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View Full Version : Pre-existing condition on record?


lynet
02-19-2006, 04:27 PM
I have student insurance that's not worth much. Just had an appointment because I fainted last week and haven't had much hearing in one ear for several weeks. I saw a GP and he referred me to a neurologist for an MRI.
The student insurance only covers up to $500 and I assume an MRI is closer to $2-3,000.

My parents have been uninsured since my dad lost his job, but are probably going to sign up for Blue Cross Blue Shield insurance and they can include me on the plan (until I'm 25 anyway--a couple years away). Since I have had an appointment and now have a referral, do I have a "pre-existing condition"?? Can I just not mention this, get on the insurance, and then go to see a neurologist on my own? Is there a data-base or something the insurance companies can check to see what your last medical appointments were about?

This is so confusing.

Thanks for any help.

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Belle2003
02-26-2006, 03:09 AM
I just had to fill out an application for Blue Cross. The person in charge of my application said that they just know that you had a doctor visit, they don't know what the diagnosis is.

When I filled out my application, I had to list all of my past ailments from the last 10 years, including my kids. If you do not have a diagnosis yet as to what is wrong with you, then you do not have a pre-existing condition. If you do go for the MRI before getting on with Blue Shield and they find something, then you do have a pre-existing condition.

On the application it had me list my last doctor's visit, the date, and the reason I went, and the findings. I had to do this for my kid's too.

So when your folks list your last visit on the application, just say it was the flu. You have no diagnosis, so no pre-existing condition.

This is just my opinion, and I hope it was helpful.

madera74
02-26-2006, 06:01 PM
This is definitely a pre-ex condition, and to not disclose it on your application for insurance coverage amounts to insurance fraud. They will ask if you have had symptoms OR treatment for a variety of conditions and will ask if any tests or procedures have been recommended. Insurance companies do query the Medical Information Bureau to see if any "hits" come up on you. An MIB hit would let the insurance company know what you were seen for. There are numerous different MIB codes, so it definitely tells more than just that you saw the doctor. In the event that you didn't disclose this information and then ended up seeing a neurologist after you were on the plan, this will be a big red flag for the insurance company's claims department and they would likely investigate to see if this was due to a pre-ex condition. If they pull medical records and determine that you were dishonest in your application for coverage, the whole policy could be rescinded. Honesty is really the best policy.

 
 
 




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