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Life & Health Insurance/knee injury / pre-existing condition?


Good morning,

I am currently insured by Aetna through my employer in Philadelphia, PA.  I will be getting married in May (2013) and then plan to leave this company in June (2013).  Upon leaving the company, I will be included on my *future* husband's insurance policy - United Health Care.  He is insured through his employer - he lives and works in Pennsylvania, though his company is based in New York.

I have a knee injury that is currently being treated with physical therapy.  The physical therapy treatment is slow going and if it ultimately proves to be ineffective, the injury may have to be treated with surgery.  Since this type of surgery can possibly require months of rehabilitation and additional physical therapy, I am curious as to whether a new insurance policy (in this case United Health Care) would view this as a 'pre-existing condition' and deny coverage for anything regarding this knee injury.

If this, indeed, is the case, what options do I have?  I'm feeling particularly pressured to figure this out since June is only four months away!!

Thank you,


This is a great question with a good bit of "ifs" and "buts" to it and the actual answer, but I'll do my best to help guide.

First thing you need to do is see how United will view your knee. You can actually reach out to them through his employer and ask how the plan would handle your scenario. Many times a health provider will not make a big deal about pre-existing issues if you have had previous coverage with another provider recently (which you have). Secondly, United has been very good recently with relaxing their "pre-ex" clause based on the health reform model. It's risky for them, but their goal is to stay a solid option through it all.

Each plan in a business can be different so your best outreach is to the employer and their HR department OR United directly. Their sales team is pretty nice and really good.

To ultimately answer your question, you have the option to stay on Aetna under COBRA or go to United (which I feel will be an option).

I hope this guides you some on your journey for answers.

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Gene Ramsay


I can answer questions from people regarding health, life, and voluntary insurance. I can also answer certain annuity questions, long-term care, medicare, vision, dental, group products, individual products, and certain carriers. Another area would be general discussion on an individual basis to determine need and help individuals make the right decisions for them. I can also field questions from other insurance providers about carriers I represent so we can do some business together and I am also willing to offer my thoughts on certain issues they may be having with clients/customers, etc.


My experience comes from helping many people every day handle tough situations in the health, life, and voluntary insurance markets. I do not claim to know it all, but I will always be direct and professional.

National Association of Health Underwriters, Alabama Association of Health Underwriters, Birmingham Association of Health Underwriters

Self Funding Magazine,, Birmingham Business Journal, North Jefferson News

My educational credentials are holding a health and life insurance license in multiple states.

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Colonial Life Rookie Sales Award of the Year (2006), Treasurer - Birmingham Association of Health Underwriters (2010), NAHU Region 5 & 6 Leadership Conference Participant (2011), "Benefits Selling" Magazine Reader Council Advisory Board (2011), President Elect - Birmingham Association of Health Underwriters (2011), President (2012-2014), VP of Technology - Alabama Association of Health Underwriters, (2011-Present), NAHU LPRT Soaring Eagle Award Recipient (2013)

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