Bad News today

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browneyedgirl
Regular Member


Date Joined May 2007
Total Posts : 150
   Posted 10/9/2007 1:06 PM (GMT -7)   
Hey everyone,
 
I am so bummed out! I just heard back from the insurance company today and they won't cover any pre-existing conditions for one full year because I don't have insurance now. (I had Medicaid while in college but that dropped as soon as I got a job and that particular job didn't offer insurance.) Kinda stupid, like if I had insurance already I wouldn't need it now. I just started a new job in August and they had a 60 day waiting period before you are even eligible for the insurance in the first place. Now I have to wait another year to have the CD and hypothyroidism covered. I guess I should be grateful that they'll cover me eventually but that doesn't help me now. Especially since I am very close to needing surgery for my stricture in the TI. It will be so hard to pay that premium every payday and get next to nothing for it. Sorry, but I just needed to whine about this for a minute.
 
On another note, I won't see the Charity GI doc until the 23rd regarding my SBFT results. Since the radiology doctor actually came in to take multiple pics of the strictured area himself, I am assuming the news on that will not be good. I'll let ya'll know when I find out. I was hoping my insurance would cover the surgery and I wouldn't have to have it at University Hospital. I have been getting treatment for the CD through our Free Care system and while I thank God we have it, it is certainly not that great. So that's my b#$%& session for the day. Thanks for listening.
Jennifer/32
CD since 10/2005
Asacol 2 pills 3 times daily
 Imuran 75 mg once daily
 Lomotil as needed for cramps and D
B-12 supplement 1 mg daily
Women's Multivitamin
Biotin 1mg
Calcuim with Vitamin D 600 mgs
Levoxyl (Thyroid)
New Orleans, La, US


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 10/9/2007 1:26 PM (GMT -7)   
Well that sucks! If it looks like you are going to need surgery, go ahead with the free one. No need to suffer for another year. Plus, you might not be able to wait anyways. I sure hope you get feeling better soon. God Bless!
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.


browneyedgirl
Regular Member


Date Joined May 2007
Total Posts : 150
   Posted 10/9/2007 1:39 PM (GMT -7)   
"""Well that sucks!"""

Thanks Nanners. You're response was word for word what my boyfriend said when I told him....

I am so grateful to have him and ya'll on days like these and always.
Jennifer/32
CD since 10/2005
Asacol 2 pills 3 times daily
 Imuran 75 mg once daily
 Lomotil as needed for cramps and D
B-12 supplement 1 mg daily
Women's Multivitamin
Biotin 1mg
Calcuim with Vitamin D 600 mgs
Levoxyl (Thyroid)
New Orleans, La, US


mboyle
New Member


Date Joined Oct 2007
Total Posts : 4
   Posted 10/9/2007 1:51 PM (GMT -7)   
insurance companys suck. i have been going through hell trying to get my meds approved. since the does is so high there is so much to go through to get anything approved and during that time i go with out meds.
im sure you have tried this. but what about going through the state?? i cant think of the name right now but i see comercials all the time about how to get meds. for near to nothing. and i know you can get just about anything on the internet.
i know its hard when all you want to do is get well and the insurance co. are keeping you from getting there.
my heart goes out to you and i hope things turn a bright corner for you.
crohns- u.c suffer for thirty years. ugh. that makes me feel old. any way thinken of you.

FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 10/9/2007 3:20 PM (GMT -7)   
Check into the laws in your state to make certain that this is legal. In some states, group insurance (the kind you and all your coworkers get through a job) are not allowed to have pre-existing condition clauses. Sometimes they are still written in their policies because the company spans multi-states. Other states allow pre-existing conditions when there is a gap in insurance. The policy reason behind that is a healthy person might not get insurance until they are diagnosed with a disease and then decide to go sign up for insurance. The flaw in this is where you stand. What if you were diagnosed before you had a chance to get insurance? I am so sorry you are in this predicament and it absolutely sucks. On the plus side, if you get in a car accident or something that will be covered. Could you offer to pay a higher premium to have your pre-existing conditions covered? Could a stricture be considered a new condition or does it just fall under the blanket of crohns. What a mess!! At least you have found a way to still get care... I wonder if the care you have been getting could be used to negate the pre-existing conditions clause. Its not that you went untreated, or that you paid out of pocket, you were getting free care. Hmmmm.... thats an angle to try!
25 Year old married female.  Diagnosed w/ CD 2 years ago, IBS for over 10 years before that, which was probably the CD.
 
I started getting a ton of junkmail after putting my myspace profile link on here.  Im taking it off but if you want to contact me just email me and Ill give you a link to my myspace.  Sorry!


browneyedgirl
Regular Member


Date Joined May 2007
Total Posts : 150
   Posted 10/9/2007 3:43 PM (GMT -7)   
Hey Fitzy,

I already plan on trying that angle! LOL! I am going to try everything I can to get around it if possible. I am just trying to get my emotions together before I call and argue my case. Thanks for your ideas, I really appreciate the different thoughts you all are having on the subject. PLEASE keep them coming!

mboyle,

I will respond to your post later because I have alot to say in regards to it! :-) Some info on meds to share too. But right now my chicken is cooking and I don't want to burn it. LOL.

Talk to ya'll later. thanks for all the kind replies.
Jennifer/32
CD since 10/2005
Asacol 2 pills 3 times daily
 Imuran 75 mg once daily
 Lomotil as needed for cramps and D
B-12 supplement 1 mg daily
Women's Multivitamin
Biotin 1mg
Calcuim with Vitamin D 600 mgs
Levoxyl (Thyroid)
New Orleans, La, US


Sugarmarie
Veteran Member


Date Joined Jul 2003
Total Posts : 1205
   Posted 10/9/2007 4:39 PM (GMT -7)   
I do not understand this from what I have heard group insurance through work has to take you with no pre-existing. Call the stat insurance commissioners office. Dr.William Meyers in metairie is very good.He works out of east jefferson.
Confucius say : He who goes to bed with itchy butt wakes up with stinky finger.

Words of wisdom: Never trust a fart

:) Sugarmarie A.K.A. Poopy Pants :)


Matthew
Veteran Member


Date Joined Oct 2004
Total Posts : 3932
   Posted 10/9/2007 6:21 PM (GMT -7)   
Yeah, but there is always a loop hole with these insurance people..

Matthew

huckleberry
Regular Member


Date Joined Sep 2007
Total Posts : 317
   Posted 10/9/2007 8:19 PM (GMT -7)   
Did anyone see Sicko -- the Michael Moore movie about the health care system? A few really memorable scenes, including one in which a man has to decide which finger he can have re-attached after an accident. The insurance will only pay for one or two -- not all!

Crazy.
44 years old, newly diagnosed after an 8-day hospitalization in September 2007 but symptoms for several years before that.
Taking Pentasa, Prednisone (tapering), Cipro, Prilosec, probiotics, calcium and a multi-vitamin -- also Levoxyl for hypothyroid (Dx 2004)
Gall bladder surgery in 1997.
Single working mom to three wonderful kids, ages 9 to 15.

So appreciative to have this forum -- it's all new to me!


MBJOH
Regular Member


Date Joined Mar 2007
Total Posts : 257
   Posted 10/10/2007 5:39 AM (GMT -7)   
Browneyedgirl - just an FYI, in New York we have the pre-ex clause also, that if you have gone without coverage for more than 63 days any pre-ex won't be covered for 11 months - BUT - that doesn't apply to RX's. I know you were concerned about your surgery but I wanted to let you know that any RX's should be covered. The reason why insurance companies do this is so people don't just jump on a plan when they need a medical service and then jump off the plan once they are all set. Our premiums would be even higher if they allowed pre-ex to be covered right away. I agree something needs to be done with our health care system though. MB
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