My family is shopping for new insurance at the moment. We reside in the United States, Georgia specifically. We have had insurance continuously since she was born. My daughter, born in 2011, was born with hip dysplasia and a cleft lip and palate, both considered birth defects. She has had several surgeries, but has no operations scheduled. At the moment we are shopping for individual coverage (I'm self employed) not the exchange.
My question: should one of her doctors decides she needs a procedure or operation of some kind, would that be considered a pre-existing condition, and hence not covered?
Update after talking with Insurance Broker - We are faced with (AFAICT)
- If we go with an exchange plan - we lose most of our doctors, but the birth defects are not considered pre-existing in any way
- If we go with a non-exchange plans we get to keep all of our doctors, but any actions related to the birth defects are in a gray area. She has nothing scheduled, pending, or needed at the moment. The only real question is what if a doctor decides that something needs to be done about something related to the birth defect. The broker did not know the answer to that.