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Pre-Existing Condition & Insurance?

Hi all, Does anyone know about how this all works? It's kind of confusing to me. If I get laid off, I'm planning on getting on my partner's medical insurance right away. However, since I have MS, will there be a waiting period before they cover any of my MS related medical stuff?  

One of my co-workers has RA.  Once she started at my work, I know that our insurance isn't covering any of her RA expenses for 6 months. I do think it's because she had a gap in her insurance, but I'm not entirely for sure.  I'm going to ask her about it.

Thanks!
Kelly
Best Answer
279234 tn?1363105249
If you are currently covered on an insurance plan & you get laid off, & you plan to switch to your partner's plan RIGHT AWAY...then there shouldn't be an issue with pre-existing conditions. It's only when you have a lapse in coverage when this comes into play. I think when I looked up info on it, there is a certain amount of days that you shouldn't go without health insurance..They want you to have continuing coverage. Get proof from your old insurance company to show to the new one. It's called a certificate of continuing coverage.

Some insurance companies have clauses that won't cover pre-existing conditions anywhere from the time that you've had a lapse in coverage ( Let's just say that you didn't have  health insurance for 4 months...so the new insurance company would not cover your pre-existing condtion for 4 months), or say your lapse was longer..they might not cover for 6 months to a 1yr..

Whether you apply for COBRA through your work place if you get laid off, or if you get on a spouses plan, or go through the state ( medicaid or medicare), most of the time (at least from my experience), as long as there is no lapse in coverage..pre-existing conditions can not be held against you and the new insurance company must cover you.. The only exception is when you are buying private insurance. They will still cover pre-existing conditions as long as there is no lapse, but as soon as they find out you have one, your cost for your medical insurance is a lot.
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Avatar universal
Thanks everyone.  It sounds like it will probably go thru without a hitch (if/when I need it).  I'll probably just call the other insurance company to double check.  

The pre-existing condition legislation for adults doesn't start, yet. It's only started so far for dependent children. I don't think the adult part of it starts until either 2013 or 2014.

-Kelly
Helpful - 0
1896811 tn?1323978359
Does health care reform come into play here? I don't think that insurance companies are able to discriminate or have a pre-existing clause within their policies any longer.
With my brother's cancer this year, he was under my dad's insurance (he is only 23) but my dad just lost his job and my mom picked up the family insurance through her work (different insurance company). My brother is still dx with cancer and is still recieving treatment...NO QUESTIONS EVEN ASKED!
Helpful - 0
1979418 tn?1432135441

Call the new insurance company and ask...  It actually can vary depending on what type of coverage / policy is being paid for.  And it also depends on what state you're in, there are no tried and true rules for every insurance everywhere :)

I made the insurance switch after I got married and it happened during the month of diagnosis.  There was no pre-existing period and everything was picked up and paid from day one.  But, it was essentially the same company, I had BC Keystone East and went to BC PPO plan that my hubby's company pays for.  

Good luck and hope you have the same good news I got!!!

Jen
Helpful - 0
1382889 tn?1505071193
Idk the answer to this one but I am going to be reading the responses b/c my husband's company is moving to another city and we are not going.

It's not the loss of his job that worries me the most, it's the loss of the insurance. Won't happen until next year but you can never plan out these things too much.

Anyway, thanks for asking this question.

Julie
Helpful - 0
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