Hi everyone, Although it doesn't have anything to do with anxiety, I post here, so I thought I would give it a shot. I have a question....I am by no means a guru on insurance, it has always confused me. What exactly does pre-exisitng mean? I thought it meant you are fully aware of what is wrong and have been under a doctors care for the sickness or health problem. However reason I am asking, is that I had to go to the emergency room due to having abnormal heart ryhtms. ( sorry for mispelling that) They referred me of course to a cardio...because they didn't have answers other than my heart was skipping beats. SO i got insured and was finally able to afford to go to see a cardio, now my insurance company is saying it is pre-existing and they won't cover my visits. Is this normal?? Just curious. Is there a way around this? My nest office visit is coming up and without insurance it is going to be 2300.00, I cannot afford that.
If anyone has any input I would most greatly apprecaite any feedback.
Thanks Janine1, I really apprecaite you taking the time to give me some insight. So basically my insurance company is right? I have to come out of pocket for the whole visit? Sorry for asking that, but as I mentioned I am pretty much ignorant when it comes to these things. This whole issue about my heart only came about in the past 3 weeks, went to ER, and was told or referred to a cardio...now I am stuck after buying my insurance?
Yes, your heart palpitations would be considered a pre-existing condition. Basically insurance companies usually consider pre-ex conditions to be anything you've had symptoms of or treatment for. Think about it -- a lot of people think they are healthy and don't want to pay for health insurance, so they don't have any. Then they develop symptoms or a health scare (whether it be chest pains or headaches or an aching back or whatever) and decide they better get some insurance so they can go to the doctor and have this treated. Insurance companies, being for-profit, will guard against applicants who might sign up and start filing expensive claims right from the start. That's why they often request medical records or physical exams on people who have been uninsured for awhile, and why they run Medical Insurance Bureau and prescription queries to see if that person has been seen or prescribed anything. Your ER visit of course would have come up in such a query. And it's also why they ask about symptoms or treatment. Example if you said you've had severe headaches but haven't seen a doctor for it, they might deny coverage until you've had an evaluation to make sure there's not something serious going on. Hope this helps - good luck!
Good morning, I truly appreciate everyone's response. Yes it makes sense, I totally understand. Reason I jumped and got insurance is because when I got the referral from the ER, my 1st cardio appt, was going to cost $ 2300.00, so I figured I needed the insurance.
Reason I didn't have it before, because being a college student, i couldn't afford it. I had already come out of pocket at the ER. Guess I have to deal with it.
Pre existing means different things in different states. Essentially if you have sought treatment for it, and you have not had any insurance for the last 90 days, again depending on the state, it is considered pre existing. If you have had insurance within 90 days of pick up the new policy they cannot consider it preexisiting
It was the visit to the ER, and the diagnosis of some sort of heart condition and the referral, that caused the "pre-existing" clause to be invoked. If you had NOT gone to the ER and been dx with that problem, and instead waited until you had insurance, it would not be "pre-existing" since it wasn't diagnosed yet.