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-   -   couple of basic question (https://www.adrsupport.org/forums/showthread.php?t=9096)

nduetime 12-28-2006 09:27 PM

I have a couple of basic question I'm hoping might be answered here by others. If you can help I appreciate it.

1. When applying for medical insurance, it's possible that certain things are considered pre-existing conditions. Can an insurance company just flat out tell the appliciant that they won't cover a particular thing ever? I see three things can happen when I apply for insurance. One, they won't have any problems with covering my back, even with my previous disctomy and I'm immediately covered including my back. Second, they say it's a pre-existing condition and I have to wait for the exclusion perior to pass before it's covered (in California no more 12 months according to health care rights). And this is the one I'm not sure and am wondering about. Can they just say, "?No we will never cover your back."? If so, what is the term called?

2. If I get insurance and I don't have a pre-existing exclusion period (immediate coverage), is overseas medical help covered as out-of-network benifits. Does this make any sense? I'm trying to figure out if insurance companies will grant benifits for anything done overseas?

Thanks,
Byron

Harrison 12-29-2006 08:42 AM

Byron, I'll chime back in soon. In the meantime, can you insert a signature that explains your spine condition?

Thx much.

nduetime 12-29-2006 10:52 AM

Thank you Harrison. I updated my profile so I hope it shows up-b.

Harrison 12-31-2006 02:19 PM

Byron, feel free to call any time. I don't know if I can help, but I'll try! Also, check out the new support service available for Charite' patients:

http://adrsupport.org/eve/forums/a/t...1/m/6571055222

nduetime 12-31-2006 08:29 PM

Thanks Harrison for the link. I'll certainly call but I'm not sure how much it pertains to me and my present situation being that I don't currently have insurance.

My thought is that if I wait for three years to pass from the last time I saw any doctors till I apply for insurace, then I can honestly answer when they ask if I had. I figured if I apply within that time and answer yes, red flags will rise, something I wish to avoid. I'll disclose my past surgery but make it clear that it fixed the intended purpose of the pinched nerve creating complete numbness of lower right side of body.

Presently nothing is numb, I just have chronic back pain. Would this be something I need to disclose, the pain? I'm no doctor so I'm not sure why it is. Do you have to disclose that you think you have a cold when you apply for insurance if that's the case? Who's to say that I just happend to forget my pain when I apply for insurance?

A lot of really stupid questions I know. Probably none of which can be answered by anyone on this site, I'm just attempting to ask everything I can so that I can figure out a way to be covered.

Thanks again,
Byron

fl man 01-01-2007 10:16 AM

Byron,

I would get insurance sooner than later. They will look harder at you the longer that you go without insurance. The pre-existing condition exclusion that you ask about will be based on what you have been treated for in the last 12 months. I changed insurance companies and they excluded any out-patient care(chiropractic)until I was able to go a year w/o going to the chiropractor or any other doctor for my back. My insurance did pay for my ADR while that exclusion was in place.

I would be honest in the questionnaire but if your not currently under a doctors care then it is not a problem now and only history. Everyone’s back gets sore from time to time. Get signed up now, wait as long as you can and do what you need to do when the back pain becomes too much to handle.

Remember that all insurance polices are a contract that you need to fully read and understand. It would be worth letting an attorney read it and fully explain your rights and responsibilities to you.

Happy New Year

Pat

nduetime 01-01-2007 09:19 PM

Thanks fl man for the reply.

I have a couple questions about it if you don't mind.

Quote:

The pre-existing condition exclusion that you ask about will be based on what you have been treated for in the last 12 months.
Does this pertain to all insurance companies in general? Or does it depend on each company?

Quote:

I changed insurance companies and they excluded any out-patient care(chiropractic)until I was able to go a year w/o going to the chiropractor or any other doctor for my back. My insurance did pay for my ADR while that exclusion was in place.
Your insurance company DID pay for your a.d.r during that exclusion period? I'm not sure if I'm reading that right. It seams as if that would defeat the puropose of the exclusion period.

I hear what your saying about being honest, I have every intentions of doing this. The last thing I want to do is not be honest and be denied coverage of anything. Having an attorney read a policy sounds like a great idea, just one more thing for me to save for now.

Thanks again,

Byron


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