Jaw Surgery Forums » Pre-Surgery Questions

Pre-existing Condition

(2 posts)

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  1. Emily
    Member

    Hey everybody,

    Technically, I already had my surgery, but I am dealing with the insurance claims after the fact. I honestly didn't realize that Aetna (or any insurance carrier) had a waiting period for pre-existing conditions until now, unfortunately. I'm 19 years old and was not very well-versed in the ways of health insurance...

    According the Aetna and HIPAA, if I was continuously insured before enrolling in Aetna, the pre-existing condition exclusion would be reduced or eliminated. I had Medicaid until January of this year, which was when I enrolled in Aetna instead.

    Some of the claims for my surgery are stating that Aetna needs further evidence to see if a pre-existing condition exists. They have also previously requested a certificate of credible coverage from my previous insurance provider. I'm not quite sure how to obtain a certificate.

    Anyway, would a malocclusion be a pre-existing condition? Any advice or suggestions would be helpful, I'm freaking out right now and I can't even call people to get some help.

    Thanks!

    Posted 1 year ago #
  2. Brandon
    Site Administrator

    Hey Emily,

    I'm surprised this didn't come up at some stage before the actual surgery?

    I'm not sure if the malocclusion would be considered a pre-existing condition or not, but I know with my insurance (Anthem), I had to wait a full year after getting the insurance, before they would cover my surgery.

    I'm Brandon, the creator of JawSurgeryBlog.com. I personally had upper and lower jaw surgery on October 30, 2007. Thankfully, everything went beautifully, so I'm trying to make sure everyone else's surgery goes smoothly as well!

    http://www.facebook.com/pages/Corrective-Jaw-Surgery/114627165257701
    Posted 1 year ago #

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