Bite-Sized tips from 23-year Insurance Veteran

Preexisting Conditions, Insurance and Timing

Filed under: pre-existing conditions — Tags: , , — Alston @ 22:14 March 16, 2009

A preexisting health condition can prevent you from qualifying for medical insurance.  Timing your applications and medical examinations can keep you from being denied coverage in certain situations.

Timing your Medical Exams

A preexisting condition becomes an insurance issue when one of three things happens.  You receive medical advice for the condition. Your have symptoms that would cause a prudent person to seek medical advice.  Your insurance company discovers the condition during an exam.

If you are considering changing insurance policies you may not want to see a doctor until you have been approved by the new company.  Why?  If you are genuinely unaware of a medical condition and haven’t had symptoms that would cause you to seek medical attention an insurance company should not hold that condition against you unless it is discovered during their underwriting process.

If you have a medical examination just before applying for a new policy, your physician might discover a condition that would keep you from being approved for your policy.  You may be better served if you wait until you are covered by the new policy before you are examined.

Of course, there may be situations where waiting even a week to have an exam could have serious repercussions.  On the other hand if a serious condition is discovered a week earlier the timing may save your life.

However, if the treatment for the condition isn’t covered because your old policy expires shortly after your diagnosis, you may not be able to complete your treatment.

This is not medical advice. You will have to weigh the pros and cons of waiting verses not waiting to have an exam.

Aging of Preexisting Conditions

Not all medical conditions get worse with age.  Some are treated more favorably as they age.

A person who was diagnosed with a condition too recently may be denied coverage even for a minor condition.  This is because the insurance company wants to make sure that the diagnosis was accurate and that the treatment prescribed works.

A person who was diagnosed with asthma a year ago and has their symptoms controlled with medications will likely be approved for a medical policy.  A person who was diagnosed a week ago may not be.

Often people with serious conditions like cancer are able to qualify for medical coverage.  This depends on the type of cancer and how long it has been in remission.  Five years without treatment or need of treatment can be enough for many cancers.  The waiting period for other cancers is much shorter.  For certain others the waiting period is longer.

Ask your insurance agent if he or she for guidance if you are concerned about being denied.  You may be able to keep a rejection off your insurance history simply by waiting to apply.

If You are Denied Health Insurance

Be aware that different insurance companies may underwrite the same condition in different ways.  Be sure to check with several companies if you have been denied insurance due to a medical condition.

You should also be aware that different types of policies will have different rules.  A group health insurance policy may accept you regardless of your medical history.  This may be true with state-sponsored health care programs.

Until we have Universal Health care, preexisting conditions will have a devastating impact on certain families and individuals.  You can reduce your chances of being denied a health insurance policy by delaying a health exam until after your new policy is effective (so long as it doesn’t jeopardize your health).  You can also reduce the chances of getting a denial by waiting to apply until a recently diagnosed illness is considered stable by a new insurance company.

Save on: State: