Will my new health insurance pay for upper endoscopy if was referred for it under old insurance?
Back in May I saw a gastroenterologist at my PCP office for symptoms of GERD. He recommended that I get an upper endoscopy done. Unfortunately I did not get it done right then and have since waited. I changed insurances from a Group plan to Individual plan in July. I did not mention the GERD on the application since I thought it was so minor and just didn’t think of it. I am worried now that if I go schedule to get the test done they will not pay for it. Would they classify that is a pre-existing condition? Their information says they do not pay for anything relating to pre-existing for 12 months. What should I do?
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If you tell them that you have seen a Dr for it already it will be considered pre-ex and you would have to wait the full 12 months before they would cover it. You might could go see a different doctor about the GERD and see if they recommend an upper GI also and if they do then the ins co might pay for it and not consider it pre-ex.
GERD isn’t minor, it’s material, and they would likely classify your ommission as a material misrepresentation, and could possibly cancel the policy. They likely won’t pay for it.
I agree with Isabella…the insurance company could consider this a material misrepresentation, cancel your policy, and not cover anything.
Is there any way that you can get back onto your group insurance policy?