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Posted by Carol A Glascock on January 25, 2003 at 17:34:33:

In Reply to: Re: New job with health insurance that dosen't cover my health problems posted by Monica on January 24, 2003 at 06:24:42:

: : I have a new job with health insurance that won't cover a health problem that I had taken care of by a previous employer's insurance. I carried COBRA till I got new insurance.

:
: Call your former employer and tell them you need them to send you a "HIPAA Certificate of Credible Coverage." HIPAA states if you are covered by another insurance plan and you have met your pre-existing condition clause, the new plan cannot subject you to their pre-existing condition clause. Sounds like that's might be the problem. Send the Certificate to your new insurance company. That should eliminate the problem. You can then re-submit the claims that were denied and the new plan should pay them.

: If your new health plan still won't cover the condition, they have to state the reason why they are denying the claim. If your "health problem" is something that is not routine, or is a controversial issue like a gastric bypass, some plans don't cover those types of procedures. However, if it is just an ordinary, chronic condition, the HIPAA certificate should take care of the problem.
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They say they won't cover my morphine pump because it is long term care and not temporary, like if I was dying of caner or in hospital Carol

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Subject: Re: Re: Re: New job with health insurance that dosen't cover my health problems

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: : : I have a new job with health insurance that won't cover a health problem that I had taken care of by a previous employer's insurance. I carried COBRA till I got new insurance. : : : : Call your former employer and tell them you need them to send you a "HIPAA Certificate of Credible Coverage." HIPAA states if you are covered by another insurance plan and you have met your pre-existing condition clause, the new plan cannot subject you to their pre-existing condition clause. Sounds like that's might be the problem. Send the Certificate to your new insurance company. That should eliminate the problem. You can then re-submit the claims that were denied and the new plan should pay them. : : If your new health plan still won't cover the condition, they have to state the reason why they are denying the claim. If your "health problem" is something that is not routine, or is a controversial issue like a gastric bypass, some plans don't cover those types of procedures. However, if it is just an ordinary, chronic condition, the HIPAA certificate should take care of the problem. : FOLLOW UP : They say they won't cover my morphine pump because it is long term care and not temporary, like if I was dying of caner or in hospital Carol

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