Question:
Are you

I have been told By Fortis Health Care Ins. that after the surgery, you are uninsurable. That is if you have a need to change insurance companies in the future. Has anyone tried to obtain other insurance (medical) after the surgery? Besides a group ins(where there is an open enrollment period)    — Lynda C. (posted on March 14, 2002)


March 14, 2002
I asked a question similiar to this a few months back. This is what I was told: If there is a lapse in coverage (appx. 90 days), and you go to re-apply...your surgery can be considered pre-existing. BUT, no matter if you have a lapse, and you go to work for a company that has a "group" plan, it may not be such a big deal. I hope that narrows it down a little bit. I have to be honest...I know nothing about the rules and regulations...so take my statements with a grain of salt...and if you find something else out; LET ME KNOW!
   — Kristin R.

March 14, 2002
I asked a question similiar to this a few months back. This is what I was told: If there is a lapse in coverage (appx. 90 days), and you go to re-apply...your surgery can be considered pre-existing. BUT, no matter if you have a lapse, and you go to work for a company that has a "group" plan, it may not be such a big deal. I hope that narrows it down a little bit. I have to be honest...I know nothing about the rules and regulations...so take my statements with a grain of salt...and if you find something else out; LET ME KNOW!
   — Kristin R.

March 14, 2002
This is a crock. Taking the word of some claims adjustor or sales agent at an insurance company is not what I would consider a reliable source. That is a form of discrimination that can get insurance companies into BIG trouble. You may find that the premiums on an individual policy may be high due to risk adjustments, similar to people with diabetes or a history of cancer, but you will always qualify for coverage on a group policy. There are certain provisions that you have to be on the policy for one year for coverage of pre-existing conditions, but once that year is up and you have had continuous coverage, any new insurer (such as when your employer changes carriers) MUST cover you. Reference Pres. Clinton's Health Care Coverage Portability Act.
   — merri B.

March 14, 2002
You could be declined for individial PPO/POS plans or approved, but subject to higher premiums. Most insurance companies do ask health questions on their individual applications. Having worked in a broker's office for a number of years, I have seen applications declined for medical/health reasons. When that happended, individuals were offered the opportunity to enroll in HMO plans.
   — Rosario T.

March 14, 2002
That is wrong! In fact, most insurance companies would insure you especially now that you're not a risk. I've always used my husband's insurance so I don't have any information about private insurance. I'd check them out and don't mention that you've had surgery. See what they say.
   — dolphins94

March 14, 2002
There is a big difference between an individual insurance policy and a group policy. If you plan to stay with a group it should be no problem as they can't really deny you. If or when you may need an individual policy in the future it WILL. In the last two months I've been searching for an individual policy as my current employer does not offer benefits. They ask about ALL previous surgeries, conditions, etc. One lady I spoke with had had a bariatric type surgery 20 years beforehand and they denied her the policy she was wanting just this year! Because of my weight and health status I was also just denied the policy I wanted. Its sort of a lose-lose situation. Can't get it like I am, won't get it later if I resolve these issues because I'll trade it for another excluding factor (WLS)! BUT by state law they HAVE to offer a minimal plan. Its there that things change. What the minimal state required plan require varies state to state from what I understand. In ID they offer 4 plans, 1 basic 50/50 (500 ded), 1 standard 70/30 (1000 ded), and two catastrophic with very high (up to $5000 ded!). They really are more of an insurance policy against a major illness as there is really no insurance coverage until you meet that deductable and then what they cover is very limited. PLUS your rates are high. Even the minimalist policy of 70/30 with a $1000 deductable will run me (29 nonsmoker) between $170-200 a month. And from here on out because of age, etc my rates will just keep going up. Not trying to be a downer but I wanted you to know that it will affect your rates and options if you ever need an individual insurance policy.
   — Shelly S.




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