Chronic Health Conditions Discussion and Support

anon223

(15 posts) Tue Oct 30, 2012, 04:45 PM Oct 2012

Does anyone know how to get "the letter" from an insurance company?

I'm in a bit of a spot. I need surgery soon, and I'm trying to sign up for a pre-existing condition insurance plan -

https://www.pcip.gov/Who%27s_Eligible.html#Documents

Turns out I need a letter from a health insurance company turning me down or offering me coverage that excludes my pre-existing condition (or an insurance agent or broker). This is the issue - I'm getting the runaround. One outfit wanted me to give them my credit card info, and then they would bill me for a month's coverage without telling me how much it would be in advance. If I didn't care for their rate, I could ask for a refund. No thanks. I called the PCIP info line, and they told me that if I had done that then I would have been ineligible for 6 months - I would have had insurance, even if it was only for a day.

They advised me to call some agents and/or brokers. I'm working on this, but it doesn't look promising.

I have a short window to sign up for health insurance with my employer. I really don't want to do this, because the cheapest coverage is almost twice what PCIP costs. I'm can't really afford it, but if I can't get something moving soon with PCIP then I'll have no choice.

If anyone here can help, I'd really appreciate it. Thanks!

6 replies

= new reply since forum marked as read

Highlight:

Does anyone know how to get "the letter" from an insurance company? (Original Post) anon223 Oct 2012 OP

I believe if you have an employer option that will cover the pre-existing, you cannot get PCIP. Lionessa Oct 2012 #1

According to this anon223 Oct 2012 #2

Then get a quote from them and use that. I don't understand the problem. Lionessa Oct 2012 #3

I don't need a quote - anon223 Oct 2012 #4

Exactly my original point. If available at some price, you can't get PCIP or that doc would work. Lionessa Oct 2012 #5

Ah - anon223 Oct 2012 #6

Lionessa

(3,894 posts)

1. I believe if you have an employer option that will cover the pre-existing, you cannot get PCIP.

Reply to anon223 (Original post)

Tue Oct 30, 2012, 04:54 PM

Oct 2012

PCIP is for those that cannot get coverage, not for those that don't like the rates offered through normal channels like employer.

So you need to find out if your soon to be employee coverage will cover your condition and then if they say no, get it in writing.

anon223

(15 posts)

2. According to this

Reply to Lionessa (Reply #1)

Tue Oct 30, 2012, 05:17 PM

Oct 2012

PCIP is also for people who have trouble finding health insurance they can afford:

http://finder.healthcare.gov/about_me/results?utf8=%E2%9C%93&state=VA&audience=cond&nojs=n&situation=need&age=3&medical_condition=y&special_need=y&no_afford=y&x=58&y=19

It's not that I'm trying to save a little money - I really can't afford the coverage my employer offers. As I mentioned, the difference is cost is around 60-70%.

Lionessa

(3,894 posts)

3. Then get a quote from them and use that. I don't understand the problem.

Reply to anon223 (Reply #2)

Tue Oct 30, 2012, 05:19 PM

Oct 2012

anon223

(15 posts)

4. I don't need a quote -

Reply to Lionessa (Reply #3)

Tue Oct 30, 2012, 05:30 PM

Oct 2012

I need a letter denying coverage, or a letter offering coverage that excludes my pre-existing condition. An offer letter that covers my condition, ever if the cost is 10X what I make, is not a qualifying document.

Lionessa

(3,894 posts)

5. Exactly my original point. If available at some price, you can't get PCIP or that doc would work.

Reply to anon223 (Reply #4)

Tue Oct 30, 2012, 05:42 PM

Oct 2012

Sounds like you are running yourself in a circle here. Either it covers for extreme cost or it doesn't, if it does, then indication of extreme cost should work. To get a bogus denial of coverage is a form of fraud, be careful.

anon223

(15 posts)

6. Ah -

Reply to Lionessa (Reply #5)

Tue Oct 30, 2012, 06:19 PM

Oct 2012

I have no intention of getting a bogus denial of coverage. Different companies offer different options - some cover almost anything if you can pay for it, others would deny coverage. I tried to post a link to the required docs, but I'm new to DU and it looks like posting links is restricted for newer users or more difficult than it appears to be.

healthcare dot gov - pcip dot gov

We'll see if that works - thanks!

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