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Pre-existing condition - WHAT??

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7 years 6 months ago #55738 by eklein
Pre-existing condition - WHAT?? was created by eklein
I have a new job so new health insurance - but I'm working for the state and have a normal good plan with Health Partners. So I was pretty surprised to have a letter from them today saying they had to see if some claims related to pre-existing conditions and asking me to report all medical care between March and September so they can view my records. WTF, right? So I called the number provided and they customer service guy was as shocked as I was. He agreed that President Obama had taken care of that nastiness pretty much. He thinks the letter is a mistake ("most of our plans are compliant with the Affordable Care Act including the ones you have") and will research further and call me back.

That was weird and scary, I thought maybe I didn't read enough of the small print when I picked a plan. Well we'll see.
Hope everybody is doing ok - Erica

And she was!
Diagnosed May 2005, lowest count 8K.
4/22/08: 43K (2nd Rituxan)
10/01/09: 246K, 1/8/10: 111K, 5/21/10: 233K
Latest count: 7/27/2015: 194K

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  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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7 years 6 months ago #55741 by Sandi
Replied by Sandi on topic Pre-existing condition - WHAT??
The weird thing is that pre-existing conditions were not a problem in a group plan prior to the ACA, only private plans. I know that for a fact.

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7 years 6 months ago #55744 by eklein
Replied by eklein on topic Pre-existing condition - WHAT??
I remember pre-ACA that the trick was to not let insurance lapse. If it didn't lapse, then you could go to a new plan and no pre-existing condition problems. If it lapsed, everything was pre-existing and not covered. Much earlier it was worse. Back in 1989 I went to a doctor for allergy treatment two days before my insurance from a new job kicked in and therefore all my expenses for the allergy treatment were a pre existing condition and not covered.
Erica

And she was!
Diagnosed May 2005, lowest count 8K.
4/22/08: 43K (2nd Rituxan)
10/01/09: 246K, 1/8/10: 111K, 5/21/10: 233K
Latest count: 7/27/2015: 194K

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  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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7 years 6 months ago #55748 by Sandi
Replied by Sandi on topic Pre-existing condition - WHAT??
Right, you couldn't have a lapse in insurance but you could also get right into a group plan with a pre-existing condition with no problem. I went from my husband's private plan to a group plan at work easily. The reason I couldn't quit my job for years after that was because I couldn't get back onto my husband's private plan with a pre-existing condition, until the ACA. The only other option was to pay COBRA but that runs out eventually.

It's odd that they would even question a pre-existing condition with a group plan because that was never an issue, even before the ACA. I really hope this was a fluke...let me know how it goes.

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  • Hal9000
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  • Give me all your platelets and nobody gets hurt
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7 years 6 months ago #55754 by Hal9000
Replied by Hal9000 on topic Pre-existing condition - WHAT??
Is it possible they are asking for them just to see if you will deliver them - so they can see potential future costs risks in their business model ? That they can't deny you coverage if you refuse ?

I thought it was illegal to sell healthcare insurance now that didn't comply with ACA mandates?

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7 years 6 months ago #55755 by
Replied by on topic Pre-existing condition - WHAT??
I know someone who before ACA had to COBRA when he lost his job & before he got a new job w/medical and since he had a pre-existing condition he made sure he was not without medical for even 1 nano-second - but...............

His new job obviously had a group plan, a well known group plan, and they tried to say he had a pre-existing condition so wouldn't pay. So yes he could get right into a group plan but that very well known group plan tried to not pay due to pre-existing.

The reason I like ACA is because it "deleted" pre-existing. Keep us posted!

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7 years 6 months ago #55780 by Aoi
Replied by Aoi on topic Pre-existing condition - WHAT??
I get these letters from time to time from my insurance. I've had private insurance for 10 years, via the ACA since its inception. I discovered that insurance companies are sometimes looking for other ways to collect; e.g.: if your condition can be attributed to an work accident, car collision, or other actionable fault by a third party, the insurance company wants to know. After asking among my friends, I discovered that this can happen even with very high-quality group plans.

Please share what happens.

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7 years 6 months ago #55809 by eklein
Replied by eklein on topic Pre-existing condition - WHAT??
Here's what happened. The customer service guy from my insurance company (Health Partners) did call me back yesterday. He said the letter was a mistake and I should ignore it. I'll watch my billing and explanations of benefits and make sure everything processes normally. But it should.
Erica

And she was!
Diagnosed May 2005, lowest count 8K.
4/22/08: 43K (2nd Rituxan)
10/01/09: 246K, 1/8/10: 111K, 5/21/10: 233K
Latest count: 7/27/2015: 194K

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7 years 6 months ago #55824 by Aoi
Replied by Aoi on topic Pre-existing condition - WHAT??
That's good news. Glad it all got sorted so smoothly.

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