How the 'pre-existing condition' works

Written by Rosa Colucci on .

I must say letter writer Nick Kyriazi's comments regarding "Insurance Illogic" (Aug. 10 letters) made me laugh out loud. Do he and others truly believe that is the concept of how pre-existing condition works? If so, let me set them straight.

Pre-existing condition on health insurance policies excludes conditions for which you may have received or will receive medical advice within a certain period of time. Usually the look-back period is six months prior to the effective date. That does not mean the insurance company will reimburse you for any claims you incurred prior to your effective date. However, it will not pay any claims related to that condition for the next 12 months.

Now, if you had coverage through your employer and you switch jobs, you should receive a HIPAA certificate of coverage, which would waive any pre-existing clause that your new employer may have in its policies. Most large employer plans do not have pre-existing clauses. You normally see these types of conditions when purchasing individual policies or under small employer plans.

The one best benefit under the "Obama" health plan would be to eliminate pre-existing conditions. This way more people would have access to health-care coverage.




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