about insurance & answer to Suzy

[Guest guest]

Ok y'all....let me give you some " inside " information on this

insurance " game " that the insurance companies are playing these days.

#1 - If you've been covered under a Group health plan, and never had

more then a 63-day break in coverage, a company CANNOT deny you

coverage. They have to write it as a guarantee issue. Now what

they can do though is hit you with big time rates, and ryder your

policy to not cover specific conditions (forever, or for a specific

time period)IF you tell them everything that you've ever been to a

doctor for.

Here's the scoop. If you haven't been to a doctor for a specific

dx, or tx for at least two years (because you haven't had a problem

with it or aren't taking mainenance meds), don't tell them! (Most

of the time they'll only look back one year.) The new carrier will

probably wait and do a pre-existing condition/look-back on you when

you file your first claim. It's at that time, and then

subsequently, that whenever you're going to be treated for a certain

condition, e.g. 's cervical dysplasia, that they'll want to

know if you've been treated for it in the past.

What they're not going to do is send out a letter to every

physician, pharmacy, and hospital in your area asking them if

they've ever treated, seen, or served you UNLESS you've listed them

all on the application! Well let me rephrase that because if you

live in a small rural area and have only got one hospital to go to

within a 50 mile radius, as an example, it wouldn't surprise me if a

carrier would go ahead and send out requests for history. :o/

Best advice, keep in mind that they don't need to know if you had a

ingrown toenail that needed to be removed three years ago. You

don't need to list every doctor you've ever seen because those are

the ones they WILL send letters to asking for history.

I understand that y'all want to tell the truth and/or be honest with

these kinds of things but there's just times, especially when it

comes to insurance, that you just can't do that or it's gonna screw

you in the end! Believe me, they're gonna try to screw you as much

as they possibly can when it comes time to paying your claims so you

have to learn to play their games!

Speaking of insurance, I quit my old job working for the TPA the end

of July and went into an A/R Dept. for a manufacturing company.

Just interviewed for another job back in insurance, only this

position will be procesing FSA claims. Should find out if I'm

getting this new job by the middle of next week. Huge company, and

the bene's are the GREATEST! And no, they will not be able to pre-x

me because I've been carrying COBRA and paying the big premiums

since I left my old job!

{{hugs}}

Debbie

P.S. Suzy, the reason we left MI was because my husband was in the

concrete/masonry construction business. We lived in on during

the late 70's and early 80's and things went from bad to worse

there, including the weather. It got so bad that the last couple of

years we were there, he couldn't even work enough weeks to collect

unemployment during the winter, so we decided to move here where he

could work year-round and I could get a job not working in a grocery

store! Office jobs were few and far between in a place like

on!

It was REALLY hard the first two years and we almost moved back to

MI a few times just because we were so home sick! No snow at

Christmas was the hardest to get used to, going xmas shopping in

shorts was strange too! LOL But, we had family, and friends, that

lived down here so it wasn't like we were coming to a strange place

and knew no one. I had never been to FL until we moved here so I

was really shocked that the whole state wasn't covered in sand and

palm trees! ;o) hehe