Health Insurance Denied, Then I Wasnt Completly Honest . . . Posted: 11-12-04 22:57pm
I had health insurance and lost my job, I
did not take cobra because it was so
expensive and I have adhd, when I went to
get health insurance several months later
through bcbs, I was denied because of adhd
and not having health insurance for the 3
months. I applied at another company
and a friend told me I should not dislcose
the fact I have adhd, well, I have health
insurance now, it serves no purpose, I
cant get my meds or go to appointments,
and I want to come clean. I dont feel
right deceiving and I should of never
listened to this friend. Now I do not
know how to do this. . . . Has
anyone out there made a mistake like this
before?
Knowing what I know now, I could of gotten
health insurance through a major company
right after my unemployment and it would
of been half of what cobra is.
how do I notify them of this mistake on my
part, and try and make it right. Ugh
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nicoluzakis
New User, Becoming EHEALTHy
Joined: 16 Dec 2004 Posts: 5 Location: Phoenix, Arizona
Being Honest With An Insurance Company Posted: 12-16-04 12:41pm
So you hid some treatment for a medical
condition from an insurance company; no
big deal, right? Wrong!
Yesterday I spoke to one of my clients who
had purchased a policy from me with a
major company a little less than one year
ago. In august of this year she had a
major heart problem that required
emergency surgery and spent a little over
2 weeks in the icu. Her bills are
totalling around $300-350,000. Upon
submition of the claims, the insurance
company is going to review everything to
try to get out of paying that kind of
money. They found a small prescription
issued a few years ago for irritable bowel
syndrome that she never even took or
refilled. In fact, she never even was
really diagnosed with irritable bowel
syndrome.
To make a long story short, the insurance
carrier claimed that she wasn't being
truthful on the application by not
mentioning the above ibs medication and
wanted to recind the policy all the way
back to the effective date, refunding any
premiums paid minus any claims filed.
This would essentially get them out of the
$300-350,000 liability and cause the
client to be financially bankrupt.
Luckily, we were able to come to an
understanding with the insurance company
and they will pay for the heart
condition.
Blue cross is a good policy, but has some
of the toughest underwriting guidelines.
Normally, adhd is simply a rated or
ridered condition. You have nothing to
fear by calling the insurance company and
telling them everything. Ask to speak to
their underwriting department for
individual medical. If they don't want
you anymore, there are plenty of companies
that will take you. Please do not put
yourself in the same position my client
did. It's simply not worth it.
Hope this helps.
Jason
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donaldmolbert
New User, Becoming EHEALTHy
Joined: 21 Jun 2005 Posts: 6 Location: Nashville, TN
Posted: 06-21-05 18:25pm
Harriet:
i'm curious. In your message, you stated
"i have health insurance now, it serves no
purpose, I cant get my meds or go to
appointments".
This confuses me greatly. What do you
mean by "it serves no purpose"?
Harriet, you need to reevaluate why you
are purchasing health insurance. Health
insurance was never designed to pay the
"small" items such as medications and
doctor appointments. However, due to
public pressure, insurance companies now
offer coverage for these items.
Back to the question about why you are
purchasing health insurance. If the
reason is to get your meds and Dr. Paid,
why would you pay such a high premium for
such a small return.
In short, major medical health insurance
is designed for the "big" items. $350,000
cancers, $200,000 heart surgeries, $1/2
million accidents, and so on. Big ticket
procedures that your hospital is not
obligated to perform if you do not have
the "right" type of health insurance.
