Re: Are Colon Polyps a Pre-Existing Condition?
Usually each policy has a clear definition of what "pre-existing" means in that policy. See if there's a glossary or definitions page.
Often pre-ex refers to any related condition or treatment that occurred within a certain time frame before the policy coverage began.
-For example, it could say no condition is covered if it is pre-ex, if it occurs within the first 12 months the person is covered. As an example, if the colonoscopy was 9/1/08. The insurance coverage began 10/1/08 and the poilcy excludes pre-ex from 12 months prior to coverage - then if there is any claim for anything related before 9/2/09 it can be considered pre-ex and may not be covered.
-But if the colonoscopy was 5/1/08, the insurance started 6/1/08 and the pre-ex period is one year AND the surgery is needed 7/1/09 - then it's likely not pre-ex.
A colonoscopy that found a polyp would be "pre-ex" if the person is seeking any treatment or medication or consultation (etc) for colon issues.
The key will be (1) the policy's specific definition of pre-ex (2) the period they look at (i.e. 12 months before coverage began, or 3 mo, or 60 days, etc).
Policies do vary widely.
Once you've had coverage for a while, nothing is then pre-ex under MOST policies. So, for example, if the polyp was found in 2005 and she has been covered since 2006 and now needs colon treatment of any kind - it's likely pre-ex does not apply.
I hope that wasn't too much of a rambling answer.
Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08
Last edited by SpineAZ; 04-13-2009 at 11:50 PM.