Question:
If I pick up new insurance thru my husbands company will there be a pre-existing issue?

I have gotten recommendation from my pcp for WLS. I have Cigna HMO thru my own employee and I know that they will deny me based on there criteria. My question is, my husband has his own company and is looking for health care coverage for his employees in which I am part of his company. If we pick up an insurance in the next few weeks will how likely will they approve my surgery if I have not seen the surgeon or gotten any treatment for my morbid obesity as of yet. I do have an appointment with the surgeon in 2 weeks but I'm wondering if I should wait until the new insurance kicks in. Thank you for any help that you can give me.    — Ann M. (posted on March 29, 2003)

March 29, 2003
I work with insurance so i can tell you this. as long as you keep the insurance you have now until you have now and there is not a lapse in coverage for more than 2-3 months depending on the insurance, and as long as you have had continuous coverage without a lapse for the past 3-5 years (depending on ins) there is not a problem with pre exisiting, even if you had already seen the surgeon there would not be a problem.. just make sure that there are no lapses in coverage.. Good Luck
   — amberb

March 29, 2003
If I understand you corectly your husband is looking to change insurance companies for his business. I assume he offers single and family plans to his employees. If so, then all he needs to do is take a family plan under the new insurance for him and you. <p>Like the other poster said as long as the coverage stays continuous is what matters. I'm assuming you would keep your insurance also, especially if it is provided free to you. Based on other posts I read in the last few months of people who have Cigna, that seems to be one of the insurances that does pay for WLS. If you can start the process under Cigna and get as much out of the way as possible - whatever they will pay for before reviewing, I would go for it. Then if you get a denial from Cigna you can pursue your husbands new family policy, which would be your secondary insurance. <p>This is pretty dicey as to buying a new insurance that will guarantee you coverage of WLS. Your husband would have to dig into the details of their criteria to be sure it would be approved. I'm assuming he owns a smaller company and would be buying a package plan, rather than writing his own and picking and choosing, like most large companies do. Good luck and don't get rid of your Cigna until after your surgery is done. You just never know with a new insurance what could go wrong.
   — zoedogcbr

March 29, 2003
There have been several posts regarding pre-existing clauses. I am posting a link to a site that can better explain some of the HIPAA laws that govern insurance on this and many other topics that have been addressed on these boards. I have not read this entire site as there is alot to know regarding the HIPAA laws. Since I work in the industry most is common knowledge to me, but this site seems to be very user friendly in helping anyone understand how it effects them individually. http://www.cms.hhs.gov/hipaa/hipaa1/default.asp
   — RebeccaP

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