Re: Anyone have PRE-EXISTING CONDITION insurance complicatoins?

[Guest guest]

Every state's insurance code addresses what constitutes

a " preexisting condition. " I don't know what state you live in, but

in CA (where I live) it's something like a diagnosis in the last 12

months (I don't remember). Find your state insurance code and the

relevant section on preexisting conditions - your insurance company

cannot deviate from the law. I just recently got Kaiser and I'm

worried that they're going to pull the same thing with me, so I

looked up the relevant statutory provision and I know that under the

law, they cannot deny me the surgery b/c the last time I was told I

needed the surgery was four years before I signed up with Kaiser.

But, nonetheless, I expect they'll give me problems too, considering

I just got coverage in February and have my first consult with the

OS next week. Good luck!

mcs

>

> I wasn't too worried about getting insurance approval, based on my

> surgeon's telling me that I shouldn't have anything to worry about

> regarding medical necessity, etc.

>

> But now I'm starting to worry, because my insurance company has

> launched an investigation into an UNRELATED claim I made for

another

> minor surgery I had in late December. Apparently, since I had only

> had

> coverage with them since November 1st, it raised a red flag when I

> submitted a moderate-sized claim just 2 months in.

>

> So it seems as though they're real sticklers for the 'pre-existing

> condition' thing. Is it possible that they'll look at my ortho

pre-

> authorization claim I plan on submitting this summer for my August

> surgery and refuse to cover it based on an argument that it was a

> 'pre-

> existing condition'. While it's true that a few general dentists

I

> have seen had previously commented on my open bite and thrown out

the

> idea that ortho would fix it, I had never really considered the

> surgery

> seriously until I switched to my current (much better) health

> coverage.