insurance application process

[sprinty]

What is the name of your state? PA
I need to see a physician and am currently uninsured.
If I enroll for individual insurance, when should I expect it to kick in?
Also, will they deny my claim or be suspicious if they see multiple claims so soon after my enrollment.

thanks for any advice.

[moburkes]

Originally Posted by sprinty

What is the name of your state? PA
I need to see a physician and am currently uninsured.
If I enroll for individual insurance, when should I expect it to kick in?
Also, will they deny my claim or be suspicious if they see multiple claims so soon after my enrollment.

thanks for any advice.

When they have underwritten the policy. There is no law that requires them to backdate the coverage. And, by the way, your deductible is likely to be higher than the initial doctor bill anyway. You should contact a local health clinic that has a sliding scale based on your income, or a free clinic.

[TIMMAAYY]

What..... Mo and CBG aren't going to sing the praises of group insurance!?!?!?


Sprinty, if you have not had coverage for awhile, and your visit is for something that you've been treated for in the recent past, you could be pre -x'd. That is, they might not cover it and you would have to pay the entire bill yourself. Since you haven't given us any other background on your insurance history, I am just tossing that out there.


Whatever date you request ( as long as it's not BEFORE the application date ) can be your start date, as long as the application process doesn't take so long that you have to REAPPLY.... this could be anywhere from 30 days to 90 days.... depending on the carrier and their rules. Not a very common thing to happen.

As far a them being suspicious, no.... if you are covered, you are covered.

[Betty]

Originally Posted by sprinty

What is the name of your state? PA
I need to see a physician and am currently uninsured.
If I enroll for individual insurance, when should I expect it to kick in?
Also, will they deny my claim or be suspicious if they see multiple claims so soon after my enrollment.

thanks for any advice.

re individual coverage through an agt. - you would be underwritten & your medical hx, etc. would be checked out. After underwriting then a decision would be made if coverage can be issued (sometimes declined) & if so it could possibly contain a waiver or extra premium
or could be issued at standard rates with no waiver/extra premium. (A waiver is an addition to the policy which would indicate the ins. co. will not pay any benefits for a certain condition(s)/impairment(s). )

[cbg]

If the poster had asked my opinion on whether to join a group plan or purchase individual insurance that's one thing.

The ONE advantage, in my opinion, to individual insurance is that you don't have to wait for an open enrollment period (in most cases). You can't always join a group plan whenever you want to.

Since the poster did not indicate that a group plan was a viable possibility I saw no point in rubbing salt in the wounds.

[sprinty]

moburkes: When they have underwritten the policy. There is no law that requires them to backdate the coverage. And, by the way, your deductible is likely to be higher than the initial doctor bill anyway. You should contact a local health clinic that has a sliding scale based on your income, or a free clinic

This medical issue that I have is new and will not be in my history. I guess you can say I was in perfect health before today. It's not something minor and I expect to be sent for xrays or something of the sort.

I initially thought of and actually scheduled an appointment with a clinic but I don't really know if the sliding scale extends to further testing. Because of this, I'm not getting a plan with a deductible.

TIMMAAYY:
Whatever date you request ( as long as it's not BEFORE the application date ) can be your start date, as long as the application process doesn't take so long that you have to REAPPLY.... this could be anywhere from 30 days to 90 days.... depending on the carrier and their rules. Not a very common thing to happen.
As far a them being suspicious, no.... if you are covered, you are covered.

I'm glad to hear that. I know that these individual plans eventually increase their premiums and I hope that it doesn't increase drastically based on the extent of usage.

cbg: If the poster had asked my opinion on whether to join a group plan or purchase individual insurance that's one thing.
The ONE advantage, in my opinion, to individual insurance is that you don't have to wait for an open enrollment period (in most cases). You can't always join a group plan whenever you want to.
Since the poster did not indicate that a group plan was a viable possibility I saw no point in rubbing salt in the wounds.

I'm sorry I missed your first post cbg , but you're right in assuming that a group plan is not an option for me.

I only know of ehealthinsurance.com. Is any other way to find a good plan?
based on the options, looks like I'll have to go with Aetna HMO with 0 deductible and 0% coinsurance .. monthly cost is $223.

[moburkes]

Where have you found an individal plan without a deductible?

You will not be covered for this condition or any tests, xrays, or prescriptions for at least the next 6 months.

The premiums cannot increase based on your usage. The premiums will increase for ALL 37 year old males who are nonsmokers in your county, for example.

[sprinty]

the plan was among many at the site, [url]www.ehealthinsurance.com[/url]

so I'm paying the premium for doctor visits only? and any diagnostic tests won't be covered..even EKGs? Is this with all HMOs or with individual plans in general?

Is this because my condition is new or because I'm newly enrolled or both?

Originally Posted by moburkes

Where have you found an individal plan without a deductible?

You will not be covered for this condition or any tests, xrays, or prescriptions for at least the next 6 months.

The premiums cannot increase based on your usage. The premiums will increase for ALL 37 year old males who are nonsmokers in your county, for example.

[moburkes]

Not because its new, but because you were seen/treated for a medical condition shortly before purchasing the policy. Now, the policy won't cover that condition, treatments, etc for probably 12 months. Otherwise, people wouldn't buy insurance until they knew they were about the have a lot of medical bills. They pay the "small" monhtly premium, and let the insurance company pick up the large tab.

[sprinty]

I'm assuming it's a typo and you meant "after" purchasing the policy.

that sounds logical enough. 6-12 months is too long to wait. I'll have to look into the clinics and see how far they can help me.

btw do you think the insurance reps will tell me if I asked them directly about this?
maybe it varies and I'm hoping that some plans will allow diagnostic testing/treatments within a few months.

[moburkes]

I meant before, but now that I re-read the thread, you haven't been yet. Is that correct? Okay, then it will be covered.

[sprinty]

yes that's correct, I was never diagnosed with anything and was in good health.
thanks for your help! I'm glad to hear that!

[moburkes]

I'm not talking about diagnosis. I'm talking about someone as simple as a doctor's visit. If you haven't been, then you don't have to worry. However, remember, the insurance company determines when the policy kicks in.

[sprinty]

Originally Posted by moburkes

However, remember, the insurance company determines when the policy kicks in.

I'm hoping that's something I can ask about before purchasing.

[moburkes]

Ask away. There are no secrets.