Insurance & Pre-existing Conditions Question

[JoiseyMom]

We currently have Cobra, and the new insurance kicks in on August 1. Now, if I don't do Cobra for the month of July and we are technically uninsured for that month..will pre-existing conditions still be covered? I wasn't sure if the limit was 30 or 60 days??

FYI: I have one months grace period, so that if I an emergency comes up I will pay the Cobra at the end of the month of July...but I would really like to save the 1200 for the month!!

Thanks guys!

 

[C.Ann]

It may have changed since I last had it, but at that time you had to have continuous coverage with no breaks at all (not even a month) for pre-existing conditions to be covered by your new insurer..

You probably should make a few phone calls just to be sure..

 

[clutter]

That was my memory, too. No breaks. Remember, pre-existing conditions can occur after you get coverage. I don't know if it's still true or not, but it used to be if you were diagnosed with something like cancer or diabetes during the pre-existing condition period, the insurance company could deny coverage as it was likely to have been pre-existing, even though unknown.

 

[The Mystery Machine]

You must have continous coverage, no breaks.

And yes, you can still get denied for coverage even though you do have continous coverage.

The insurance companies are using every loophole to deny coverage. It was meant to ferret out fraud, however they are using it to deny coverage.

Esp. if this is individual coverage.

Here is the PBS show that covers what is going on in the USA with denying coverage.
http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/view/

 

[mamacatnv]

Call the broker or speak with the HR person, our plan allows for a 60 day break without penalty and I am pretty sure it is Federal law.

How long have you been on COBRA? Was it due to job loss? Were you eligible for the subsidized premiums that went retroactive to Sept. 2008?

 

[golfgal]

Cobra is designed to cover a 60 day break and as long as you secure coverage during that time it is not considered a break. I think it is actually 63 days or something goofy but you will be fine going one month w/o paying for Cobra like you plan.

 

[bettyann29]

I would check with your HR as I assume that is where the new insurance is coming from..

Even if you have no break in coverage you could still be subject to pre existing.. It depends on the new plan and your state.. I work for a health insurance company and pay claims and can tell you different states work different ways..

 

[Ohiodislover]

Depends on the insurance. DH was covered after a 90 day break between jobs. He did not have Cobra, or the ST insurance that the girls and I had.

Check w/ the HR person at the new job.

 

[Nancy]

Depends on the insurance. DH was covered after a 90 day break between jobs. He did not have Cobra, or the ST insurance that the girls and I had.

Check w/ the HR person at the new job.

I agree, check with the benefits department. My insurance has a no pre-existing clause which means no look back period. BUT, I see plans that have a 3 month or 6 month period for continuous coverage...otherwise pre- existing won't be covered for 12 months. I have even seen different time frames for the employee and other family members...for example: it will be 3 months for the employee and 6 months look back for the rest of the family.

 

[NikiM20]

At DH's company it is something very strange. Like for every one day you didnt have insurance, you were not covered for preexisting conditions for two days. I had never seen anything like this before.

 

[denisenh]

i went through an issue with this....the federal trade commision in boston was a huge help to me. i do believe there are federal laws regarding this like a pp said.

 

[golfgal]

I would check with your HR as I assume that is where the new insurance is coming from..

Even if you have no break in coverage you could still be subject to pre existing.. It depends on the new plan and your state.. I work for a health insurance company and pay claims and can tell you different states work different ways..

For group plans and the federal portability laws how would it be different in each state. Individual plans are something else but for group plans they can't have pre-existing condition clauses.

 

[WDWorBUST]

Call HR....usually the waiting period at the new job does not count as a break at all. So you start a new job and have a 60 day waiting period - that 60 days does not count as a break in coverage. But....some plans don't have a pre-ex anyway and it wouldn't matter.