Pre-Existing Clause on Insurance?
Hey everyone, I had Lap-Band surgery back in July 2007 and after losing and then regaining a bunch of weight on it, I'm now looking at doing a revision to RNY. My mom actually had the same problems with the Lap-Band that I did and is doing awesome after her revision to RNY, which is what made me decide that this might be the right path for me.
However, I am now having some insurance issues. I am currently covered under my stepfather's plan as a dependent, but in 2010 (when I turned 23) was kicked off his insurance and never received a letter of credible coverage. So I did go more than 63 days without insurance, never knowing I wasn't covered until August when I went back to my surgeon's for a routine follow-up and found out then. But then I was allowed back on his plan on January 1, 2011 because of the new health care law. But yeah, anyway...now I have the opportunity to go back on my employer's insurance (the insurance I originally had which covered the Lap-Band). It is Anthem Healthkeepers with the Obesity Rider (which covers weight loss surgeries). Here's my problem: we've talked with the insurance people a bit and decided not to go with it after they said I would have a pre-existing condition for 12 months before I could even start the surgery process because of my already having Lap-Band. However, they did initiate the process before I had a chance to cancel, and yesterday I just received a letter about the pre-existing clause. It pretty much said that I had to list any medical diagnoses, advice, treatments or care that I had received in the 6 months prior to enrollment.
This is why I'm now confused. If anyone has had this kind of situation or knows anything about this, that would be great. My philosophy on the matter is: I haven't been to the doctor's or been treated for anything at all in the past 6 months (including anything Lap-Band related), so can my Lap-Band be a pre-existing condition for any weight loss surgery? The pre-existing clause letter also stated "equipment received" in the last 6 months, and the Lap-Band as "equipment" was received in 2007, so that's my opinion.
Any expert advice out there would be much appreciated.
However, I am now having some insurance issues. I am currently covered under my stepfather's plan as a dependent, but in 2010 (when I turned 23) was kicked off his insurance and never received a letter of credible coverage. So I did go more than 63 days without insurance, never knowing I wasn't covered until August when I went back to my surgeon's for a routine follow-up and found out then. But then I was allowed back on his plan on January 1, 2011 because of the new health care law. But yeah, anyway...now I have the opportunity to go back on my employer's insurance (the insurance I originally had which covered the Lap-Band). It is Anthem Healthkeepers with the Obesity Rider (which covers weight loss surgeries). Here's my problem: we've talked with the insurance people a bit and decided not to go with it after they said I would have a pre-existing condition for 12 months before I could even start the surgery process because of my already having Lap-Band. However, they did initiate the process before I had a chance to cancel, and yesterday I just received a letter about the pre-existing clause. It pretty much said that I had to list any medical diagnoses, advice, treatments or care that I had received in the 6 months prior to enrollment.
This is why I'm now confused. If anyone has had this kind of situation or knows anything about this, that would be great. My philosophy on the matter is: I haven't been to the doctor's or been treated for anything at all in the past 6 months (including anything Lap-Band related), so can my Lap-Band be a pre-existing condition for any weight loss surgery? The pre-existing clause letter also stated "equipment received" in the last 6 months, and the Lap-Band as "equipment" was received in 2007, so that's my opinion.
Any expert advice out there would be much appreciated.
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