Pre-Existing Condition is Any Visit to the Doctor?

I’ve come to the realization that universal health coverage is actually a good thing, if the whole point of health coverage is “just in case,” like auto insurance. And the people who tag “universal health coverage” as being “socialist” clearly have never applied for an individual health plan.

Currently, I have 2 options:

  1. Apply to as many individual plans as possible and hope that the law of averages tips in my favor and one of them will grant me coverage
  2. Apply for coverage under the Illinois Comprehensive Health Insurance Plan (CHIP)

I am perfectly OK with applying for as high-deductible a plan as I can find. I don’t really need coverage, as I’ve said before, but experience has taught me that it is good to have “just in case.” Call it a security blanket if you want. There is comfort in knowing that it is there, and a great deal of discomfort with the knowledge that, right now, it is not.

Both options require time, so I went online and filled out the “Online Application” for CHIP. The Illinois state government definition of “online application” means that you fill out a form which converts to a PDF that you then must print out, sign in ink (they specifically state ink) and then mail to the address provided with all supporting documentation. That supporting documentation must come from the former employer and/or insurance company to officially verify that:

  • Yes, I was laid off
  • Yes, I was covered under COBRA for 18 months
  • Yes, all options have been exhausted and other coverage denied or exhausted
  • No, coverage has not lapsed for more than 90 days

So I had to contact my former employer and now I have to wait, though not too long as an email from CHIP said “We received your application. Please mail the signed application, along with all supporting documents, no later than 21 days after submission.” And then I have to wait 2-4 weeks for the application to process, and there is no guarantee that I will be covered. Isn’t that nice? Apply for state coverage and the state may deny you as well.

When I called to inquire about the process and told them I had been on COBRA and received an individual plan rejection letter that included the CHIP phone number, they said I was a “high risk” applicant and should apply for coverage under the HIPPA CHIP plan since it has no “pre-existing” condition clause. I bit my tongue and hung up since, as far as I have been able to find on any number of “pre-existing” condition lists, I don’t have any.

So imagine my surprise when I read Step 11: Important Information on the CHIP application. It states:

A pre-existing condition is any condition for which medical advice, diagnosis, care or treatment was recommended or received within the six-month period immediately preceding the effective date. Medical treatment includes prescription drugs.

By that definition, a doctor’s visit for the common cold six months before the effective date means a pre-existing condition exists.

That is a considerably more expansive list than any list I have been able to find so far. Reminds me of “SiCKO” where a former health insurance employee said the “pre-existing condition list” was quite expansive, followed by the theme from Star-Wars as an alphabetized list appears like the opening of the Star-Wars back story.

Or am I missing something?


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