Neurology coverage

TA | April 14, 2009

Q: I am looking for insurance for my 27 year old son. He had a seizure and needs to go to a neurologist. Will this insurance become effective immediately and cover this to find out what might be wrong?

A: Core Health Insurance becomes effective on the day after completing the online application. A confirmation of acceptance is sent by e-mail that includes the effective date of coverage.

The waiting period for coverage of pre-existing conditions is 30 days for sickness benefits and 12 months for hospitalization benefits. Core Health Insurance covers up to 5 doctor's visits per year. See the full description of benefits for a complete explanation and the dollar amount of coverage available. So in your son's case, assuming immediate enrollment, the coverage for the neurologist's office visit would not start until one month from now. It seems likely that more than one neurology visit would be recommended so assuming that his doctor recommends monthly follow-ups, perhaps you should pay the initial visit out-of-pocket and rely on the insurance for coverage beginning in the next month's office visit. If possible and prudent, you may wish to schedule diagnostic testing after the first 30 days to include that benefit.

While neurology office visits for diagnosis are not particularly expensive, there is a possibility that the long term treatment for this issue could be very expensive. Core Health Insurance is a limited benefit insurance that is best used to supplement the benefits of other insurance. Based on your brief description of the issue, it seems prudent to investigate the high risk coverage options in your son's state. Every state has a major medical plan that accepts all applicants but the cost is substantial and the waiting period for office visit benefits for pre-existing conditions is probably longer than the Core Health Insurance plan. If you use Core Health Insurance as the only coverage, realize that while the office visit coverage may be adequate in this situation, the coverage for catastrophic expenses is limited. 


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