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prexisting condition
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prexisting condition

I have poly cystic ovarian syndrome (PCOS) recently i went to the doctor and took routine lab tests and the bill was around $800 because hormonal tests are expensive.  I work part time and just enrolled in health insurance this year, it is minimal coverage my annual maximum is $1000 i believe.  So after taking these lab tests my insurance company put that claim on hold and mailed me a letter saying they need my past 6 months of medical history.  I have to list in this form all the doctors i saw in the past 6 months.  So if they find this PCOS was preexisting condition would they terminate my claim and i will have to pay for this myself?? Just not sure how the new law works regarding preexisting condition?
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Dear sarah480,

It sounds like your current insurer is trying to determine if you were aware of this condition and/or consulted someone in the medical profession regarding this condition (in the past 6 months). If they establish that is the case, they might ask you why you did not mention it in your health insurance application (assuming you filled out one)! They will then have to decide the next steps based on your response.

The new law has set restrictions on rescinding policies. According to SEC. 2712. PROHIBITION ON RESCISSIONS; an insurer is not allowed to rescind an existing policy or coverage, unless a covered individual has done something that constitutes fraud or makes an “intentional misrepresentation” of material fact as prohibited by the terms of the plan or coverage.

I hope this helps you with your questions.

Sincerely,

Amir Mostafaie


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