Precondition Issues With Health Insurance

by Ethan Kalvin

I am in my forties and have three small children. I want to share what recently happened with me and my insurance company. Between all the different stories you hear about people and their health insurance companies, this topped the chart for a middle class mom making $36,000.00 a year.

The company I work for does not provide me with health insurance. I did have coverage, it was affordable and a decent plan. It did not cover everything like vision and dental but I paid co-payments only at doctor visits and for prescriptions. My deductible was a little high but that kept my premium low. With the three of us and the boys being so young we had many visits during a years time.

A friend of mine had insurance with the same company. After taking about her plan I really needed to switch to a the family plan. It had more benefits and the premium was a lot less than what I currently paying. I decided to call the company to change my plan. When talking to the agent I mentioned that I had recently paid my premium. He informed me that I could not transfer the funds and they had to cancel my policy first and start all over with a new one. I would receive a check between five to 7 weeks. So now I was out that money and needed another payment immediately to stay insured.

Shortly after the shock it was time for a routine exam I needed for a condition I was covered for on this policy. Just before I make an appointment for the exam I get a letter from the insurance company. They are telling me that my condition was a precondition and that if it was determined that I may need surgery after the exam it would not be covered. I thought this was a joke right?

So here I am sitting, waiting to set my appointment. Terrified enough that I may have a life threatening condition but how the hell am I going to pay for it. I should have asked and probed for many more questions. Did the agent know that this would be the case? Did they just assume I would realize that? Or maybe I did not read the small print. I will get to the bottom of it someday but to busy right now to make my self sick over it. I would love to fire them but its not likely that an insurance company will take someone with a precondition and be affordable for me.

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