Question:
What is a medical history review?

After being approved by my insurance company, they send me a letter saying they are doing a medical history review and want the names of doctors,hospital, and pharmacies I used since 2001.They aslo want prior proof of insurance. i gave them also this info when I first applied for the insurance.What exactly are the looking for they did not do in 2004 when I got the policy?Any advice would be appreciated. teesha    — javoanta2 (posted on March 27, 2006)

March 26, 2006
Odd that they would ask for this info after giving an approval. What it sounds like to me is that they are looking for a way to eliminate your pre-existing clause. If you have had continuous coverage with a group health plan with no more than 60 days laps, they can not put the pre-x clause in place. That would usually be the only reason they would ask for prior coverage. Looking for medical history since 2001 would let them see if you have sought treament for obesity, therefore allowing them to deny due to pre-x. In my claims payment history, I've NEVER looked that far back, especially if the policy had been in place since some time in 2004. If you've had this policy for 18mos, or less than and a previous policy, you have nothing to worry about with the pre-x clause...that's law. Other than that...I can see no reason why they would request such info.
   — RebeccaP