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This Web site contains a compilation of more than a thousand consumer finance  columns written by Tony Novak from the 1980s through 2006, updated and reformatted for maximum usefulness today.  New material was added after 2010.

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Accuracy of medical history

originally posted: 4/20/2006  revised: 12/17/2010

Q: You mentioned in your advice to the guy from Florida that he should look into the 12x3STM Coverage plan, but it doesn't cover preexisting conditions for 5 years, which he has. Perhaps that isn't important to him? I don't understand how he can say that he takes glucophage for insulin resistance and yet doesn't have diabetes? Huh? Since when? I'm insulin resistant and control my diabetes by diet and exercise, so if you're taking glucophage, you have diabetes.

A: Most health insurance policies do not immediately cover pre-existing medical conditions but the purpose of our advice is usually to help find an affordable way to get to that full coverage. Short term health insurance never covers the cost of pre-existing medical conditions.

In this specific case the person asking the question specifically wrote that she wanted to cover her medications out-of-pocket in order to avoid the cost of the state's HIPAA plan or a COBRA conversion. She was aware the limitations of coverage and this option does seem to be the best alternative.

There are many reasons why medical history presented in matters of insurance may not be accurate. Intentional or unintentional misstatement is always a possibility. We accept at face value that there are medical uses for the prescription drugs mentioned other than diabetes as presented. Your medical comments may well be accurate - we simply do not know. An insulin-dependant diabetic, of course, would not eligible for any short term medical insurance policy or any other of the lower cost options.

An important but often unstated consideration in medical insurance planning where significant pre-existing medical conditions exist is the applicant's access to the home state's HIPAA plan. In both FL and GA, for example, an applicant can always switch to an insurance policy that covers pre-existing medical conditions as long as they can afford to pay and provide a Certificate of Creditable Coverage. In many respects, this is the biggest benefit of short term medical insurance; it provides the Certificate of Creditable Coverage and helps the applicant save money now in order to cover budgeted health care expenses over the long term. Also, separately, the five year limitation of benefits reference you mention refers to the look-back period before the policy starts to determine what is a pre-existing medical condition. (Note that the definition of pre-existing medical condition may vary from state to state but the language quoted is the standard generic provision of this insurance policy).

As od December 2010, 36 month short term medical insurance policies are no longer available. Consider a 6 or 12 month policy instead.

More resources:

Health Insurance for Diabetics