Health Insurance - Preexisting Condition

[toloquta 0]

If all goes well at the medical and interview my fiancee will be moving to the states in late October. My employer will provide her with health insurance once we're married. Is it likely that we'll have problems with our health insurance provider (Cigna) with preexisting conditions? Do we need to take any steps to prevent a "gap in coverage"? We're just trying to cover our bases. It wouldn't be the first time a US health insurance provider #$&*@! me.

[Udella&Wiz 325]

If all goes well at the medical and interview my fiancee will be moving to the states in late October. My employer will provide her with health insurance once we're married. Is it likely that we'll have problems with our health insurance provider (Cigna) with preexisting conditions? Do we need to take any steps to prevent a "gap in coverage"? We're just trying to cover our bases. It wouldn't be the first time a US health insurance provider #$&*@! me.

When your spouse is added because of a 'Life event' your insurance just takes the new spouse on, regardless of pre-existing conditions. Which type of pre-existing conditions are you referring to? Diabetes, Ovarian cysts, depression etc.... are usually not an issue. A medical is not required in order for her to qualify - becoming your new wife is what qualifies her. I imagine if she was currently undergoing cancer treatment or something more serious that would be something you need to talk to your HR/Benefits person and CIGNA about.

Since the new Healthcare legislation they cannot refuse her for a pre-existing condition as I understand it.

Some of us have purchased insurance for the period between leaving Canada and getting married - some of us have gotten married relatively quickly and did not bother with insurance to cover the gap. I personally did not buy anything extra and I was married within 2 weeks of moving...I took the low risk that something might happen. I filled all my prescriptions before I left work so I had a good 3 month supply when I moved as many others here have as well.

Edited September 16, 2011 by Udella&Wiz

[Colleens 40]

And your wife will be covered under the HIPPA laws. Since she is coming from a country with a national health care plan it is like she is moving from another insurance, so she can't be denied for pre-existing conditions.....at least that is how BCBS explained it to me!!

I don't think that health care legistation comes into effect until 2014 Inky...I thought I read that somewhere recently, but could be wrong.

Good luck

[Udella&Wiz 325]

And your wife will be covered under the HIPPA laws. Since she is coming from a country with a national health care plan it is like she is moving from another insurance, so she can't be denied for pre-existing conditions.....at least that is how BCBS explained it to me!!

I don't think that health care legistation comes into effect until 2014 Inky...I thought I read that somewhere recently, but could be wrong.

Good luck

Right you are about the HIPAA law - to the OP - coming from Canada is a gold stamp generally as they are aware of our healthcare system - if you have any doubts you should work through your HR Benefits person - it's their job to help you understand this.

[Kathryn41 3,205]

When I moved here my husband had CIGNA and I have a pre-existing condition - diabetes. CIGNA denied my health claims and said because of the pre-existing condition I was ineligible for coverage for any claims resulting from the pre-existing condition for one year - unless (a big UNLESS) I had proof of coverage up until I applied for coverage with them. My employer had coverage that extended 30 days beyond my final date of employment (and I also had 3 1/2 weeks of holidays and overtime owed to me so my last day of employment was 6 weeks after my arrival here and my health coverage continued for another month). I was also covered by OHIP, which technically still covered me for 6 months as I felt I could argue that until my marriage I could still return to Canada and it would only be treated as a 'visit' (didn't want to have to push that one, btw ). I obtained a statement from my employer's health coverage provider stating when I started to be covered by them and my last day of coverage by them, as well as printing out the statement from OHIP that all Ontario residents were covered as well as up to 6 months out of the Province and sent both of those in to CIGNA with a request to reconsider the claim. They allowed the claim.

So, I am not sure how the new health act affects your circumstances and whether the cost to pay for the pre-existing condition coverage will be higher than if you are able to provide proof of continuous coverage or not. If you can provide proof of continuous coverage then try to obtain it and present it with the first health claim you submit to CIGNA.

When we switched to BCBS the following year (the company did), I had to provide proof to them as well that I had coverage the previous year. CIGNA provided that proof without a problem.

Edited September 16, 2011 by Kathryn41