FYI Insurance

Sweet Nurse
By Sweet Nurse Latest Reply 2009-12-16 09:31:10 -0600
Started 2009-11-19 21:15:42 -0600

I have been on the same type of insurance for 10 years, I switched to my hospitals insurance. I was denied at first (no I did not have a lapse in coverage). Makes sure you fax a letter of Certification to the new insurance and if you are diabetic (like me), NEVER lapse in coverage. I cried when I got the letter that said I was DENIED. Like I can go without my insulin? Of course it was all worked out, but I would have loved to know about the letter I needed, and to never lapse in insurance. Scary.

6 replies

Alleykat 2009-12-15 23:29:15 -0600 Report

ok yea you have insurance but for those that are not on an insurance plan… how do we get insurance

kdroberts 2009-11-20 07:54:59 -0600 Report

It's a little more complicated really.

Some insurance plans don't have to follow HIPAA guidelines like most private, individual plans. They can deny you for whatever reason they want and there is nothing you can do about it. Qualifying plans can't deny you for pre-existing conditions but you do need to apply creditable coverage to eliminate or reduce the exclusion period. To do that you have to have had a qualifying plan with no gaps in coverage of 63 or more days. Then you have to apply the length of time you had the insurance towards the exclusion period so as long as you have had it for at least 12 months then you're good.

You can also use the pre-existing condition definition you your advantage in some cases.

Sweet Nurse
Sweet Nurse 2009-11-20 14:03:31 -0600 Report

Really? I had no idea, the frustrating part for me lately is that I was double covered and I could not for the life of me get the Diabetes Specialty Store (I get my supplies through them) to bill my secondary insurance! I am now only covered by the one insurance, but it was quite the mess. Thanks for the input

Hinboyz3 2009-11-19 21:42:30 -0600 Report

Isn't it something when you do everything the right way and something takes a terrible turn for the worst. I understand exactly how you feel. Hope everything has finally turned out the right way. Sometimes the people pushing all the necessary papers have no hearts I think. But we got to have Faith that things will always turn out the right way.

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