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I've been getting different information on the terms of health insurance as a med student, and how pre-existing conditions handled by OMA insurance and/or RBC? I'm hoping someone with some knowledge could help out as I'm quite concerned and I'm worried I'll make things worse if I speak to the wrong people

Here's my situation: I've been investigating a couple relatively benign health concerns over the last 2 years. One of them is probably going to be chronic and could become less-benign in the future. I have dependents that I need to provide for so I'm worried about getting screwed on insurance in the worst case scenarios where things go south in the future :(.

I've been told that anything I've seen a doctor for within 1 year prior to starting my insurance will be counted as a pre-existing condition and exclude me from converage. I know this isn't ideal, but does this mean I should stop seeing doctors if I want to have coverage in the future? Is it the same for the OMA and RBC? I already signed up for OMA insurance earlier this year, so am I already screwed there, or can I cancel my policy, wait a year, and sign up again?

It's a sensitive topic and it's been really stressful for me trying to figure this stuff out, so thank you in advance to anyone who can help out.

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  • 1 month later...

Hi There,

I’m sorry to hear you are stressed out over this issue and very glad you decided to post on this forum to get answers. 

Most disability insurance offered without medical evidence has something called a pre-existing condition clause.  For OMA Insurance, this means if you saw a doctor for a condition in the 1 year prior to your policy date, they may deny the claim for disability related to that condition in the first year of coverage.  Once the first year of coverage is over, you will be fully covered for all conditions.  All companies have a pre-existing condition clause.  When the OMA first started offering insurance sixty years ago, the idea was to make sure physicians of all health types were able to get coverage.  That is why we offer our members a 1 year pre-existing condition clause.

The industry standard for most disability coverage is a 2 year pre-existing condition clause.  If you saw a doctor for a condition 2 years prior to your policy date, they may deny the claim for disability related to that condition in the first 2 years of coverage.  After the first 2 years of coverage is over, you will be fully covered for all conditions. 

It’s best to ask questions and get advice directly from the company you have questions about, so that the information is up-to-date and accurate. 

I hope this helps but if you have more questions, please feel free to connect with me directly to discuss your particular OMA Insurance policy and I am happy to answer any questions you may have. 

Thanks,

SHEILA GODSE
Specialist, Education & Engagement
Ontario Medical Association / OMA Insurance Inc.
150 Bloor St. West, Suite 900, Toronto, Ontario  M5S 3C1
email: sheila.godse@oma.org | tel: 416.340.2246 | cell: 416.602.4997 | tf: 1.800.268.7215 ext. 2246 | fax: 1.855.432.2998 | web: www.OMAinsurance.com

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