Fellow dopers, I need some information/advice. Go ahead and be brutally honest, you’ll certainly be more kind than the insurance company.
The History:
I have high blood pressure. I was first diagnosed two years and two jobs ago, my husbands jobs - not mine. I was covered (prescriptions, doctors visits, etc) by his insurance.
Then my hubby changed jobs and that particular employer did not offer insurance, so while he looked for something else, we payed my prescriptions out of our own pockets.
So, between roughly 10-24-99 and 01-24-00 we did not have any insurance. Nor did we get on Medicaid, we just struggled along.Fine.
On or around 01-24-00 hubby hired on with his current job, who does offer insurance. We recently became eligible and jumped on it. They have happily payed for my prescriptions thus far.
The Problem:
Last month, I made a doctors appt. because (and only because) no one would refill my Rx’s without having me see a Doctor. My old Dr. would not accept this insurance so I made an appt. with one who would. Fine.
Now I have recieved a letter in the mail asking about pre-existing conditions and telling me that I filed a claim for one . They want proof that I was covered by insurance for the exact time that hubby worked at the job woithout insurance. Obviously, I wasn’t.
The Twist:
Hubby’s current employer is changing insurance companies. I just finished signing us up online with the new insurance. The new insurance becomes effective Jan. 1 . They are an HMO whom we have had coverage before. As I understand it, HMO’s are much less hostile about pre-existing conditions.
The Question:
Am I screwed? Is the current ins. going to be able to deny me coverage for my high blood pressure because we were without insurance for three months(10-24-99 to 01-24-00) ?
Is there anything I can do? Or should I just put it all off until January when the new insurance kicks in?
I’m not an expert, but yes, they probably can deny coverage for you.
Let me pass along this tip. I use a generic blood pressure medicine (Pindolol). I went to http://www.costco.com and went to the pharmacy section. You can buy medicine from them even if you’re not a member. I signed up and emailed them, asking for the price of 180 pills - 6 months worth. The price was really good - about what I’d pay for 2 months of pills from my local pharmacy. Also, shipping is free. So if they have a good price on your medicine, this might help you out until the insurance kicks in.
Three Bunny,
How the heck are ya? Sorry to hear about your blood pressure problems.
It’s awfully hard to say without knowing your specific insurance info, but I’ve had EONS of experience with insurance companies, and they can deny you coverage for a pre-exiting condition.
The company I have now has several different plans available, and my husbands employer (he’s very close with the owner) specifically picked the more expensive plan without the pre-exitsting condition clause in it so that I could get treatment for my back (which I had surgery on).
I’ve been denied coverage in the past for back care, and once had to go 1 1/2 years without treatment because that’s how long the ins company made you wait before they covered anything. It’s a bitch, but the way it goes. I never found a way around it, and believe me I tried.
You may end up paying cash for your visits and meds until Jan. I don’t have experience with many HMO’s, but if you know what company it will be with and what plan they’re offering, you should be able to call them and ask.
There are both state and federal laws regarding coverage for “preexisting conditions”. Coverage varies from state to state depending on what the condition is. You might try calling your states insurance board. They should be able to answer your question, or direct you to an agency that can.
In general, a health insurer cannot exclude coverage for preexisting conditions IF you do not have a gap of more than 90 days between your old coverage and your new coverage. Sounds like you may be right on the line.