pre-existing conditions??? help?

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jesimae
Regular Member


Date Joined Oct 2009
Total Posts : 110
   Posted 1/18/2012 2:48 PM (GMT -6)   
Hello fellow Lupies. I have a few questions I can't seem to find the answer to. My PCP "diagnosed" me with lupus some time before Christmas, however there is no formal diagnosis on paper. Only symptoms, tests, treatments, etc. He set up an appt for me next month with a rheumy for treatment.
 
I had insurance through my employer, but it was taken away because my health wouldn't allow me to work full time.
 
My husband and I applied for private health insurance, since he works construction (he can't keep coverage continously).
 
This is the problem I'm facing. If I have scheduled an appointment, before insurance was actually issued, are they going to deny coverage? Will anything that falls under the lupus category now be pre-existing? The waiting list is long for the rheumy and I need to start treatment.
 
Any insight/advice greatly appreciated.
Jessica, diagnosis: Celiac Disease, Systemic Lupus Erythematosis
MVP, Clinical Depression, Anxiety
Celexa, Atenolol, Prilosec, Prednisone, Meloxicam

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 1/18/2012 6:45 PM (GMT -6)   
If your doctor says lupus before your insurance kicks in it is known as a pre-existing condition and you will have a very hard time getting insurance coverage.

I'm stuck with my insurance now because I've got a diagnosis and no other insurance company will cover me. :(
Joy

Lynnwood
Forum Moderator


Date Joined May 2005
Total Posts : 7720
   Posted 1/18/2012 9:33 PM (GMT -6)   
Just answer the questions from the insurance company honestly, and don't add any extra information they do *not* ask.

As I recall, they ask: "Have you been diagnosed with ____?", which is NO.

I've never been asked "Are you waiting for diagnosis for__?" or "Do you have appointments scheduled to investigate________?" -- for those type of questions you'd have to reveal your scheduled appointment, otherwise I personally would think you'd be ok.

Only an insurance professional representing the specific company you are purchasing from could answer the question, but as you can guess, asking the question may not be the best idea!
Lynnwood, Lupus & Sjogren's Moderator
DIAGNOSING-LUPUS & LUPUS-RESOURCES
"Life is far too important to be taken seriously" - Oscar Wilde

SmurfyShadow
Veteran Member


Date Joined Dec 2008
Total Posts : 2386
   Posted 1/21/2012 1:31 AM (GMT -6)   
Its not an official dx til its on paper. PCP probably having Rheumy varify dx
"The Walking Medical Mystery"

Too many Allergies / Too many RXs & DXs

A Rare Gem for Doctors and Guinee Pig
~Medical Caregiver and Doctors Worse Nightmare~
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