Breast cancer after approval??

[vic120]

Have a client that we just switched to new Med Supp with Aenta we did the app early in the month with 03/01 effective date

She was approved fairly quickly

Now a few weeks later she had gone in for an annual test and emailed me

I just tested breast cancer positive said was caught very early and It's caught early and small so they are thinking a lumpectomy will take care of it. I hope this doesn't make a difference in the insurance policy for Aetna

Now she already canceled the previous coverage

Could she have issues?

Should I be concerned for her insurance?

The strange thing is I had this happen last month but it was before the underwriting was complex and I pulled the app for the client


Never had it happen before 2021

 

[David Taylor Jr]

Was this a T-65 enrollment?

Is she subject to a pre-ex waiting period on her plan?

 

[rousemark]

Have a client that we just switched to new Med Supp with Aenta we did the app early in the month with 03/01 effective date

She was approved fairly quickly

Now a few weeks later she had gone in for an annual test and emailed me

I just tested breast cancer positive said was caught very early and It's caught early and small so they are thinking a lumpectomy will take care of it. I hope this doesn't make a difference in the insurance policy for Aetna

Now she already canceled the previous coverage

Could she have issues?

Should I be concerned for her insurance?

The strange thing is I had this happen last month but it was before the underwriting was complex and I pulled the app for the client


Never had it happen before 2021

1. Should never cancel coverage before the effective date of the new coverage.

2. Instead of cancelling coverage, I always call the company and have them place the old plan on direct bill. That way they have their 30 day grace period to pick the plan back up by simply paying the premium if something comes up.

3. Even though the answer about cancer was truthfully answered on the application and the policy was issued, this particular condition can and probably will be considered a preexisting condition (if allowed in your state on replacements) as she was diagnosed prior to the policy effective date.

 

[David Taylor Jr]

3. Even though the answer about cancer was truthfully answered on the application and the policy was issued, this particular can and probably will be considered a preexisting condition (if allowed in your state on replacements) as she was diagnosed prior to the policy effective date.

Yeah I agree with this statement.

 

[DonP]

Couldn’t she have called today and recinded the cancel on the other policy since it’s technically still in force ? That’s a good question . How do you handle a replacement? Do you keep the coverage of the original policy in force until the first then on the 1st cancel it . I would assume this is a preexisting condition now and the claim will be in peril . Could this be an E&O claim?If this were a mapd no big deal .Also how do you know client didn’t go to dr in that one month between the new policy written and the new policy effective date and not mention an issue to you . Shouldn’t you mention to the client if any health issues come up in the next few weeks then you MUST keep your policy .

 

[somarco]

Existing policy still effective. Have her call and tell them NOT to cancel.

 

[rousemark]

Existing policy still effective. Have her call and tell them NOT to cancel.

It may not be effective if she called and told them to cancel. However, she definitely needs to call them and tell them she has changed her mind about cancelling and wants to keep it.

 

[somarco]

It may not be effective if she called and told them to cancel. However, she definitely needs to call them and tell them she has changed her mind about cancelling and wants to keep it.

I don't think a carrier will terminate early which would leave a gap in coverage before 3/1.

 

[rousemark]

I don't think a carrier will terminate early which would leave a gap in coverage before 3/1.

You may be right.. Only way to know for sure is to give them a call.

 

[vic120]

Was this a T-65 enrollment?

Is she subject to a pre-ex waiting period on her plan?

Do you think I would ask if it were T65 OE or GI