Does company policy vary from company to
company regarding the number of months
after the initial activation of the policy
(ie E 12 months, 24 months, Zero
months...etc) that a claim can be made for
a condition not originally made known on
the application? I live in Indiana.
I'ver heard about an "incontestible
period" (Federal Law(?) where-as an
applicant can make a claim for a
pre-exisiting condition after 12/24(?)
months of coverage even though it wasn't
listed on the original application or made
known to the insurer.
Is there any truth (or variations) to the
above? Does it vary from company to
company or is it all just considered
insurance fraud?
Please advise?
Thanks!
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DoorIn
New User, Becoming EHEALTHy
Joined: 16 Aug 2007 Posts: 19 Location: Coral Springs, Fl
Posted: 08-23-07 07:25am
With Health Insurance, a policy is always
contestable.
That being said, each company handles
pre-existing conditions differently. It
also depends if you have a group policy,
individual policy, and if you had credible
coverage before.
With some, you may not be eligible, with
others, they may excluded, or rider that
conditions. There are some that will have
you wait 12 months before it is covered
and some that may cover that condition
right away.
That's why honesty is truly the best
policy.
Your thinking of Life insurance, where the
contestable period is 2 years, after which
the policy can not be rescinded other than
for non-payment.
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frank123
New User, Becoming EHEALTHy
Joined: 28 Aug 2007 Posts: 1
Posted: 08-28-07 12:37pm
Hi ..i am new to this.
Basically, I had good Blue Cross Blue
Shield Group coverage for 9 years and then
I lost my job. Was on Cobra (from Jan to
end June this year- for six months) as it
was free for me for 6 months only (did not
want to go full 18 months as its expensive
after the first 6 months of COBRA). Got on
Goldenrule.com's short term policy for
July and Aug and about to sign up for Blue
Cross individual policy which is like $425
per month for me and wife (with maternity
coverage). They said that cataract surgery
I had before will not be covered for at
least 2 more years. How come? I have
certficate of pre-existing coverage from
my former group plan? But then they
exclude me for this?!! Is it because I am
moving from a group policy to a individual
one even though I am with the same
company? Dont know much about health
insurance so please advise!! Thanks !
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Carifairy
Extremely EHEALTHy
Joined: 12 Nov 2005 Posts: 2610 Location: Charlotte n.c.
Thanks: 12
Thanked:0
Posted: 08-28-07 12:59pm
Usually pre existing conditions do not
count when you switch from one plan to
another..
It can vary though, I am sure.
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DoorIn
New User, Becoming EHEALTHy
Joined: 16 Aug 2007 Posts: 19 Location: Coral Springs, Fl
Posted: 08-28-07 19:27pm
Private Health Insurance plans are much
more affordable than group plans. That's
because they handle pre-existing
conditions differently.
With group, as long as you have a
continuation of coverage, your
pre-existing conditions will most likely
be covered.
With Individual, it doesn't matter in most
cases. They don't generally cover
pre-existing conditions and can therefore
charge significantly less.
Think of it like you would auto insurance.
If an Insurance Company had to cover and
pay for the repairs on an automobile that
already had banged up fenders before the
insurance policy’s inception, that
insurance policy and everyone else’s
insurance policy would have to cost a lot
more than if they just excluded those
fenders. Make sense?
