frustrated with insurance company

sdaniel75 · August 6, 2007

:angry I just recieved a call today from the clinic stating that when she called my insurance company they said my policy had a pre-existing claus in it. Due to this it may not be covered. Has anyone else had this happen to them? My insurance company is BC/BS PPO. I just hope that all the testing and things I already have scheduled will not be for nothing. When I called the insurance to see if they covered this and what I had to do they said nothing about considering this as a pre-existing condition.

Alexandra · August 6, 2007

Did you have insurance prior to being picked up by this current company? If you had continuous coverage, your new carrier CANNOT exclude anything as a pre-existing condition. What are the circumstances of your starting coverage with BCBS (new job, loss of job, individual coverage, etc.)?

sdaniel75 · August 6, 2007

No I didn't have any insurance because the job I had didn't offer it. So I guess this is just 1 more battle I will have to fight.

Candle · August 7, 2007

When I switched insurance companies recently, they wanted to see that I had 18 months of continuous coverage previously. Other wise they can deny things deemed "pre-existing"

I think 18 months is the norm.

How long do you have to wait for coverage? 12 months?

Alexandra · August 7, 2007

No I didn't have any insurance because the job I had didn't offer it. So I guess this is just 1 more battle I will have to fight.

Well, in that case your carrier does have the right to exclude treatment for pre-existing conditions for some period of time. It's typically 12 months for individual policies.

This does not mean it's "all for nothing," though. You just have to wait a bit. You're in much better shape than someone who has insurance that doesn't cover it at all!!

sdaniel75 · August 8, 2007

thank you for responding and you are right. I believe this is worth waiting for. The decision to have the surgery was not made overnight so I am willing to do whatever it takes. I have to wait until April and then it will be covered. I also found out that all the testing I have already had done for the insurance company will still be good and I will not have to do it again. A little disappointed that I have to wait, But you are right atleast I am able to have it covered.