Switching from United Health Care to Blue Cross/Blue Shield question re: pre-existing pregnancy.?

Question

I will be switching jobs from a 50+ person company with UNited Health Care to a less than 50 company with Blue Cross/Blue Shield. My wife is pregnant, would that be covered or considered pre-existing?

Answer 1

Under the provisions of the Health Insurance Portability and Accountability Act (HIPAA), pregnancy CANNOT be considered a pre-existing condition under a group policy, whether you have previous coverage or not, or whether there's a gap or not.

Go here: http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html and read question # 18, "What is a pre-existing condition."

Answer 2

Sorry about your mother's stomach trouble. Unfortunately, the others are correct that the colonoscopy is related to the diverticulitis & therefore would be considered pre-existing. It's a shame or she didn't verify with the doctor's office or BCBS the possibility of it being pre-existing. Right now, practically all health coverage has a pre-existing conditions exclusion that lasts up to 18 months (reduced by any previous recent coverage); this is a HIPAA provision. The only exceptions I'm aware of are Medicare and Medicare supplement plans obtained thru the Federal open enrollment period (the first 6 months after the beneficiary's Part B effective date AND 65th B-day. I'd see about contacting the providers and explain your circumstances, asking for a reduction in the charges and/or a payment plan to pay it off, even just a few dollars per month. Good luck!

Answer 3

Lifesajoy is right. If you go from one insurance immedately to another, you should be okay. You should get a letter of termination from the United HC plan because more than likely when the first claim for Blue Cross/Blue Shield is filed, they're going to send you a letter asking for "Coordination of Benefits" - meaning is there ANY other insurance that could possibly pay for the claim. There's often a phone number to call, if not Xerox the termination letter from United and send it to BCBS.

Answer 4

Unless you have a gap in your coverage, I believe 2-3 months minimum, you should be just fine.

It's typically when you're uninsured, then try to get insurance, that the preexisting stuff is a problem. Continuing coverage through a job switch should be fine.

I've had ongoing illnesses (allergies), that require all sorts of prescriptions and doctor visits, and I've never had a problem when I've switched companies.

Answer 5

Typically - if you go from one insurance coverage to another - everything is covered. The pre-existing only comes into play when you have a gap of no insurance and then get insurance.

Answer 6

lifesajoy is right. as long as there's no gap (and as long as the policies are generally equivalent), there won't be a problem.