Insurance Change and Pre-Existing Conditions
Last Modified: November 1, 2001
Dear OncoLink "Ask the Experts,"
I am considering changing from my current health insurance coverage (BC/BS of the National Capital Area) to my husband's insurance (BC/BS government employee) coverage during open enrollment. Since I was diagnosed with localized malignant melanoma 6 months ago, I was concerned that changing health insurance may create problems for us with respect to coverage of a "preexisting condition" if I am later seen by a doctor for a related health problem. I called my husband's health insurance customer service line and was assured that a preexisting condition would not affect my coverage. Can I believe this? Should I contact anyone else before we make the change?
Since the open enrollment period ends December 10, I'd appreciate a
prompt reply. I only discovered your service today; otherwise I would
have written earlier.
Employers are typically offered the option of including or excluding a pre-existing condition clause. Inclusion will mean an added expense to the employer, translating into a higher premium for employees. Pre-existing condition clauses are typically customized for the employer, and may have different requirements for employees versus their dependents. For instance, the employee may be covered from day one for a pre-existing condition but the spouse (or other dependent) may not be covered for a period of six months. In other words, not all pre-existing condition clauses are alike, and we strongly urge you to obtain written confirmation that you will be covered. Contact your husband's health insurance customer service line and request a copy of the pre-existing condition clause, and/or a letter specifying the terms of the conditions. We do not recommend that you change your coverage until this information is received, reviewed and deemed acceptable.
June 15, 2011
June 24, 2016