Trying to get new insurance after resurfacing

[tofu55]

I am looking into getting new health insurance. I just applied with Humana. I told them I had my right hip resurfaced in May. They came back with a permanent rider on my right hip and a minimum of two year rider on my entire body for osteoarthritis, arthritis or rheumatism. Has anyone else had this concern?

Nancy

[Gav]

Hi Nancy

I work in the UK in the insurance business!!!! It might be a bit different over here, but if you apply for medical cover for the first time, you will be underwritten and certain things would be excluded from the policy, or a moratorium applied. However, once you have been accepted they are permanent covers, and the insurer is obliged to keep you on as long as you continue to pay the premiums. Premiums go up each year due to medical claims inflation, and they are morbidity rated.

However, in UK it might be possible to transfer from one provider to another on a protected underwriting basis, meaning that the new insurer buys the business in but cannot underwrite the applicant again. We did this a few years ago when we changed provider.

It does not surprise me that any potential provider would make such restrictions, as we are more likely to have further problems as we get older. Remember they are not charities!!!!

[tofu55]

"but if you apply for medical cover for the first time, you will be underwritten and certain things would be excluded from the policy"

  I am not applying for the first time. I have had continuous health insurance for the past 20 years. The company I am with now had another rate increase and I wanted to see what else was out there.  Before I had the resurfacing in May I had an extensive physical and passed with flying colors,  I am taking no prescription medicines and have no pre-exisitings. I had thought there was something about Creditable Coverage in the United States but am still unclear what it exactly covers.
  Putting a Rider on my entire body makes me a bit nervous, as the interpretation can be wide.  I did expect a new company to perhaps put a year or two Rider on my unoperated hip but not my entire body.

[tofu55]

I found out the answer to my question. If one has Group Health Insurance coverage, most of the time you can change your policy to another Group policy and have no pre-exisitng or Riders, or at the most there will be a time limit to your pre-existing. But if you have an individual policy, which I do as I am self-employed, and you try to change your policy to another individual plocy, the new insurance company can put any sort of Riders on that they would like or even not accept your application. Oh well.

[Vt waddler]

tofu, I am self employed, yet I have group insurance coverage..I am a group of 1 (g).
I'm in Vermont, but could be different where you are. I'd certainly check on it..

[tofu55]

  I can also be a group of 1. My current health insurance is with UnitedHealthcare, connected with AARP. I have no problems with them except their premiums go up every six months. The monthly Humana premium would have been substantially lower and with a lower deductible(mine currently is $5,000). I will look into group health insurance but since I have had the hip resurfaced I will probably have similar Riders from anyone else.

Nancy

[Gav]

Hi Nancy

Hope you get decent terms from your chosen carrier.

Luckily for me I can switch carrier at each anniversary, because I've been insured continuously since 1990 when I had no medical problems to declare. In the UK you can transfer at no worse terms on individual and group policies here, so that seems to be main difference.

However, we pay higher premiums than we would pay if we elect to be underwritten, or have a moratorium or waiting period as you say.

Best Wishes

Gav