Hi thank you so much for this website. My father has Amerihealth HMO in NJ and has had insurance for at least 12 months altogether with Horizon prior to Amerihealth. Now we want to switch to Oxford HMO but he was also diagnosed with pancreatic tumor last week. Does “guaranteed issue” protect us from Oxford denying the claims for treating the tumor? I don’t want to change from amerihealth if there is that chance… thank you
Answer by moderator - October 16, 2009 @ 11:04 am No CommentsNo comments yet. Leave a comment |
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Guarantee issue does not necessarily guarantee claims payment. It only means that an applicant can’t be denied acceptance when applying for coverage. There are many situations in which an insurance company can deny claims, and the waiting period for certain benefits can vary based on the specific condition and the length of prior coverage. This may also vary from HMO to PPO and not all plans in NJ are guaranteed issue. So, the best thing to do is discuss this with Oxford prior to applying for and switching coverage.
