Would this be a pre existing condition? (insurance question)?

Hi,

I have a health insurance plan that turned out to be REALLY terrible. They said "$1700" deductible all over the policy, but for outpatient surgery, the limit is ONLY $1,000- that was hidden in the fine print! This is CRAZY b/c even a simple surgery could be $10,000! Anyway, I hurt my leg the other day and when I found out about it I applied for another insurance policy which is MUCH better. However, the policy doesn't kick in until Jan 1st...

Anyway, I have not seen a doctor yet (but I made an appointment for friday) but am wondering if even making an appointment would make my injury qualify as a pre existing condition. I don't think it would be I do NOT trust these insurance companies at all! Any thoughts would be helpful.

They define a pre existing condition as: "a condition for which medical advice, diagnosis, care or treatment was recommended or received within the 6 month period prior to the effective date of insurance."

Thanks!

Rick

Did you disclose the leg injury on your application for the new policy? If you didn't, your new policy can be voided completely.

If you did disclose the leg injury on the application and were still approved for the policy, then you should be okay...as long as you've had continuous health insurance (without a break in coverage longer than 63 days).

If you haven't had continuous health insurance, then yes...going to the doctor for an appointment regarding the leg injury before your new policy begins would make it a pre-existing condition.

To sum it up...1) I hope you disclosed it on your application, or it will cause big problems for you. 2) If you haven't had a break in insurance coverage, you'll be fine. 3) If you *have* had a break in insurance coverage (longer than 63 days), then don't see the doctor before January 1st or it will be excluded for pre-existing.

No, making the appointment should not affect anything in that regards. Now, if you keep your appointment...then Yes, your injury would be considered a pre-existing condition. Also, the date of your injury may be taken into consideration as well.

Yes, the leg that is already hurt is pre-existing. Just because you fail to treat it, doesn't mean it hasn't happened.

Yes. A pre-existing condition is any condition that has been diagnosed by a medical professional in the last 12 months.

So, if your insurance doesn't kick in until Jan 1, and you see a doctor before then, then it's a pre-existing condition.

They will deny the claim. I guarantee it.