Will my current insurance cover an injury that occurred last year while I had different coverage?
I hurt my shoulder last summer. It's not too bad on a day to day basis, but it does get sore and stiff if used much. I have not visited a doctor, but have spoken about it with several knowledgeable people and strongly suspect that surgery will be required to make it right. I have had continuous coverage through my employer, since before the injury, but our plans changed on 1/1/10. I'd prefer coverage under the new plan, but am concerned that since the injury occurred before my current coverage began, there could be an issue, especially for something as expensive as surgery.
Will the current insurance cover this without problem due to the date of the injury? Will they try to push it back to my carrier at the time of the injury, and if so, how will my previous carrier react?
Health Insurance claims are always subject to review & approval by the insurance carrier, but in my experience your current employer sponsored group plan should cover the treatment of your shoulder. That is because as long as you have had continuous credible coverage (which includes group plans), your pre-existing conditions are covered by your current plan.
Having said that even though you remember getting injured last summer, you can’t be certain that your current pain is due to that particular injury; I recommend you tell your doctor everything that you know (including the injury) & let him diagnose you. But either way there should be no concern as for the time of the injury.
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