Health Insurance Pre-Existing Condition

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Health Insurance Pre-Existing Condition

If I see a doctor while I do not have health insurance, and I pay cash for the visit, is the doctor obligated to pass that information along to an insurance company once I do have insurance? Is there a statute that says that this information would be considered private under doctor / patient confidentiality? If they are required to pass this information along, it causes a “pre-existing condition”, especially if I see my regular doctor about an issue. Am I obligated to see some obscure doctor, and use a fake name while I am uninsured? Please help.

Asked on May 20, 2009 under Insurance Law, California

Answers:

B. B., Member, New Jersey Bar / FreeAdvice Contributing Attorney

Answered 11 years ago | Contributor

I don't know that there's any requirement for the doctor you see without insurance to release that information.  The problem would come when you get insurance, within a year after that treatment, and then go to a doctor for more treatment for the pre-existing condition.

However you might go about trying to evade the pre-existing condition limit to your coverage, once you have it, it's insurance fraud, and if you're caught, it can be very serious trouble.


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