Okay, I know the kind of policy you mean and to be honest, I'm not sure which way it falls, either. My experience with that kind of policy was twenty years ago and a lot of insurance law has changed in that time; when I dealt with that kind of policy in the early 80's it was brand new. I THINK it counts as a group policy but I'm not positive.
Here's why I'm asking. If it was a group policy, then since you did not have any gap in coverage they CANNOT call any condition pre-existing. NO pre-ex. None. Nada. Zip. Can't be done. Illegal. This counts as long as EITHER the old or the new plan was a group plan. Group to group, individual to group, or group to individual are all protected. This is under a Federal Law abbrieviated as HIPAA. HIPAA does allow for pre-ex conditions in some circumstances but not under the ones you've outlined - as long as you are or were in a group policy.
If it was an individual policy to an individual policy, however, then HIPAA does not come into play and an insurance carrier can (but does not have to - not all of them do) consider a condition pre-existing. Your state may have limitations on how long a look-back period there is and how long a condition may be considered pre-ex.
Has your new insurance carrier actually denied coverage, or have they simply asked for information to determine if pre-ex exists? It's not unusual, even in a group plan, to do some investigation to find out whether a condition is pre-existing. As I said, even under HIPAA pre-ex IS permitted in some cases.
Here are a couple of things you can do. First, call the old insurance carrier and ask whether or not your policy was considered group or individual. If they say group, ask them to send you a HIPAA certificate. They are required to do this by law. The HIPAA certificate, if you can get one, will be all that you need; send it to your new insurance carrier and all pre-ex problems will go away as long as you had coverage for a full 12 months or more. If you had it for less than 12 months, the pre-ex period must, by law, be reduced by the amount of coverage you had. For example, if you had eight months coverage, then they can only consider a condition pre-ex for four months. The length of your old coverage and the length of the pre-ex cannot add up to more than 12 months.
If your old policy was individual, ask your new carrier the same question. If THEY say group, you can't get a HIPAA certificate from them because it's still an active policy, and it wouldn't prove anything anyway - it's your old coverage information they need. So in that case ask them what they need from the old carrier to prove coverage so that you can invoke your rights under HIPAA. They will probably say a letter from the old carrier will do it. Then call the old carrier and arrange it. They're probably used to that.
If it turns out that both policies are considered individual and HIPAA does not apply, then the only thing you can do is call your state insurance commission and find out what, if any, limitations Ohio puts on pre-existing conditions.
You can also try getting your doctor to put it in writing that the two conditions are totally unrelated but that doesn't always do it.
