new insurance, help!

brehmermom
on 8/5/06 5:53 am - Cedar Springs, MI
Hello everyone! I was with an insurance compnay that was a real pain in the fanny to deal with. However, a wonderful job opportunity came up and now I'm with a different company with insurance that, from this website, seems a lot easier to get along with. How long after I begin having insurance coverage should I begin seeking approval for surgery? I've wanted surgery for 2 years now, so this is not a sudden desire for me. Can I get denied just because I haven't been with them long? Does anyone know or have had this experience?
shell0995
on 8/5/06 7:23 am - Farwell, MI
I had my surgery on 7/3 and the Friday before the surgery I got a call from the surgeon's office stating my insurance company flagged me to the hospital when they sent in the preadmission information. We had to get a few things clarified, one being that I had insurance prior to my husbands insurance being effective. Actually we had seven days of double coverage. My surgeon's office told me in Michigan there has to be coverage for 60-70 days (can't remember exact number) prior to the new insurance taking effect. Therefore, I was safe. Your surgeon's office might know more about this, so I would ask them. The first step you should do is contact the insurance company to find out their criteria and if there is a preexisting condition, explaining that you did have coverage xx many days prior to the new insurance taking effect. Also make sure you get the name of the person you speak to and write everything down. It may help you later down the road. Michelle 311/274/140
Mifiremedic
on 8/5/06 12:04 pm - MI
So if I understand you correctly, as long as you wait the specified time as that period the insurance has to cover it? I am contemplating get insurance from my employer when its open season, and then starting on my journey towards weight loss. I am afraid I will get the insurance only to have the insurance tell me I have to wait an longer period of time because I am a new insuree. Has anyone else started the WLS process shortly after getting a new insurance policy? Thanks
shell0995
on 8/5/06 12:57 pm - Farwell, MI
The way I understood it was this: If I did not have insurance coverage the preceeding 60 whatever days prior to my husbands insurance going into effect, then I would have to wait a full year (your insurance could only be 6 months - all are different so you should check). Since I did have insurance coverage the preceeding 60 whatever days, in the state of Michigan it overrides that 'pre-existing' clause or atleast that is what my surgeon's office told me. You should still check with the insurance company for the criteria. As far as being afraid to get the insurance and then being told you have to wait - the longer you wait to get the insurance could make it a longer wait for surgery. It's a hard choice to make, but you should get all the facts from the insurance company and/or your employer before you make your decision. They know your policy and should be able to tell you what it what.
(deactivated member)
on 8/6/06 1:40 am - Paw Paw, MI
Alaine, I had ins coverage through my husbands company as an employer. The company I worked for would not cover me unless I was dropped by my prior insurance. I dropped the ins through my husband as an employee and picked it up through my employer because they do cover the surgery at it was an exlusion on my husbands companys insurance. If you were covered by your prior employer and pick-up the new insurance with-in thirty days there is not questions asked because you had prior coverage. If you take this new job and don't take the insurance right away and what until open enrollment you will have to what their grace periods and they may not cover pre-existing conditions. If you pick-up the insurance within the 30 days you can start seeking surgery right away. Becky
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