don't seem certain that you are changing jobs. On top of that, a new company may make you wait 90 days for coverage. Since you don't know the details of the plan you *might* end up on in several months, it is safer to go get yourself checked now.