Need Advice About Eye Exams

atlas13

New Member
1
If a person hasn't had an eye exam in yrs.. say over 6 yrs or more.. and then buys a plan, gets an eye exam and has a claim .. for cataract surgery... would they pay it.. and no previous existing conditions on those prior exams in yrs past.
 
Re: Need Advice

You've got 4 issues:
1.) The way the pre-existing conditions clause is worded.
2.) Options available to you that won't have restrictive pre-existing conditions clauses - like some group insurance, or a state high-risk pool (if you can still enroll in one), or a HIPAA policy if you just came off group insurance, etc.
3.) An option to wait until 1/1/2014 when it doesn't matter if you have a pre-existing condition because Obamacare will cover everybody.
4.) The way the health questions on the application are worded. You don't want to commit fraud, or material misstatement of fact. Most applications have a "catchall" question that asks if you've had symptoms, medical advice, treatment, or if you are aware of any other condition... If a normally prudent person should have known that a condition exists, it's very hard to convince a judge that you really, really didn't know.

My suggestion is that you contact an experienced agent in your state and have him guide you to the best option that is 100% legal and ethical. Some of the ones I mentioned in #2 and 3 above come to mind, and there may be more options in your state.

Another option is to research the cash price for a cataract surgery. You may be surprised that there are discounts for paying cash.
 
Re: Need Advice

Put them on www.PCIP.gov plan...........oooops, maybe not. Too bad the gov't can't forecast well.

A person knows when they have bad eyes or possible cataracts. But, it is something that can maybe wait until O'care hits o 1/1/14.
 
Re: Need Advice

If a person hasn't had an eye exam in yrs.. say over 6 yrs or more.. and then buys a plan, gets an eye exam and has a claim .. for cataract surgery... would they pay it.. and no previous existing conditions on those prior exams in yrs past.

Who is the carrier that you used for this case?
 
Back
Top