Pre-Existing Condition Limitation

cowboy4life
on 7/30/09 11:46 pm - Laplace, LA
While checking the alternative medical plan that my employer offers, I noticed that there is a pre-existing condition limitation of $1,000 for the first 12 months whereas my current health plan has a $0 maximum for the first 18 months.  Now, I am a type II diabetic. So does that mean that if I switch from my current plan, (Humana HMO), to the alternative (BCBS of TX PPO) I won't get my medications and testing supplies filled.  Also, Humana has an employer-placed exclusion on WLS, but BCBS does not which is why I am looking to switch in November.  November is the open enrollment for next year's benefits with my employer.  Can someone smarter than I explain this to me?
Chad M.
on 8/1/09 1:47 pm - Indianapolis, IN
Pre-existing conditions would not apply to you if you are switching group coverage, and if you have been covered for the previous 12 months. Talk to your HR department to make sure that this provision of HIPAA applies to you and your plans (there are a few cir****tances where it doesn't).
Vicki Browning
on 8/2/09 4:33 am - IN
Check with your HR department but I think if you switch from insurance to another the pre existing should be waived if you do no have a lapse in coverage or no more than 60 day lapse in coverage. Some insurance will waive the pre x if you have had 12 months of creditable coverage with no lapse. 
cowboy4life
on 8/12/09 12:20 am - Laplace, LA
Thank you both very much.  I will check with my HR contact when I get my 2010 package in October.
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