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Readers Respond: Have you been denied health coverage because of a pre-existing condition?

Responses: 32

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Updated April 15, 2010

Many Americans have health-related problems that insurance companies define as pre-existing conditions - health problems that existed before you applied for a health insurance or tried to enroll in a new health plan. Health reform has eliminated this issue for children, but this provision in the law will not help anyone over age 19 until 2014. Have you had a problem with a pre-existing condition and health insurance?

medicare pre-existing problem

i was covered by medicare for 9 years, having been on disability and then going back to work as a working disabled person. my extended medicare coverage ran out and i was notified 30 days before it ended. five days later (while i was still covered) i applied for the medicare buy-in for the working disabled, for which i was qualified and entitled to buy. my application was completed but not acted upon for over 3 1/2 months (i had to get my senator involved to finally get approved). now i am covered with a new starting date, 3 months after the termination of the policy i had for over 10 years. now i am told i've had a break in coverage, i have to pay a lifetime penalty for prescription coverage and nothing is covered for 12 months. it was not my fault that it took medicare so long to act on my application. i had applied within 63 days for a high risk state plan which approved me - i guess the coverage has to START in 63 days. i feel ripped off.
—mary88mary

PCIP Works!

I have not been able to find full time work. And I have been denied personal coverage for years due to pre-existing conditions (with thyroid cancer added to the list in 2008). I was at wits end two months ago because I need one more treatment for my cancer. Then, I found out that part of Obama's bill includes the Pre-Existing Conditions Insurance Plan. It is basically a large US GOV group plan that covers the gap for people who (a)do not qualify for subsidized care like Medicare or Medi-Cal (here in Cali), (b) can pay competitive group premium rates, (c) have a pre-existing condition for which one has been denied coverage, (d) have not had insurance for at least 6 months, (e) have been denied coverage in the last 12 months. https://www.pcip.gov/
—Guest Michael Chung

Denied Health due to mental health

I have Bi-Polar and it appears no one will touch me. My kids are able to covered as Ind. but I cannot get accepted. I just need emergency and BIG coverage, I can pay for everything else. Beside me hiring a PA and starting a Company with 2 members, it appears I am without any solution....any ideas
—Guest Jon Z

Pre-existing Condition?

My mother has just had a lump in her breast biopsied. She is 64 and currently on my father's insurance plan (expiring in January due to his death in August 2010). This insurance was offered through his employer from which was retired in Houston, Tx. My mother needs to find coverage before the current expires. What if her biopsy results show her cyst to be cancerous? Can she be denied insurance based on a "Pre-Existing" condition and/or be charged outrageous premiums? Will she be excluded from ANY pre-existing stipulations because she has had coverage for the past several years and not without for 63 days? I need to know her rights while we search for replacement coverage that is affordable. Is there a place to go for help if you feel that what you are being told is not correct? Thank you so much! Rocky
—Guest Rocky

denied because of pre-existing condition

I was laid off in 2008 after 5 years and lost my insurance, hired months later but again laid off this time after 6 months and lost my insurance. Hired a year later, waited 3 months for coverage and was then denied a $175 doctor's office visit, the first in 3 years.
—Guest Mary Miller

pre-exising conditions

I have been on COBRA for 18 months continuosly. My coverage is over. I have bi-polar conditions. I just got a new job and benefits, can they deny me prescription benefits for 12 months?
—Guest suzanne

Marcy

If we are having to pay out-of-pocket for what is medically wrong with us, why not keep the premiums we pay to to insurance companies and our medical bills. Why should I pay the insurance company for the "perception" that I am covered. Marcy
—Guest Marcy

Pre-existing condition

I lost my job in Sept. 2010. The cost of COBRA is way too high, so I have sought out private insurance. While my husband was accepted, I was flat out denied due to two minor pre-existing conditions. One was osteopenia which my doctor said was minor, and only needed calcium, vitamin D and weight bearing exercise. No prescriptions or medical intervention at all. The other pre-existing condition is asthma, which has been well under control for years now. I only keep my albuterol prescription current as a matter of precaution. I do not take any other meds for it, as it is well under control. So, my question is, can an insurance company out-and-out deny me coverage? Or should they give me coverage with an exclusion to either of these conditions?
—Guest Deborah K

Special Illness Exclusion

Hi there! Hope you can help me because as a foreign national i'm having some difficulties to understand how me medical coverage works I have been recently diagnosed a disc protussion and, for to have that diagnosis, I've seen several doctors and had X-Rays and an MRI done. Lately I read the insurance policy again and, much to my regret, found the following: The following conditions which manifest themselves within the first 180 days of coverage are excluded: .... hernia,... disk disease My pain started to manifest within the first 180 days but I didn't see the doctor until after that exclusion period. Does this mean that all the expenses I have incurred will not be paid by my inssurance? or otherwise that from the moment I have my diagnosis they won't pay more bills? In other words, how could I know it was a disc protussion without seeing the doctor? Hope you can help me. Thanks
—Guest toni

bcbs denial

i was covered by cigna for 10 months,then my company decided to switch to bcbs & both my husband & i were sent letters from bcbs that we were denied because of pre existing conditions until jan 1 of 2011. what a rip,i am a kidney transplant patient & have to see the doctor every 6 months for labs & my husband was my donor so her needs to have his creatinen checked every 6 months & of course those 2 things happened in oct. while we are not covered & now i have to scramble to see if i can come up with money to cover all these bills coming in.i didn't want to switch from cigna but i had to do what the company wanted i've dealt with bcbs before & not too happy with them either.
—Guest patricia anderson

DENIED (for what - this INS

Denied because of so called preexisting condition. I got this supplemental INS on May 1, 2010 for disability INS. Discovered I had Breast Cancer on May 12, followed by surgery, rad treatment, etc, all in June. Just so happened, not by my choice, that this Cancer go me 19 days into the policy. Nothing was preexisting. I did have a Mammogram in Towards the end of April, however officially discovered this condition in May. Called and waited for 4 months for them to lie, stating my policy was effective on June 1st , but all my paper work says May 1st . This insurance company sucks, they had no right to deny me, I pay premiums every month. Does anyone know a good insurance lawyer in Detroit or Dearborn Michigan. Thanks. Like the commercial ( I need my money & I need it NOW )
—Guest Deb

age 19

my son is 19 and well 20 in july how dose the in pre excisting law affect him? Answer to Dave: If your son has no health insurance, he can stay on your plan until he is 26. If he has not been insured for at least six months and has a pre-existing condition, he may be eligible for a Pre-Existing Condition Insurance Plan. See www.healthcare.gov for information.
—Guest dave

Can I move to other company..?

I am breast-cancer survivor(it's been 3yrs after treatments done). I am working same company since 2005. I want to move to other company which offer better with insurance. I am just afraid of being reject with re-exist condition from new insurance. So, I blew off several chances. My company knows what i am afraid.... and they use it. I hate this company...... Please tell me it is enough for waiting or not? Can I move? or I have to wait until 2014.
—Guest Eunice

Request was granted!

Just wanted to share a happy tale with you. A couple of years ago my husband had surgery on his nose (4 times broken, it was bad and he couldn't breathe through it anymore). We were insured through United in Nevada, a POS plan. We had to pay 20% of his bill if we went to an in-plan doc. We chose the doc and had his surgery. When we got the bill it was $$$$. Huge. The insurance denied us because although his doctor was in network, the hospital where he performed the surgery wasn't! We were billed for the whole thing. I wrote to the insurance company and told them that I had called in to verify that his surgery would be covered and they said yes. And that if we'd known that the hospital wasn't covered we would have had the surgery in one that was. Still, I was shocked that this insurance company agreed with me and covered the surgery at the 80% rate. Sometimes the system actually works.
—Guest BillieZ

denied coverage for lapse of insurance

United Healthcare (in California) has denied coverage to me for 365 days (legal max) because under a 'pre-existing condition' exclusion. I lost my job 3+ years ago, and in the final 70 days prior to getting a new job we could not afford to continue to pay our insurance premiums for non-group benefits privately. I took my job to get insurance for my family, and UHC, exploiting a portion of the law that does not apply to us (none of my family members or I had any pre-existing medical conditions) they've denied payment of all claims for the first year of my employment (2008), which they're just telling me about via form letter (got 30 of them yesterday) in late 2010! These people are, at best disingenuous, and at worst evil. It looks like they can get away with this?
—Guest brian

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