Patient survey New patient education video Facebook Twitter www.onxlti.com
Results 1 to 8 of 8

Thread: Insurance and pre-existing condition??

  1. #1
    Join Date
    Jul 2010
    Location
    Austin, Texas
    Posts
    61

    Default 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. #2
    Join Date
    Jan 2005
    Location
    southeast
    Posts
    432

    Default

    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.

  3. #3

    Default

    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) www.caringbridge.org/nj/justinw

  4. #4
    Join Date
    Feb 2007
    Location
    louisville, KY USA
    Posts
    1,967

    Default

    Quote 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., Dr. Richard Wood & Dr. Gordon Danielson surgeons. No surgery (heart or otherwise) since. On Warfarin ACT since surgery. No diet, lifestyle, or activity restrictions....and I live one day at a time.

  5. #5
    Join Date
    Nov 2007
    Location
    North Texas
    Posts
    1,636

    Default

    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

  6. #6
    Join Date
    Oct 2009
    Location
    USA
    Posts
    1,164

    Default

    Quote 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.

  7. #7
    Join Date
    Jun 2001
    Location
    Texas Hill Country
    Posts
    1,836

    Default

    Hi Laurie ~~ you're in Texas..!! Hip, hip, hooray.. 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..."

  8. #8
    Join Date
    Jul 2010
    Location
    Austin, Texas
    Posts
    61

    Default

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

    Laura

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •