Effective date?

[jsevigny]

What is the name of your state (only U.S. law)? Louisiana

Recently, I purchased health insurance through work. In the past 12 months i have not been treated for anything at all. My effective date is 12/1. In the early morning of 12/1, I recived services for the hospital and was diagnosed I had been suffering for months and it had come to the point where I could no longer fuction normally. Can they screw me and consider it a pre existing condition? Please and Thanx

 

[cbg]

Did you have health insurance prior to 12/1? If so, was it a group policy or an individual policy? Had you ever had any treatment for the condition in the past?

The policy went into effect at 12:01 am on 12/1, I can tell you that much.

 

[jsevigny]

I did not have health insurance before that nor any existing condition. I knew i had health insurance as of 12/1. They are scaring me by saying that the effective date isnt always correct. You have to do a pre existing worksheet and all that so i am confused if that was a ligitamate coverage date and will try to say that somehow it it now pre existing I am loosing my mind over this! Thanx alot

 

[cbg]

The coverage is effective at 12:01, December 1.

If you have not been treated for this condition for six months prior to that, then by law, they cannot consider it pre-existing.

You have nothing to fear by completing whatever paperwork they provide you with as long as that is the case.

Relax.

 

[jsevigny]

That is the case. So when i complete the pre-existing condition form this isnt classified as pre existing correct? Since the effective date was 12/1 regardless of how much paper work is left I recived help during effective period? Thank you very much

 

[cbg]

Since this is a group policy, they CANNOT legally consider a condition pre-ex unless you have been treated for it within the last six months. But they are not required to take your word for it; they are entitled to medical verification. That is what the paperwork is for; to confirm whether you have or have not been treated during the look back period. When the paperwork comes back verified that you have not, there will be no issues with pre-ex.

 

[jsevigny]

So they cannot cosider my diagnoses on the effective date a pre existant even though the paperwork hasnt been completed? Thank you

 

[cbg]

What part of, THEY CANNOT CONSIDER IT PRE-EXISTING IF YOU HAVE NOT BEEN TREATED FOR IT IN THE SIX MONTHS BEFORE THE COVERAGE BEGAN are you not understanding?

For the last time, NO. It is not based on when you complete the pre-ex questionaire; it is based on when the coverage begins.

You DID complete an enrollment form previously and get an ID card, correct?

 

[jsevigny]

Of course, I did. Thank you I understand

 

[ecmst12]

You WILL need to complete all the paperwork they ask you to and cooperate with their investigation, which may take some time. But ultimately you will be covered.