dang - high PSA result in middle of changing insurance

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

lvas12
New Member


Date Joined Dec 2008
Total Posts : 2
   Posted 12/8/2008 3:26 PM (GMT -6)   

Well the title pretty much states it. Where I work we had to elect our 2009 health

Care coverage in OCT but we don’t switch over to the new choice until jan 1 2009.

Well I changed coverage from UHC to GHP.   Anywho I went  to the doctor

For my annual physical first of Nov and he did a DRE and said I had a mushy

Prostate and what he thought where some irregularities (lumps) I guess.

 

He put me on 500mg cipro for 30 days  which finished end of Nov.

 

then I had a PSA done last week and Its 6.4.  now he wants to refer me to a URO for a biopsy I guess.  He wanted It done this week but I said hey lets slow down here as I don’t want to get Diagnosed with PC and then switch insurance carries on Jan 1 and have them Tell me it’s a pre-existing condition and not covered.   So will have to wait until Jan before I go see a URO – shouldn’t be a big deal I guess but kinda plays with your Mind a tad J   oh I’m 53 and sure hoping I don’t become of member of this club – no Offense guys.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 12/8/2008 3:35 PM (GMT -6)   
Hi Ivas12,
No offense taken. We would prefer to not be growing this club as we are. This is a question best answered by your benefits coordinator at your place of work. i can say that I switched insurance companies in the midst of treatment and while I was covered even with a pre-existing condition it was an annoyance at times. Even today, the lab that does my blood work, Qyest Diagnostics, bills my old insurance company regularly. Even though it's been 16 months since I had that insurance. But the key is that I was covered. And since you are with a company, you probably are too. but go ask, and then get to that urologists office. I would not delay this as cancer does not read premiums.

Peace!

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 12/8/2008 10:34 PM (GMT -6)   
Shouldn't be a problem as prior creditable coverage will offset any preX wait period. Especially when dealing with group health plans. Good luck with your diagnosis.
Age 50
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00


hangin-in
Regular Member


Date Joined Sep 2008
Total Posts : 78
   Posted 12/9/2008 11:33 AM (GMT -6)   

I agree. I think the only exclusion for prior condition is if you had no previous coverage. But if you had coverage with another company they must cover you too. I think it's the law. Check it out.

Life Insurance is different. I wonder... Does it make sense to get a life insurance policy before the biopsy?

 


Rising PSA 12/06=1.6 12/07=2.1 5/08=2.6
Biopsy 6/4/08 12 core 4 Positive 15%,15%,8%,3%
Diagnose @ Age 51 Gleason 3+3=6
Bone & Cat Scans Normal
Lapro Surgery 8/18/08 at Memorial Sloan Kettering
Pathology report stage T2c organ confined with positive apical margin Gleason 3+3 = 6 (with tertiary grade 4)
Catheter removed 8/26 - reinserted 8/29 - removed 9/2
No continence or potency problems from the get-go.
First post op PSA 10/2/08 < 0.05


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 12/9/2008 6:26 PM (GMT -6)   
Hangin-in, you're correct about that being law. That rule is part of HIPAA.
Age 50
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00


lvas12
New Member


Date Joined Dec 2008
Total Posts : 2
   Posted 12/10/2008 8:36 AM (GMT -6)   
cool, thanks for the advise. So in light of they should have to cover me I went ahead and told my GP to proceed with scheduling some more items.  getting freepsa and total psa test done tomorrow.  I know that is just a indicator but might as well get it done.  also scheduled the appt with the URO - its not until Jan 9th but thats to be expected with the holidays and such.
 
so now its just a waiting game until all the tests are done and then seeing the results. 
 
I know I shouldn't get to ahead of myself but since i'm only 53 i've pretty much decided if it comes back postitive to go ahead and get the devinci procedure if i'm a good candidate for it.

Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 12/10/2008 3:57 PM (GMT -6)   
Good luck Ivas12. Hope you don't get to join our club.
New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, May 27, 2018 6:02 AM (GMT -6)
There are a total of 2,966,326 posts in 325,328 threads.
View Active Threads


Who's Online
This forum has 162733 registered members. Please welcome our newest member, Ad24.
282 Guest(s), 6 Registered Member(s) are currently online.  Details
SantaZia, MaryQueen99, trishlongmont, Tudpock18, Herophilus, formerMarine