Question:
I need help w/ bcbs fl they told me I have pre existing but i dont
I called to check on the status of my approval and the rep. told me they sent me a letter out I asked her to tell me what it says and she said i need 12 month consecutive med, supervised diet which i only had that friom 6 yrs. ago she also told me they needed letter from my pcp which I had faxed already and then she told me that i have a pre existing clause which will b up in july,3003 But I told her how can it b pre existing in my policy it states that as long as I didnt see a doctor for 6 months preceeding my start of policy for my obesity then i should b o.k. she said that they dont pre approve until i had the policy for 12 months which will b in July I dont get it because that is if you already had pre exiisting I have not seen a doctor since 18 months before my husband even had the policy can someone please help me understand this I dont know if I should just re apply in july and i will have all the 12 mth supervised diets by then I also told her i dont know if I am going to appeal this or not yet and she told me I cant appeal it because it cant b due to the 12 month thing i am confused please help w/any advise thank you........ — marie M. (posted on March 28, 2003)
March 28, 2003
Call and ask to speak with a manager or a supervisor, customer service rep.
does not know what she is talking about. You are correct in what you are
saying.
— Jeana S.
March 28, 2003
They might be asking for proof of prior coverage. If you didn't have a
lapse of insurance coverage for more than 63 days before that insurance
there may be a waive for the pre-existing clause. If you had another policy
with another company they should have sent you a letter stating when your
coverage ended. If you don't have that letter, contact your old insurance
company and have them send or fax you a copy. You can then forward it (or
perhaps they can fax it for you) to the new insurance company. **Robin**
— Robin J.
March 28, 2003
You may want to speak with your State Government Insurance Office for laws
covering "pre-existing condition". Some states have laws which
limit the number of months/years or types of illness which can be
considered as a pre-existing condition. If your husband works for the Fed,
they also have rules which benefit the employee. It also sounds like you
need to get your benefits administrator involved at your husband's job.
— M B.
March 28, 2003
Marie:
Do you have BCBS of MN?
Kris
— Kristine A.
March 28, 2003
thanks for the replys I called my husbands human resource dept. and she
told me it doesnt sound right to her niether and then she had the lady call
me that sells the policy to them I explained to her the situation also and
she said it should b covered she wants me to fax her the paper they sent me
and she is going to find out whats going on,I also called bcbs back and
spoke w/ another rep. and this one told me that it looks like somewhere it
said i was seen for this before i told her unless i am going insane i know
for a fact i did not see a dr. since th E.R. room in may 2001 which is way
b 4 i was covered by ins. she had me on hold and said the lady that could
look up exactly what is going on is not at her desk she gave me a
confirmation # and i have to wait until Monday for them to call me back I
think they r just looking for an excuse not to cover it well in the
meantime i am going to fax to the other lady and hopefully i will find out
more on Monday thank you for responding I have bcbs fl ppo blue
choice....MARIE
— marie M.
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