Ask Our Specialists

Pre-Existing Condition Story Hey Everybody, I have a question about pre-existing condition with my short term health insurance plan. In 2014 I was playing soccer and hyper-extended my right knee. I got an MRI which showed I partially tore my ACL and had a small meniscus tear. I was told I did not need surgery and that I could attempt to let it repair itself. At this time I had full health insurance from my full time employer. I ended up letting the knee get better and seemed to be OK. Fast forward to 2017, I was playing soccer again and twisted my right knee and heard a noise and fell to the ground. I went into the doctor again and got an MRI. The report showed I had a complete disruption in the ACL and two tears in my meniscus. At this time I am covered by a short-term health insurance plan since I left my job to do some personal traveling. I was covered by this short term policy at the time of the new injury. The doctor has seen both MRI's and has concluded that the injury in 2017 is a completely new injury and that now I suffer from instability, which I did not prior. The surgery is scheduled and has been pre-authorized with my insurance provider. However I am concerned that they will retroactively come back after the surgery and call it a pre-exisiting condition and deny coverage and leave me with the full bill. Does anyone have any advice or inputs to give me? Since the doctor says the 2017 injury is a new injury, does that mean the 2014 is not considered existing? Has anyone had an experience like this? Can the insurance company even access my old MRI to see my previous injury? Should I call my insurance company to request a pre-determination review and open a can of worms that i maybe should not? Any help would be so awesome!