Need Medical Insurance Help

[Mr_Donktastic]

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I really think it's not "pre-existing" if she's never been diagnosed, treated, and the whole condition is pure speculation.

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Ha - beat me to my edit...I think this is correct. Just be careful though and read all of the fine print.

[mosdef]

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I really think it's not "pre-existing" if she's never been diagnosed, treated, and the whole condition is pure speculation.

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This is a good guess but generally wrong. Most health insurance doesn't cover anything where the onset precedes the commencement of coverage. If you think about it from the insurer's perspective, you should be able to see why this needs to be the case.

Oh, and as noted by others just read all the fine print carefully. You may be able to find coverage that includes non-diagnosed previous conditions. The premiums should be substantially higher though.

[Skoob]

My wife has endometriosis and it's very common. I doubt you would be denied coverage for that.

There is a way you can "beat" the preex thing though, so long as you have been honest on the application.

Here's how it works, at least at the big "blue" insurance company that I work for.

A claim comes in with a diagnosis on it. A letter is sent to that doctor to find out when the first visit for that diagnosis was. All you need to do is to not see any of the same doctors or go to any of the same hospitals that you have been to before you enrolled. And it's not a scam either.

[ginko]

Hey skoob you are the bearer of good news ! We havn't been to any doctors. So I just get the insurance, go see a doctor and we are good to go?

Do I put on the application we think she has endometriosis (ive never seen one of these applications before). Or just tell the doctor when we see him?

[ginko]

Actually she says she talked to a gynecologist/nurse(only qualified for testing of cancer and papsmears) person at Planned ParentHood, will this present a problem?

[BillytheKidd]

Just bite the bullet and buy the most expensive plan with the best coverage. Usually this plan will have higher monthly payments but minimal deductibles and copays. This is what you will want if you are expecting some problems. Hopefully after getting the coverage, she can go to the doctor, nothing will be wrong and you can drop coverage to a cheaper monthly plan. Another option is to get married, join the Army, go to Iraq. Then insurance is freeeeeeeee. Good luck.

[ginko]

lol

[riverrchic]

As a girl, your description of endometriotis sounds like just regular cramps to me. (Please bear in mind that I do not know much about endometriotis, but I know a lot about menstral cramps). Is she on a pill version of birth control? If so & she still has these major pains during her period, then that is a bit more fishy.

I do, however, know a lot about pre-existing conditions as I have asthma. And, I know a LOT about Planned Parenthood. [img]/images/graemlins/wink.gif[/img] No, just talking to a doctor at PP does not qualify as a "pre-existing condition". I think you guys are fine if you just apply for med insurance, and only write about any health conditions that you KNOW she has. Then, once she actually has insurance, you can demand 2nd & 3rd opinions on the endometriotis diagnosis (or mis-diagnosis).

Really, though, I wouldn't be too afraid of her stomach pains. Is there anything else unsual that makes you think she has something more than just regular cramps?

[JPinAZ]

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My wife has endometriosis and it's very common. I doubt you would be denied coverage for that.

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My wife was treated for endometriosis when we had employer provided insurance. When we had to switch to our own, anything related to endometriosis was explicitly denied coverage on the policy.

[ginko]

What did you end up doing JPinaz? Were you able to get covered?

Hey riverrchic, yea I'm pretty sure its more than cramps. I've already written so much, so I won't go into more detail, but it's a lot more than just cramps.