Does the Health Insurance have to cover pre-existing condit?

[mcovet]

just a quick question, for the self-sufficient/students, does the comprehensive sickness insurance have to cover pre-existing medical conditions too?

No private health insurance company would cover pre-existing conditions at any cost, so in theory, no way of getting a COMPREHENSIVE insurance as such? How do the Member States go about that?

Thanks in advance for the replies.

[nonspecifics]

"CHAPTER 9 APPEALS

3.4 Sickness Insurance
Persons must not become a burden on the public finances of the host Member State. In paragraph 93 of Baumbast, the ECJ found that it was disproportionate for a lack of sickness insurance that covered emergency medical treatment within the UK to be a reason for refusing to grant a right of residence on this basis.


Furthermore, the law in regard to the NHS prevents us from restricting people from obtaining medical treatment after they have been here for more than 12 months. Presenting Officers should seek to argue that an EEA national who holds no form of medical insurance is not appropriately covered.

Where evidence of medical insurance is produced, it must clearly demonstrate that the EEA national and their families are covered in respect of all pre-existing medical conditions that require medication and/or treatment as well as any treatment that may be required for serious or long-term medical conditions.

Any arguments should focus on whether or not the EEA national or their families could be considered an “unreasonable burdenâ€

[mcovet]

Thanks a lot for the reply. The problem with medical cover is that no private insurance would cover it! As these are high risk, many simply exclude these medical conditions. Same as if you took out an insurance via moratorium, i.e. you dont declare anyth at the outset of taking the insurance but if you want to claim, all pre-existing conditions are excluded (in the past 5 years' treatment etc). So the question is, how on earth does one cover for pre-existing medical conditions? Sounds excessive to require this, maybe the foreigner's home country should offer such insurance? In the uk kind of difficult. Any other ideas would be appreciated.

Thx

[mcovet]

http://www.the-insurance-surgery.co.uk/ ... cash-plans

found smth like that one above, don't know whether it's going to cost an arm and leg, but presume so. There was a user "toni64" or smth on here who had WPA insurance accepted, but they specifically exclude pre-existing conditions, so the caseworkers of the UKBA overlook the requirement to read the policy wording of each health insurance provider... anyway, will do a quote on above and see how much it'd cost.

So, just looked at the pricing, it is either 12 or 24 month contracts and this insurance is in addition, rather than a replacement for your WPAs, BUPAs, AXAs etc. Their policy covers pre-existing conditions with this wording:

"PRE-EXISTING MEDICAL CONDITONS
You will be able to claim for Specialist Consultations and Tests and Therapy Treatments,
which relate to a medical condition of which you are already aware and which your GP
has included on your medical records.
BUT for the period of 2 years from the start date of the policy we will not pay any
hospital related benefits (Hospital In-Patient and Day-Patient, Recuperation and Home
Help and Home Care), which arises from any medical or other condition of which you
are aware of or which is being investigated, at the date of application.
After the expiry of two years, you may request us to review the exclusion and at our
sole discretion we may decide whether to continue with the exclusion or not."


All in all, the whole thing with the insurance is a big bloody mess, UKBA don't know what they require in the first place and even then do not adhere to the requirement... well, nothing new here.

[nonspecifics]

I am sure I read somewhere that cash plans (where you pay for the medical care then claim back the cost from the insurer) is not acceptable as CSI.

I do not know it would be accepted as part cover if combined with other CSI policies.

[mcovet]

Which means that the requirement you highlighted in your first post (regarding covering pre-existing conditions) is ill-thought and impossible to satisfy?

Wonder what the answer would be for someone I'm helping who has back problems and WPA excluded cover for spinal injuries on the certificate... even if he hadn't disclosed the injury, the policy would specifically exclude undeclared pre-existing medical conditions and shouldn't be acceptable by the UKBA, here the exclusion is on the face of the certificate of insurance from WPA... interesting... hope the caseworker dealing with it will use common sense and ignore it, or else it'd be impossible to explain/prove that he ain't no burden on UK.


P.S. Chapter 9 Appeals above that you quoted is bloody ambiguous. First, it says that Baumbast says that lack of insurance covering emergency medical treatment isn't enough to refuse residence and then it says that the insurance has to cover pre-existing conditions and long term health issues??? So... which one is it then? Lack of insurance is ok or not? And how should the first paragraph be interpreted?

Thanks again

I am sure I read somewhere that cash plans (where you pay for the medical care then claim back the cost from the insurer) is not acceptable as CSI.

I do not know it would be accepted as part cover if combined with other CSI policies.

[toni34]

yes,i used wpa for my health insurance when we applied and my pre-existing condition was expressly excluded on my health cover.it was accepted by the homeoffice,so there is no big deal about it.
if they refuse it based on that ground they will be discriminating against you.

[mcovet]

in what way would the discrimination arise? firstly, i could never prove they issued you with the RC based on such a policy (barring FOI request in general) and secondly, they could always say that the other ones should never have been issued etc. etc. etc.

But hope you are right and they overlook the actual requirement... thanks for commenting, by the way!!! (dear -thin ice- club member)

yes,i used wpa for my health insurance when we applied and my pre-existing condition was expressly excluded on my health cover.it was accepted by the homeoffice,so there is no big deal about it.
if they refuse it based on that ground they will be discriminating against you.

[Healthcare09]

Health insurance may cost a lot but having no health insurance at all cost more. Medical bills incurred from an accident could burn a hole in your savings. And in cases of cancer treatments, with all the doctors' check ups, laboratory tests, and chemotherapy that one has to go through it could ruin you financially.Health insurance could help you pay for the cost of a regular medical check ups, surgeries, contact lenses and glasses and even emergency treatments.

health insurance

[Bluecross02]

Hi,

I agree this Topic. I also refer one site for health insurance. It may be very useful to your health insurance. Have a nice day.

[Directive/2004/38/EC]

It is very unclear. UKBA apparently do not have any guidelines for their officers evaluating CSI, which either means they do it very badly or that they do not bother and just accept whatever you send.

See http://www.whatdotheyknow.com/request/e ... es_and_csi