How do I know if I have a pre-existing condition?

How do I know if I have a pre-existing condition?

A Pre-Existing Condition is any medical condition that has been diagnosed, treated or experienced a change within the policy’s look-back period. Depending on the policy, the look-back period is typically 60-180 days prior to the effective date, but can be 12-36 months prior to the effective date.

What happens to health insurance with pre-existing conditions?

Private medical insurance providers would have to significantly increase the price of their policies if they were to accept all pre-existing conditions. The number of claims would obviously rise as the treatment for certain illnesses could be required over an indefinite period of time.

Why do health insurance companies use prior authorization?

Insurers use prior authorization to make sure patients’ health care is necessary and appropriate. In theory, that helps to protect patients and control costs. 2) How does this practice affect patients and providers?

Why did my insurance company deny my prior authorization?

Insurance companies can deny a request for prior authorization for reasons such as: The doctor or pharmacist didn’t complete the steps necessary Filling the wrong paperwork or missing information such as service code or date of birth The physician’s office neglected to contact the insurance company due to lack of time

Are there health insurance for people with previous medical conditions?

Some insurers will take into consideration those with existing or previous medical conditions. This is good news for those with a previous history of medical conditions, as both health and life insurance can offer valuable peace of mind should things go wrong.

Can a health insurance company deny you coverage because of a pre-existing condition?

Insurance companies cannot deny you health coverage based on a pre-existing condition, including pregnancy. It is also illegal for them to charge more money for your plan just because of a pre-existing issue.

When do you need prior authorization from your health plan?

If you need special treatment, service, or medical equipment, you may need to get approval first from your health plan. This is called prior authorization. A health plan gives prior authorization when a service is medically necessary.

What to do if you have an issue with your health care plan?

Many issues can be resolved with a phone call to your plan. Managed care enrollees and providers can file a complaint with certain government agencies. Depending on the type of health care plan involved and the kind of complaint, there are different agencies that can help.

Insurance companies can deny a request for prior authorization for reasons such as: The doctor or pharmacist didn’t complete the steps necessary Filling the wrong paperwork or missing information such as service code or date of birth The physician’s office neglected to contact the insurance company due to lack of time