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me-wa | What happens if you don't tell your insurance about a pre-existing condition? ? |
I am going to be getting new health care coverage soon. The thing is that I have taken pills for years for stomach acid. They won't cover for 'pre existing conditions'. So I was not going to mention this on my application and stock up on pills before I am covered and than about 3 months AFTER I have the coverage I will start getting it on the new plan.
Do insurance plans do a check with your doctor file? |
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latj
 |
Honesty is always the bet policy. Trust me that the insurance companies have these things on lock down. These are trillion dollar businesses and are not looking out for the welfare of the people like you and I. If you get past the "preexisting" problem then you are going to run into a problem when they ask for your previous medical records. One way or another you will get caught up in a web of deceit and they will drop you. Fraud in insurance is not pretty. Good luck.
Peace & Love :) |
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Mamaof2
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If they find out you have this condition and didn't tell them you will be cancelled and they may have the option to make you payback any money they have put out on you. I haven't ever actually contacted the Dr., but have heard of some companies that will do this. Sometimes the company will find out because of medical work that will be done on you, some medical coders for the Doctor will specify that it was a pre-existing condition and the insurance company will find out this way. Best to be honest or find a company that will take pre-existing conditions, even if it is 3 months down the road. |
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Elyse K
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The Medical Information Bureau has info on all your medical files. Insurance companies regularly use this source. If you carefully read the application forms you will see that where you sign to accept the plan you are also signing a broad authorization for the insurance company to get your medical information.
If you are going from one group health plan to another group health plan and there has been no breaks in your coverage (no gaps where you didn't have coverage) then your new plan should cover your preexisting condition without any problem.
Also pre existing condition exclusions are usually for 12 month period of time. So even if you waited 3 months, they wouldn't cover your medication.
Before you try to do something that will jeopardize your entire health plan, why don't you read the materials and ask your human resources dept about the pre existing condition clause or call the toll free number for the plan and ask? |
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TK
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I would imagine that they do or will if they have the legal right to do so and it strikes them that your stomach ailment could be a preexisting condition.
I understand that the overproduction of stomach acid is caused by a bacterial infection that occurs most frequently in individuals who endure a lot of stress and anxiety. Perhaps, there are better treatment options for you than stomach acid pills that you should consider exploring with your physician. |
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MavistheMaven
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Yep, insurance companies always, routinely, conduct an investigation when a claim is filed that could possibly be related to a pre-existing condition.
You can always try filing the claims. The worst that will happen is that they will be denied.
How did you get the prescription to begin with? If you had health insurance within 30 days of starting the new plan, COBRA laws wipe out the pre-existing clause, so your condition wouldn't be denied for that.
Are you sure your new plan has only a 3 month pre-existing limitation? Most plans have 6 month or 1 year pre-existing condition periods.
Even if you try to go to a new doctor and pretend it's a new complaint, the insurance company will ask you for the name of your previous physician and then get your medical records from him/her.
It's usually best to choose an HMO for the first year, just because they don't have pre-existing restrictions. Then, the second year, you can upgrade to a better plan and because you were covered by insurance for the previous year, you won't be subject to pre-existing restrictions.
Be careful if you have the pre-existing clause. Say you get a bad sore flu and you go to the doctor. That's not pre-existing, but if the doc even asks how your stomach is and you discuss the stomach acid, he might put it as one of the visit diagnoses - and then your visit claim would be denied, even though you went because you had the flu.
By the way, I have never heard of a company cancelling health insurance for a pre-existing condition. Maybe if it's an individual policy rather than one through a job or other group plan, but more likely, they'll be happy to keep collecting your premium payments while refusing to pay your claims. |
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debijs
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~~Yes they and will check past medical records. If they find out you have preexisting conditions you did not disclose, you will be dropped from your insurance and all previous claims will have to be reimbursed by you.~~ |
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♥~*Momma Bear*~♥
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You'd go to prison for fraud. You must be 100% honest on an insurance application and when you check the "no" box for pre existing conditons, you've just lied on an insurance application which is FRAUD. I would not suggest doing this at all. |
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