My insurance company (Humana) is denying to pay for my wife's medical bill stating that it be a pre-existing condition. My wife and I married in September of 07'. She come onto my insurance in October of 07'. Before this time, she have no insurance. At the time of our marriage, my company be insured with Kaiser PPO. However, In March of this year (08') my company switched insurance companies to Humana (with no lapse of service)...While we be yet next to Kaiser, my wife was diagnosed next to a goiter that is non-malignant but basically needs to be watch...as part of watching it, my wife saw her Thyroid Dr. after we switched to Humana, and in a minute Humana is refusing to earnings for that office pop in...is that legal?...appreciation sooooo much for any and all assist! Jim
Answers: yes, it can be considered a pre-existing condition since your wife has singular had coverage for 5 months up to that time going on the new plan. If she didn't hold insurance before October 07', she individual has have coverage for 7 months so far.
Your wife would have to show 18 months of credible coverage near no more than a 60 day break contained by coverage for there not to be a pre-existing condition cut.
I'm surprised the insurance company caught this though, since your wife was on the prior carrier plan, but they did and it is legal.
Your wife will hold to meet Humana's preexisting condition shortening cause in the past they will pay for any medical condition she have prior to October 1, 2007.
If Humana's preexisting condition limitation do is 12 months, they will begin to expenses related to her goiter on November 1, 2008. If Humana's preexisting condition curbing cause is 18 months, you will enjoy to add another 6 months on to that until that time Humana begins to payment for expenses related to the condition.
Check a copy of your benefit booklet to determine the exact length of the preexisting condition limitation wreak or if you don't have a booklet see your HR department.
A all-embracing range of answers. 12 months. 18 months. Let's make sense of it.
18 months is usually the length of time you hold Cobra and 12 months is generally the spell of time used in determining the pre-existing condition clause.
Your best bet is sometimes to check near an EXPERIENCED broker...
I hope this helps.
27 years contained by the business.
Yes, it's a pre-existing condition. She doesn't have 12 months of prior credible coverage - she just has since October of 07. She's get to wait it out. If in that was a lapse surrounded by the policies yes it can be considered pre-existing. The insurance company will do anything to get out of paying.
No-this cannot be considered pre-existing. Go to your HR dept and hold them straighten it out with Kaiser. This sounds similar to a job for HR
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Answers: yes, it can be considered a pre-existing condition since your wife has singular had coverage for 5 months up to that time going on the new plan. If she didn't hold insurance before October 07', she individual has have coverage for 7 months so far.
Your wife would have to show 18 months of credible coverage near no more than a 60 day break contained by coverage for there not to be a pre-existing condition cut.
I'm surprised the insurance company caught this though, since your wife was on the prior carrier plan, but they did and it is legal.
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Your wife will hold to meet Humana's preexisting condition shortening cause in the past they will pay for any medical condition she have prior to October 1, 2007.
If Humana's preexisting condition limitation do is 12 months, they will begin to expenses related to her goiter on November 1, 2008. If Humana's preexisting condition curbing cause is 18 months, you will enjoy to add another 6 months on to that until that time Humana begins to payment for expenses related to the condition.
Check a copy of your benefit booklet to determine the exact length of the preexisting condition limitation wreak or if you don't have a booklet see your HR department.
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A all-embracing range of answers. 12 months. 18 months. Let's make sense of it.
18 months is usually the length of time you hold Cobra and 12 months is generally the spell of time used in determining the pre-existing condition clause.
Your best bet is sometimes to check near an EXPERIENCED broker...
I hope this helps.
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Yes, it's a pre-existing condition. She doesn't have 12 months of prior credible coverage - she just has since October of 07. She's get to wait it out. If in that was a lapse surrounded by the policies yes it can be considered pre-existing. The insurance company will do anything to get out of paying.
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No-this cannot be considered pre-existing. Go to your HR dept and hold them straighten it out with Kaiser. This sounds similar to a job for HR
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