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pnwmom

(110,237 posts) Fri Apr 26, 2013, 06:26 PM Apr 2013

Pre-existing condition -- does anybody know . . . ? [View all]

I'm trying to help a young woman figure out her coverage, which she has had for a couple months. She has a gap in coverage, so her new insurer won't cover her for any pre-existing condition for 9 months. (At which point Obamacare will make this issue go away, but she needs coverage now.)

I tried to get the answer from the insurer, but got a very confusing explanation. It almost sounded like a newly sprained ankle could be considered a pre-existing condition.

What is a pre-existing condition exactly? Is it only a condition that you actually received a diagnosis or treatment of BEFORE your current coverage? Or can it include conditions that are diagnosed AFTER your new coverage starts?

The young woman needs mental health counseling. She has never been diagnosed with PTSD, but I think she has it, and I think it's because of something that happened years ago. Are they going to say that it is a preexisting condition because it was caused by an earlier trauma? Or will it not be pre-existing, because she never had it diagnosed or sought treatment for it before?

29 replies

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Pre-existing condition -- does anybody know . . . ? [View all] pnwmom Apr 2013 OP

Basically, it's any condition -- diagnosed or not -- that you had before you had insurance coverage unrepentant progress Apr 2013 #1

Thanks for the link, unrepentant progress. pnwmom Apr 2013 #3

I know unrepentant progress Apr 2013 #5

and the blame for this falls squarely at the Democrats. If you lost your still_one Apr 2013 #6

Why blame the Democrats because the Republicans filibustered it? pnwmom Apr 2013 #16

they could have, and still can change those rules anytime, with an up or down vote. Everything I still_one Apr 2013 #18

It's anything the insurance company wants Glitterati Apr 2013 #2

This is one of the largest disgraces of the ACA, and damn the democrats who allowed it to happen still_one Apr 2013 #4

Let's be fair, preexisting exclusions were around long before Obama, and Hoyt Apr 2013 #8

Let's be fair, they could have NOT backloaded it into the healthcare plan, and to pour salt into the still_one Apr 2013 #9

There are folks right here on DU who have coverage right now who didn't before. Hoyt Apr 2013 #10

and that is good, but they also didn't not help a lot of other people who they should have still_one Apr 2013 #11

Why are you so angry with Obama for a situation that was beyond his control? pnwmom Apr 2013 #12

First of all I blamed the Democrats in the Senate mostly if you read my comments. repukes were NOT still_one Apr 2013 #13

How do you know there was a better option that could get 60 votes? pnwmom Apr 2013 #14

I stated if they wanted to they could have changed the filibuster rules. This legislation was still_one Apr 2013 #21

Hindsight is wonderful. They would have had to have changed the rules pnwmom Apr 2013 #22

at least what I have come to understand, may be wrong, the filibuster rules could be changed anytime still_one Apr 2013 #24

I don't like any of that, either, though I'm glad for all the children who immediately pnwmom Apr 2013 #25

Because the repugs would never have voted for anything, remember this plan was essentially the still_one Apr 2013 #27

So the blame falls squarely on the DEMS because the Republicans are worse. pnwmom Apr 2013 #28

That clause is horrible. In the meantime, see if you can help her get counseling through the County Hekate Apr 2013 #7

Thanks, Hekate. pnwmom Apr 2013 #23

Don't forget to look for a Federally Qualified Health Clinic in your area for her Recursion Apr 2013 #15

THANK YOU! I didn't think of this at all. pnwmom Apr 2013 #17

Depends on the state. Nye Bevan Apr 2013 #19

My wife and I are uninsurable. hunter Apr 2013 #20

If you have ever had a cold, all colds are pre-existing conditions. kestrel91316 Apr 2013 #26

If the insurance does not want to pay they won't - period. KentuckyWoman Apr 2013 #29