Kids Under 5
- I lost my job and have been without coverage for over 63 days. I have two kids under 5 that had tubes put in their ears under the pervious insurance. The new insurance company has told me that they will not cover anything to due with my kids tubes since this is considered pre-existing. The new insurance is supposed to kick in after I sign an agreement for the kids. If I wait until September 2010 to enroll in the insurance plan, does the insurance company have to cover the kids pre-existing condition? Ryan: The new law includes new rules to prevent insurance companies from denying coverage to children under the age of 19 due to a pre-existing condition. Effective for health plan years beginning on or after September 23, 2010 for new plans and existing group plans.
- —Guest Ryan
Child Denied Coverage Pre Existing Cond
- My son now age 15 was diagnosed as SGA and has been taking human growth horomone injections which are very expensive. On 8/31/10 my extended COBRA group medical coverage with United Health Care expires. On 7/30/10 I applied for FACT group coverage in Florida offered by Golden Rule an affiliate of UHC. They have excluded my son from coverage under the group family policy we applied for due to the fact that he has been treated for the SGA growth disorder. My understanding of HIPAA and the new healthcare legislations is that my son cannot be legally excluded from our family coverage under a new group policy if we receive coverage within 63 or fewer days in the case of HIPAA or that his pre-existing condition cannot be excluded from coverage as of 9/23/10 in the case of the new healthcare act. Am I correct in my understanding, and if so where can I go in the state of Florida to get this corrected?
- —DAlanSmith
MOTORCYCLE ACCIDENT- ISURANCE KICKED IN
- Hello- I am confused on the Pre Existing exclushions and waiting period and really need to be educated on this. I was hurt in a motorcycle/dog incident this year in june 2010........10 days later- our insurance kicked in.......we had no coverage for 18 months straight, due to my husband losing his job after 20 yrs. My injuries were Broken collar bone- 4 fractured ribs and now, after several x-rays- the dr said i had a non-union injury and my collar bone is not healing....needing surgery to put in a plate. i am 48 and scared, due to not only having the surgery- but to come back in 1 year to remove the plate, along with physical theapy. Here is the thing- We had to hire a personal injury Attorney to make sure that my medical will be covered under the owner of the dog's homeowners ins- but without insurance- i feel we will go over any amount we may receive in a settlement. Is there a waiting period of somekind- or am i just in a bad way? we have basic BC/BS and live in SC
- —Guest LINDA TURLINGTON
self employed
- type 2 diabetic for 15 yrs...all of a sudden diabetes went crazy & dr put me on 2 kinds of insulin..doing fine now..Ive called numerous ins companies looking cheaper ins & no co will even talk to me..they say Im lucky to have BCBS..they cant help me..so if I loose BCBS in Jan b/c of hike rate Im left with no ins..anybody know of a co I can check out? Note from Dr. Mike: Since you currently have health insurance, you do not qualify for one of the temporary high-risk pools in your state. In 2014, the new health exchanges start and you should have access to more affordable options. Until then, private insurance companies can deny you coverage because of a pre-existing condition, such as diabetes. Hopefully your premiums won't go up too much. You may also want to consider a BCBS plan with a higher deductible.
- —Guest Loretta Jean
Denied INS coverage
- I had an echocardiogram for valve prolapsed, I had a ZERO day lag in insurance. Four mos after I got my new job they declined me due to preexisting condition exclusion. Again, I had literally no days in insurance lag and proved that through a letter from my proir insurer to my curent ins my company yet they are still denying coverage! Note from Dr. Mike: Take a look at your benefit book and check if you are subject to a 6-month waiting period for a pre-existing condition. If you are working for a large company that is self-insured, your company may be exempt from some of the continuation-of-coverage rules. You also have the right to appeal the decision, and depending in which state you live, you may be able to have a review by an independent group outside of the health plan.
- —Guest Kc
Denined insurance coverage
- I am 10 days away from first anerversary date and was denied coverage from new insurance due to preexisting clause. My insurance before this one there was a lapse of 67 days. I could not afford COBRA inbetween jobs. I had not had a problem with my Caupal Tunnel for over 4 years. I now have a problem and in need for operation and insurance company making me wait till after my August 9th 2010 anerversary date. Then they will cover me. I read that there is a limit of how far back they can go for prexisting conditions. My last was in 2007 and was a workers comp and they only gave me cortizone shots in my wrists. I wonder why they are making me wait for 10 days?
- —Guest Jay
Response to Jenn
- I'm sorry to hear about your insurance issue. Take a look at your benefit booklet to see what the appeal process is. You will need to follow that to see if you can get the decision reversed. If you are denied at each step, you may, depending on the state where you live, have access to an independent appeal outside of your health plan. Feel free to email me if you have any questions.
- —DrMikeB
Tonsilitus
- My son had Strep two times before we were covered by our insurance. Then after insurance coverage, he had it 3 more times. The Dr. said it was time to have his tonsils removed. Now we find out our insurance denied payment because it was pre-existing. We even had other insurance before and there was no lapse in coverage, but they refuse payment and wont even let me talk to anyone about the decision.
- —Guest Jenn
Pre-existing conditions
- The only health insurance I could afford was one that excluded my pre-existing conditions. Basically, I have insurance for everything except for what bothers me. Does anyone know of a good way to get lower cost insurance but also get you Pre existing conditions covered as well?
- —Guest Reba
Response to Caitlin
- Caitlin: If you are under age 26, the Affordable Care Act (the new health reform law) allows you to stay as a dependent on your parent's health insurance no matter where you live and as long as you don't have other insurance. Check with your parent's company. The law requires this to go into effect on Sept 1st, but many large insurance companies have agreed to start earlier. If you have any questions, feel free to email me at healthinsurance.guide@about.com. Dr. Mike
- —DrMikeB
Just out of School
- I just graduated college and was only covered under my parents insurance through the end of May. I've been trying to apply for insurance but every place I've tried won't give me coverage because I have asthma and have had it since I was 4. It's been well managed for years now but my doctors still required me to take two prescriptions for it. And everything has always been covered under my parent's insurance. Now I am just up a creek with no paddle it seems like.
- —Guest Caitlin
Denied covereage for pre existing
- I have just received my latest forced update to my health insurance plan. I am a contract worker for a major software company. My employer cannot hire me for more than 1 year contract before being forced to lay me off for 100 days before I can get called back, thus losing my insurance. This is common practice and few are ever hired full time. Thus I can only work for 1 year before being forced to be laid off for 100 days and lose my insurance. Now, my employer offers health care coverage, which I gratefully pay for being a type 1 diabetic to try to maintain ongoing management of my disease. Now they inform me that my pre existing clause is now 12 months before I can get coverage of anything related to my diabetis. The entire reason I need insurance is now effectively voided from coverage by my medical insurance for the entire time I am an employee and can pay for the insurance.
- —Guest Darren
Uninsurable = Unemployable
- What I have experienced is if you have a preexisting health condition, it is harder to find employment with a company that offers health insurance to its employees, which severely limits employment possibilities.
- —Guest Katharine
Response to "HELP!"
- In 2014, the health reform act will provide for health exchanges in your state to help make sure that people can find affordable insurance. In the meantime, if you have a pre-existing condition you can seek help through your state's high risk pool. Take a look at the article I wrote on this site about high-risk pools. Under the new law, you may be able to qualify for some type of subsidy, depending on your income, family status, and location.
- —DrMikeB
HELP! no insurance OR disability
- I haven't had REAL insurance since I left my job in 2007 except a present guarantee issue by Anthem that charges $7500 a year. Should I slowly die or go broke first? I tried for disability and got turned down because I am not sick enough and all insurances turn me down because I am too sick (certain pre-existing conditions). What can I do?
- —Guest coocoo
Denied after retirement
- Anthem Blue Cross of California accepted my wife but denied me health insurance after retiring due to my pre-existing condition even though we were both covered by my employer's Anthem Blue Cross of California plan and had previously received treatment under that plan....they would, however, accept me under the California Major Risk Program (MRMIP) for five and one-half times the premium they would have charged if I didn't have the pre-existing condition....sounds like government-sponsored extortion to me considering it's the same insurance company providing coverage for the same clients with no break in coverage
- —Guest Robert Owens
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