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[IP] Re:pre-existing condition


Sorry you're going through this--I've been through it multiple times,
with multiple companies. It is illegal. Often, the insurance companies
act as if they aren't aware of the laws. I've learned that unless you
call them repeatedly and quote laws to them, they will do what is
cheapest for them, i.e, not covering you. Most people are unaware of
their insurance rights, and the companies use this to their advantage. 

You should have received a certificate of coverage from your old
insurance company. If not, request one immediately-all companies are
required to send them to you when you leave their services. If there was
no break in coverage between your old and new companies (e.g., your old
company covered you until the 31st, and the new one started on the 1st),
then you are legally covered, regardless of pre-existing condition. Call
your present insurance company and speak to a manager who deals with
pre-existing condition coverage. Fax them a copy of the coverage
certificate. If there was a lapse of coverage between the two companies,
you are likely still covered. The HIPAA (Health Insurance Portability
Accountability Act) (also known as the Kennedy-Kassebaum Bill) states
that the new company cannot deny you coverage for any amount of time for
a pre-existing condition if the lapse in coverage between insurances was
63 days or less. If that is the case, again speak to the manager, fax the
coverage certificate, and state your rights under HIPAA. They may play
dumb. One company told me they had never heard of HIPAA, or Kennedy
(!)-Kassebaum bill. I faxed them a copy of the bill, which you can get
either from your local ADA chapter or your state insurance commissioner.
When they still faltered, I contacted a lawyer. One lawyer contact, and I
was covered. 

It's important to be firm and persistent with these companies. Also, keep
everything in writing. Write down all phone conversations, esp. who you
talked to and when. Some companies I dealt with denied earlier statements
made by other employees. Your record will be necessary not only in
dealing with them, but in a court of law, or for your lawyer. Also, your
local ADA office may have someone who specializes in this, who may call
the company for you. I also contacted my congressman's office and got
them involved. 

Good luck, and feel free to email me off list if I can be of further
help. If you can't get a copy of HIPAA, I have one I can send you. 

Maureen M.

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