Expert: Linda Woolsteen - 10/22/2004

Question
if a cancer policy has a 30 day waiting period is a person covered on the thirth day? policy dated 9-1-04 mamogram 9-30-04

Answer
Hi,
Your question had a typo in it, I am assuming you meant the 30th day... I really could not answer this question without reviewing your policy.   There may be a waiting period since you were just effective on 9/1/04.. I mean a waiting period other than just the 30 days, probably not, but again, without reviewing your policy I could not advise.  Usually, on those types of policies you would be eligible for benefits on the 31st day because you have to wait the 30 days.  Also, you said it was a cancer policy.  I am assuming your mammogram was for cancer?  Everything usually goes by what the provider billed for.. so if they billed the mammogram as a routine mammogram with routine codes, meaning, no diagnosis on it, just that it was routine, then I cannot see that they would pay it under a cancer policy.  However, if they put the diagnosis as breast cancer, then of course it should probably fall under an eligible expense on a cancer policy.  But, I just wanted to mention that.  Hope I was able to help.