pre-existing conditions

Hi, I'm considering purchasing an individual health insurance plan. I haven't been covered by any insurance for the past two years. I have no  pre-existing conditions. My question is this: Is there a waiting period after you purchase an individual policy before you can see a doctor and if not what if you see a doctor a week after purchasing a policy and find out you have a condition you didn't know you had such as asthma or diabetes for example. Would you be denied coverage even though you had never been diagnosed before? Do the same rules apply for group coverage? Thanks for your time.

[Amir Mostafaie]

Dear gw74,

Some carriers impose a short waiting period (like 2-4 weeks) on treatment of certain conditions like accidental injuries, hernia or chronic tonsillitis. This is to discourage anyone from applying for coverage knowing they need the treatment soon.

The other factor that can play into this is whether the condition manifested (clearly apparent to the sight or understanding) itself before the plan was purchased. Let’s take one of your examples like “Asthma”; if a person has had problems with respiration, wheezing, difficulty in expiration, accompanied by coughing and a feeling of constriction in the chest for 9 months prior to purchasing a plan, they might have issues.

My advice is to work with a licensed agent & be completely upfront. You can find a local agent or an online agency (like eHealthInsurance.com, where I work), as long as the agent represents multiple carriers in your area.

Group insurance is generally more lenient with these types of issues.

Sincerely,

Amir Mostafaie