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Some things just need repeating
.
They appear so simple and obvious
that they are just overlooked. I am
going to give you a few examples
that may help you to look at some
insurance policies in a diferent
light.
Many policies do not appear
to have a pre-existing condi-
tion clause. They are very simple
policies to read but, as we have
discussed before, simple does not
necessarily mean better. If you
carefully read the Exclusion section
of a policy, you will normally fnd
words such as “no coverage of any
kind is provided for pre-existing
conditions.”The exclusion list often
starts with war, criminal acts, nucle-
ar events and riots and then, there
it is: “Exclusion #14 – Pre-existing
conditions (Pre-Ex) and anything
related directly or indirectly to your
condition is not covered.”
This is fairly standard procedure in
most tour and cruise policies, and
is quite common in the “cheap”
policies of travel insurance or the
so-called “Super - Elite - Platinum”
plans used as price leaders. You
know those plans, I am sure; they
have super-low prices, but then
you fnd out that you do not qualify
(poor plan); you do qualify, but get
little coverage with any medical
condition you have (not-so-good
plan); you qualify, but there is an
overall limit of $10,000 (worst
plan). I am particularly unhappy
about any plan that takes your
money, but does not cover you for
the medical condition which you
have.
There are more details, of course.
A medical condition may not be
a medical condition at all, in your
mind, and you may feel safe buying
a policy with the simple Pre-Ex. If
Exclusion #14 above says nothing
else, you are giving the insurance
company the right to deny your
claim if you are taking any kind
of drug. We all take lots of various
drugs for preventive reasons and
many insurance plans will treat
those preventive drugs as a medi-
cal condition. I take a baby Aspirin
every day for preventive reasons;
would I be covered – the answer is
maybe. That is a horrible answer. I
want certainty with my insurance
coverage and so do you. What
about cholesterol drugs? Many
people are on these, again, as a
preventive measure. Some insur-
ance plans will say that you have
high cholesterol and will deny any
claim related to heart, etc. They will
consider high cholesterol as a med-
ical condition. Remember that little
clause saying “directly or indirectly
related to…”? What about drugs
which you take for headaches or
hormone replacement therapy?
Some plans do specifcally state
that these preventive drugs will
not afect your coverage, but many
do not. Some will treat the Aspirin
as preventive, but the cholesterol
drug as treatment for a condition.
You must know which it is and
what is covered. Call them! I would
get the answer in writing if you are
taking any kind of drug, if this is
not stated very clearly in the policy.
Insurance
The
Devil’s
in the Details