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Insurance and pre-existing condition??

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  • Insurance and pre-existing condition??

    Hi-

    I am under my husbands insurance and in the next year, we might be looking to move and changing insurances. I will be having surgery before the move. I have severe mitral valve regurg with a enlarged left atium. After the surgery...will insurance consider it a pre-existing condition? If so, when will this new bill take into effect that will stop insurances from not assisting people with pre-existing conditions?

    Thank you
    Laura

  • #2
    If you do a direct transfer from one insurance company to another, I do not think that pre-existing illnesses count. Others will chime in with definite answers.

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    • #3
      Debbie is right, as long as you go from one insurance to the other, with no lapse, it isn't a problem.
      It doesn't matter if it is before or after you have the surgery, as long as you've been diagnosed and it is in your records you have the Mitral problems, it is a pre existing condition.

      From what I understand the pre existing part of the UHC doesn't go into effect until 2014.. I keep hoping they move it up.
      Lyn
      Mom to Justin 25 TGA,VSDs, pulmonary atresia/stenosis ect, post/Rastelli, 5 OHS, pacer in and out ... and surgery w/muscle flap for post op infection (sternal osteomyelitis with mediastinitis) [url]www.caringbridge.org/nj/justinw[/url]

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      • #4
        Originally posted by Debbrn View Post
        If you do a direct transfer from one insurance company to another, I do not think that pre-existing illnesses count. Others will chime in with definite answers.
        Welcome Laura....what Debbrn posted has been true for many years.....Health Care Reform will be changing many of the old rules, and most of the changes will help the consumer. There are several members who are active in the health insurance business and they will be able to give you the answeres you need.
        Starr-Edwards mechanical AVR 1967 at age 31.....University of Kentucky Med. Ctr., Drs. Richard Wood & Gordon Danielson surgeons. No surgery (heart or otherwise) since. On Warfarin ACT since surgery with no diet, lifestyle, or activity restrictions....and I live one day at a time.

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        • #5
          Under Cobra, if you move from one group policy to another, without a lapse in coverage, your preexisting condition will not disqualify you from coverage.
          However, if you have private insurance, then a new company is not required to accept you for another private policy.
          At least, that's my understanding of the current situation.
          So, be sure to get the Cobra coverage on the old job to avoid a lapse in coverage between jobs, or a period before coverage picks up in the new jobs. some have 30 or 60 day waits. Very Very important, even though you pay the COBRA premiums out of your pocket, after tax.
          Laurie
          MVR & maze & pacemaker-2006
          ICD-2007;
          AVR & tricuspid repair w/ ring 8/11/2010
          home testing since 2006

          Comment


          • #6
            Originally posted by Lauratx22 View Post
            Hi-

            I am under my husbands insurance and in the next year, we might be looking to move and changing insurances. I will be having surgery before the move. I have severe mitral valve regurg with a enlarged left atium. After the surgery...will insurance consider it a pre-existing condition? If so, when will this new bill take into effect that will stop insurances from not assisting people with pre-existing conditions?

            Thank you
            Laura
            Laura,
            When your husband leave his job, you can carry the insurance for at least 18 months with COBRA. It may be a bit costly, but you would not be accepted under an individual plan with your pre-exisiting condition. You can elect COBRA, just for yourself, if you have children and husband on plan now, they could then get an individual plan (if needed) and you alone can be on COBRA.

            Once he starts a new job, you can go on his group plan. There are no exclusions for pre-existing conditions in a group plan. Only individual plans can deny people with pre-existing conditions; group plans do not.

            It's my understanding that the waiver for pre-existing conditions on individual plans does not go into effect until 2014.

            Comment


            • #7
              Hi Laurie ~~ you're in Texas..!! Hip, hip, hooray..:biggrin2: I'm just down I35 from you about 45 miles..
              Before I was old enough for Medicare, I was on the Texas High Risk Pool Insurance policy and one of the qualifying issues is an "artificial heart valve".

              You can have a look at the website and see what your rate would be according to which deductible you prefer:

              http://www.txhealthpool.org/

              I was on it for about 5 years and it was with Blue Cross/Blue Shield.
              Happy Trails,

              BAV-1999 - St. Jude Silzone recalled valve still clickin'
              CoaguChek testing since 1999
              CoaguChek S testing since 2002
              CoaguChek XS testing since 2009
              "Gee, ain't it funny how time jus' slips away..."

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              • #8
                Thank you everyone so much for answering my questions. Very informative! I love this site!

                Laura

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