Decoding Health Insurance: How AI Legalese Decoder Can Help Determine If Family History Affects Coverage
- April 22, 2024
- Posted by: legaleseblogger
- Category: Related News
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## Understanding Pre-Existing Conditions and Health Insurance Coverage
If you have family members who have had cancer, but you haven’t been diagnosed yourself, you may be concerned about whether this counts as a pre-existing condition. This uncertainty can create confusion and anxiety, especially when considering the purchase of health insurance.
Regular screening for cancer and no reported issues can provide some peace of mind, but questions about coverage for potential future diagnoses may still linger. In these situations, it can be helpful to have a deeper understanding of how pre-existing conditions are defined by insurance providers and what impact they may have on your coverage.
## How AI Legalese Decoder Can Help
AI Legalese Decoder is a tool that can assist individuals in deciphering complex language found in insurance policies, including clauses related to pre-existing conditions. By utilizing this technology, you can gain clarity on what is considered a pre-existing condition by insurance companies and how it may affect your coverage. This can empower you to make informed decisions when selecting a health insurance plan, such as Southern Cross, and ensure that you have the necessary protection in place for any potential health concerns.
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For the purposes of applying for health insurance cover, questions about family history are limited to father, mother, brothers and sisters only.
In terms of cancer history, they are roughly looking for breast/ovarian/bowel cancer in their immediate family members, under age 50/55 (I can’t recall SC’s spefic age criterion when asking for this info). You will need to obviously disclose your screening tests and why you are having these. Previous abnormal results, or routine preventative screening. You will also need to disclose results of genetic testing if you have had this (e.g. for BRCA1 or BRCA2).
You will not automatically get a cancer exclusion based on immediate family history alone if only 1 member has had cancer under 55. However, it is mother + 1 sister with breast/ovarian then this can change things.
If you are interesting in checking eligibility, just apply. Applying is free, and you will then know where you stand.
Note that SC has very limited cover for non-Pharmac drugs ($8,000 per year) unless you add the Cancer Plus cover.
I didn’t get the extra cancer cover with Southern Cross as I didn’t want to go through the extra questions (my coverage was for all pre-existing conditions). The extra cancer cover is for non-funded cancer drugs up to a higher $$$ limit if I recall correctly.
I’ve had far too many close relatives die of cancer, so I figured I wouldn’t be covered anyway. I haven’t done the questionnaire though, so my response is probably not that helpful.
Remember that poor person who tried to do everything right and still got declined due to doing a genetic test (after they got sick) and declined due to having “markers” I like how they still took her money for 20 years before hand. Bloody insurance companies. Hope I never have to use mine.
Chat to an insurance adviser/broker (insurers often share their underwriting rules, or advisers may have seen similar situations before and can let you know what the likely outcome will be, and can tell you if another insurer will cover you if southern cross won’t) or just apply and see what happens (if don’t like what they offer you, you don’t have to proceed).
Insurers will ask about cancer in immediate family members but whether this impacts your cover or not has plenty of variables – which family members, which cancer, whether you’re joining southern cross individually or through eg. A workplace scheme etc., some might take your clear screening history into account