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Pre existing medical condition

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Company benefit plan, covered OK. They didnt ask.
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Company benefit plan, covered OK. But they did ask.
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Private personal plan, covered OK. They didnt ask.
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Private personal plan, covered OK. But they did ask.
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Pre existing medical condition

Old Jun 15th 2011, 5:16 pm
  #1  
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Default Pre existing medical condition

Just curious about this.. how many people have run into problems with insurance refusals after coming to canada with a medical conditions that the NHS was treating due to its pre existing nature?
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Old Jun 15th 2011, 5:19 pm
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Default Re: Pre existing medical condition

For an employee program, no , no questions asked at all. As long as you sign up at the start of your eligibility period ( mine was after 6 months).
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Old Jun 15th 2011, 5:35 pm
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Default Re: Pre existing medical condition

I agree with Zoe. For a company sponsored group benefits scheme the insurer cannot decline anyone who joins within the time frame of the scheme rules. This is usually within one month of completing your probationary period.

In a pooled scheme the insurer sets the rates based on actuarial models. In an individual company scheme the rates are based on the previous year's claims. The insurer does not lose out. If they take on someone who is sickly and makes lots of claims they just charge the company(ies) more.

Private insurance is completely different and they will routinely decline to cover pre-existing conditions.
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Old Jun 15th 2011, 5:59 pm
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Default Re: Pre existing medical condition

Originally Posted by JonboyE View Post
I agree with Zoe. For a company sponsored group benefits scheme the insurer cannot decline anyone who joins within the time frame of the scheme rules. This is usually within one month of completing your probationary period.

they wont decline you joining.....but just start claiming $100's of dollars a month worth of (in our case) insulin/diabetic supplies then you will get a letter asking when the condition was taken by the person etc!!! cost the insurance company $5 a day just to prick his finger to check his blood sugar!!
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Old Jun 15th 2011, 6:31 pm
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Default Re: Pre existing medical condition

I voted for the company plan, but before I had insurance through my employer we had Blue Cross who also covered my pre-existing condition. I don't think they asked any questions, but we joined that about 4 years ago so don't really remember
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Old Jun 15th 2011, 6:33 pm
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Default Re: Pre existing medical condition

I've just checked with a diabetic collegue here ( diagnosed before she worked here)
no questions , no problems with coverage
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Old Jun 15th 2011, 6:36 pm
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Default Re: Pre existing medical condition

Originally Posted by Monique_in_Canada View Post
they wont decline you joining.....but just start claiming $100's of dollars a month worth of (in our case) insulin/diabetic supplies then you will get a letter asking when the condition was taken by the person etc!!! cost the insurance company $5 a day just to prick his finger to check his blood sugar!!
Who is your plan provider, out of "name and shame" curiosity?

Your experience sucks if you ask me... commiserations.

Ive a feeling that my plan in similar circumstances would max out and then a second benefit program would kick in to take up the slack, but you would have to spend several grand on medication to qualify.

Last edited by iaink; Jun 15th 2011 at 6:40 pm.
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Old Jun 15th 2011, 6:36 pm
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Default Re: Pre existing medical condition

Originally Posted by Zoe Bell View Post
I've just checked with a diabetic collegue here ( diagnosed before she worked here)
no questions , no problems with coverage
Ah, but was she covered by insurance with someone else when diagnosed, that could be the difference?
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Old Jun 15th 2011, 6:41 pm
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Default Re: Pre existing medical condition

Originally Posted by iaink View Post
Ah, but was she covered by insurance with someone else when diagnosed, that could be the difference?
thank you.....you're getting it!!!
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Old Jun 15th 2011, 6:41 pm
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Default Re: Pre existing medical condition

Originally Posted by iaink View Post
Ah, but was she covered by insurance with someone else when diagnosed, that could be the difference?
Or could the difference be that Monique's husband is covered by a plan from a US employer?
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Old Jun 15th 2011, 6:44 pm
  #11  
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Default Re: Pre existing medical condition

I've a company benefit plan that I've never had any call to use, so I checked the policy wording. There's no mention of pre-existing conditions, nor a list of excluded drugs (Manulife)
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Old Jun 15th 2011, 6:44 pm
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Default Re: Pre existing medical condition

Originally Posted by Novocastrian View Post
Or could the difference be that Monique's husband is covered by a plan from a US employer?
Think it has to be a canadian insurance carrier to be legal in Canada, but could be wrong?

Presumably there is some level of provincial legislation framework for what insurers can and cant do anyway?
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Old Jun 15th 2011, 6:46 pm
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Default Re: Pre existing medical condition

Originally Posted by Novocastrian View Post
Or could the difference be that Monique's husband is covered by a plan from a US employer?
this all happened when he worked in Canada for 7 years.....he has only worked in the US for the last 3....
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Old Jun 15th 2011, 6:49 pm
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Default Re: Pre existing medical condition

Originally Posted by R I C H View Post
I've a company benefit plan that I've never had any call to use, so I checked the policy wording. There's no mention of pre-existing conditions, nor a list of excluded drugs (Manulife)
It almost certainly says something along the lines of drugs must be approved by health canada (at a minimum), no experimental treatments etc etc..
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Old Jun 15th 2011, 6:54 pm
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Default Re: Pre existing medical condition

Originally Posted by iaink View Post
It almost certainly says something along the lines of drugs must be approved by health canada (at a minimum), no experimental treatments etc etc..
Sure, just no list of licenced drugs/treatments that won't be accepted if claimed for.
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