General Question

luminous00's avatar

Would I be declined by my new employers health insurance if I had a gap in coverage from my last job to this one?

Asked by luminous00 (350points) October 31st, 2008

I worked at my last company for 4yrs and left there to work at my current position at another company, and I’ve been paying cobra insurance (since I was a temp-to-hire position and am now being hired on), but now it’s down to having to pay for this month (381 a month) when I might be signed off on within the next week or two. I’m just afraid I’ll be declined if I have that gap…I was going to a psychologist for about 8mo and was taking diazapam on an as needed basis and even tried wellbutrin, and am now using klonapin on an as needed basis, these are anti-anxiety drugs…would these affect me getting picked up by the new health insurance? I just hear horror stories about pre-existing conditions declining people…

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7 Answers

Mizuki's avatar

Group insurance only has a 60 day pre condition period in most states, so you should be fine. Private insurance would be another story.

luminous00's avatar

What do you mean a 60 day pre-condition period? Like they only check the last two months? I only took out the klonapin within the last two months, haven’t been to the psychologist in almost 4 months

Mizuki's avatar

I think that after 60 days in a group policy everything should be covered…In a privately purchased plan, 12 months of waiting.

luminous00's avatar

Thanks Mizuki for answering this questions so quickly, I appreciate that. So with this:

“Pre-existing Conditions Recent additions to Pennsylvania law help to assure continued coverage for you and your dependents when you change jobs and obtain health insurance through a group health plan. Insurance companies may impose only one 12-month waiting period for any pre-existing condition treated or diagnosed in the previous six months. Your prior health insurance coverage will be credited toward the pre-existing condition exclusion period as long as you maintained continuous coverage without a break of more than 63 days. Pregnancy is not considered a pre-existing condition. Newborns and adopted children who are covered within 30 days of birth, adoption or placement for adoption are not subject to the 12-month waiting period.”

It essentially means I can go up to 63 days without coverage and they would still take me on without the chance of being declined? I mean I don’t even know if making psychologist visits and taking anti-anxiety meds are even pre-existing conditions, but I just don’t want to pay another 381 for a week of insurance I won’t even use…

scamp's avatar

@ luminous00 I am including a link for your quote so no one yells at you for not posting it.

Good luck with your insurance nightmare. I think denials for pre-exsisting conditions sucks!!

Mizuki's avatar

I assumed you were talking about Group Insurance, like through your work. Are you talking about private insurance?

scamp's avatar

The paragraph after the one you quoted says:

*Guaranteed Issue of Health Insurance to Eligible Individuals. New Pennsylvania law also makes it easier for you to get individual insurance under certain situations, including if you left a job where you had group health insurance, or had another plan for more than 18 months without a break of more than 63 days. Specifically, if you meet certain criteria, you are considered an eligible individual and guaranteed the right to buy individual health coverage from Blue Cross and Blue Shield plans in Pennsylvania without a pre-existing condition exclusion period.

To be an eligible individual, you must:

1) have had 18 months of continuous credible coverage, at least the last day of which was under a group health plan;

2) have used up any COBRA continuation coverage for which you were eligible;

3) not be eligible for Medicare, Medicaid or a group health plan;

4) not have other health insurance.

You must apply for health insurance for which you are an eligible individual within 63 days of losing your prior coverage.*

Does any of this apply to you?

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