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Joan
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Experience:  I believe that knowledge is Power! I would like to try to share my knowledge with others.
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30 year old female who let health insurance (was BC/BS, individual)

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30 year old female who let health insurance (was BC/BS, individual) lapse. No claims had been filed with her BC/BS, as it was very basic coverage, and family was paying cash for last 3 yr of medical care...
Her medical care included a single full psychiatric evaluation in CA, as consult. Dx was anxiety and depression. She was recommended to take lamictal and gabitril, which are anti-epileptic meds, not controlled substances. She did not live in CA, and they would not prescribe meds for out of state persons. Family included other siblings who were taking same meds, intermittently, and they shared meds. Some
meds also came from cousin who was physician, and had been taking one of same meds. Not good medical practice, but she had no money, since she was and is still in grad school.
She subsequently (2yr later) had full (single) consultation for insomnia in Colorado, and listed those above meds as ongoing, but she was
not ever asked the source of meds. Diagnosis was chronic insomnia. Klonopin was recommended by specialist. But she had no primary care.. so that med was not ever prescribed or taken...
She is now seeing
a psychiatric nurse practitioner, in Colorado, where she is now living.. and a new diagnosis of ADD has been added. She is getting all meds, ongoing basis, from
this practitioner, for last 4 months. These are prescribed for her by nurse practitioner,
whom she sees once monthly, and family is paying for prescriptions, now.
She needs to reapply for insurance. I am relatively sure she will be declined,
as uninsurable, or with mental health exclusion.

My question has to do with her applying, in terms of her answers to their questions. I assume they write down every answer to any question, and I do not
know consequences of her explaining that she was taking someone else's meds....
There are no prescriptions inbetween the consults, no primary practice physicians, if they were to ask for medical records. Will they ask whose meds she was taking?
Will this history re manner of obtaining her meds be on her record forever? Is she identified with some label that will follow her and disqualify her from any medical insurance? I know she has to be honest. She must give correct information, whether it was or was not covered by insurance. I just do not know what the policy
or standard practice of health insurance applications is, nor their consequences...
so I am worried…
Submitted: 2 years ago.
Category: General
Expert:  Joan replied 2 years ago.

Hello,

The Insurance applications are very comprehensive and they will ask about medications, Dotors seen, Dates, Ilnesses, etc. If there is anything in the history they will deny coverage.

 

There are a couple of options available. The first is the Govenment now has a Pre existing Inusrance that is available once you have been off Insurance for 6 months.

You can read about this covereage here: http://www.healthcare.gov/law/features/choices/pre-existing-condition-insurance-plan/index.html This company will require a denial letter from an insurance company and proof that you do not have current insurance.

 

The other option is there is an interim policy available that offers some Doctors visits, but it is not considered heath insurace and does not cover presctiptions. This is some information on how to go about getting one of these policies: http://www.ehow.com/how_2100009_find-health-insurance-uninsurable.html

 

I have recently gone through this because I lost my health insurance due to Lupus. I have now applied for the Pre existing Health Insurance and awaiting approval.

 

The pre existing policy may be the best chance to have coverage.

 

Joan

Customer: replied 2 years ago.
Thank you for these suggestions. My question pertains to answering the
comprehensive questions that they ask, when one applies for insurance.
What do they do with the information that you give them, at the time of
application? These questions must be answered before they deny you coverage.. Do they file the info, in case you reapply? or do they not
care where you obtained the meds..
Expert:  Joan replied 2 years ago.

Hello,

The insurance companies will dig deep and will not accept you if you do not give names, addresses and phone numbers of all Doctors, Illnesses and Medications. There is no getting around their questions.

 

It took me over an hour to just go through and answer their questions for each individual illness. If you do not answer as far as who has been seen for the illness, and type of medication prescribed, they will deny you.

 

Even being seen for blood pressure brings a whole new set of questions. The information is kept on file. It does not matter how long it has been since you were seen by a doctor for the problem, you will be denied.

 

The company I applied for to continue coverage I had been with preveiously, still turned me down after caring for me for almost 20 years.

 

The company applying to will also ask for past insurance information and will get the information from them as far as care, Doctors, etc.

 

They generally do not ask what pharmcy you get your meds from, but each company may slightly differ.

In the most ideal situation the Pre Existing Insurance is the best chance of getting insurance with what you have explained.

Joan

Customer: replied 2 years ago.
You are being most helpful...
1. After you gave all that info to insurance co on the phone,
did they deny you then on verbal info, or did they send
for med records physically from doctors???

2 She called BC after she let it lapse, and they said she had to
reapply.. Is that a denial, or does she have to do the full
application, like you did, and then, that creates denial letter.
You said pre existing companies have to have denial letter..
Expert:  Joan replied 2 years ago.

Hello,

I applied using the online application, since they want all details. I felt they wanted my life story and first born too.

 

Once I sent it in application, it went to what they call their underwritting department and they sent me a written denial letter. I immediately replied to the Pre exhisting Insurance and now waiting my card for the insurance.

 

 

The company had all the records from when I was with them. They also contacted the Doctors for records too. They do not let the slightest thing slip by, in order to get out of accepting you.

 

 

I have found the only way I could get insurance is through the pre existing insurance.

 

Joan

Joan, Internet Researcher
Category: General
Satisfied Customers: 15401
Experience: I believe that knowledge is Power! I would like to try to share my knowledge with others.
Joan and 105 other General Specialists are ready to help you
Expert:  Joan replied 2 years ago.
Hi,
Hope that you found the information helpful and that your friend will be able to find medical isurance.
Joan

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