Can I Change My Medical Expense Insurance?

The cost of your Medical Insurance has increased considerably

Have you already had a Medical Expense plan for many years?

There are some plans on the market that for several years have had a renewal cost with averages of 20% or more, added to the increase that corresponds to age. And already added it can be around 30% or more.

The big question is: what to do? And why do these plans go up so much?

Today acute events are still more common, but the number of chronic degenerative diseases such as cancer, diabetes, cardiovascular conditions, and autoimmune diseases in which treatment can take years is increasing. Statistics indicate that each year the average duration of insured claims is longer and more expensive.

The foregoing is extremely relevant for Medical Expenses insurance and explains the reason for how expensive insurance that has been renewed since before April 2013 is today.

Let's understand insurance as a business. And the medical expenses insurance in the first years is very good. New clients are healthy and hardly use their policies (since sick ones are not accepted). In addition, waiting periods limit certain ailments from being treated immediately. And together with the lack of knowledge of the clients of how to use their policies, they make the profits these years good.

To balance the above, what insurers do in order to maintain balance and business is to sell more new insurance. Therefore, the policies prior to 2013 in which no new insured are entering. Many change plans, stop paying them or die; It means that only older people who have no more options for a new policy or those who have medical conditions remain in these plans. And insurers resort to their only option: "Make strong increases in premiums"

 

What to do to solve this problem?

The answer then is obvious. Leave that insurance and change to one that continues to accept new policyholders where there is a “fresh” entry of policyholders. But; then, leaving medical insurance that you can have paid for more than 20 years should not be taken lightly.

 

If I change my insurance, will they recognize my seniority?
Yes, BUT; The problem is that insurance covers uncertain events and not known diseases. The new insurer will hardly (rather never) assume coverage for known or pre-existing illnesses**.

** Pre-existence: Disease that you already have but that is unknown since it has not presented symptoms or manifestations. In order for an insurer to be released from its obligation to pay, it must-have elements that demonstrate the pre-existence of the disease. If the patient is not aware of the condition, it is materially impossible for the insurer to find any evidence. **

 

What happens when there is a pre-existence?

Realistically, the probability that a person has been insured for more than 15 years without having used their health insurance is quite remote. So you almost certainly have a pre-existing condition for new insurance in case you decide to try a switch.

The selection process to contract new insurance is that you are going to answer a questionnaire in which they are going to ask you about the illnesses you have had. That information will be sent by your agent to the insurance company where it will reach the risk selection department. The selector, as the people who work there, are called, is very likely to require additional information such as test results, X-ray interpretations, or reports with updated reports from your treating doctor or a doctor from the specialty to which you correspond. illness.

Coaches look at history, not future expectations. So for you, the objective of this process is not to get the new insurer to agree to cover a pre-existing illness, the objective is to receive offers about the conditions and restrictions that different insurers would put on your policy.

To help you a bit with the terminology, I'll tell you that special provisions are recorded in insurance policies through annotations called endorsements.

For example, the annotations where the insurer establishes that your contract will not cover the expenses derived from a certain health condition are called exclusion endorsements.

Or on the contrary, when the insurer agrees to cover expenses that the contract would not normally cover (such as pre-existing conditions) or agrees to cancel an exclusion endorsement, it does so through an acceptance endorsement.

This example is typical of what we would be pursuing in this circumstance.

There is no way to have coverage for a hip, knee, or spine that has already been treated. However, it is very different from three lumbar vertebrae than from the entire spinal column.

Extreme caution is suggested. You are in one of the most complex parts of insurance contracts

Honestly, in this case, we recommend you to be very careful, talk to an expert agent who can guide you. Since it is most likely that they will not accept you or that the change will not suit you. 

Beware: some policies could make us think that after a period they will cover us for pre-existing conditions, however, what the contracts say is that pre-existing conditions will be covered after a certain time that the insurance is in force as long as the condition does not fall within certain conditions defined there. Does not have an exclusion endorsement and also the insurer explicitly accepts it through an endorsement that must be included in your policy. And most likely this will not happen, since it is practically impossible for you to get through all those filters without restrictions

In summary. If you already have Medical Expenses insurance and the cost of this has become unaffordable, it is possible to think about a change by taking advantage of and requesting recognition of seniority. Only that this will work as long as you are still healthy, do not have claims that are being paid or are going to be made. Since even for some conditions, even if you are clinically discharged, the insurer may not accept you. One recommendation is that you request the new insurance and until you have the policy with the conditions and coverage, cancel the previous one.