Author Topic: Should I get extra insurance BEFORE I am diagnosed?  (Read 5221 times)

microsoftfree

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Should I get extra insurance BEFORE I am diagnosed?
« on: March 14, 2009, 06:01:29 am »
I haven't had my MRI yet...it will be scheduled when I see the ENT on Tuesday. The hearing test doc is sending me back to the ENT. My group insurance is horrible...only pays 50% on hospitalizations. Should I try to get something like AARP insurance or some other as an extra? I will be 60 in a couple of months, so will be needing something anyway in a few short years. I'm thinking that if I'm going to be doing a Watch & Wait anyway, maybe I should postpone the doc visit altogether, get some extra insurance and then pursue this thing.  Any thoughts?

wendysig

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Re: Should I get extra insurance BEFORE I am diagnosed?
« Reply #1 on: March 14, 2009, 10:03:26 am »
Since insurance doesn't cover pre-existing conditions for at least a year, getting insurance prior to diagnosis is probably  a good idea.    I don't know for sure, and maybe your should ask your doc, but if you suspect you have a problem and get insurance to cover it it's not the same thing as getting it after the fact -- I would guess it would be covered.  There are folks in the forum who know much more about insurance and the way it works than I do, hopefully one of them will respond.

Wendy
1.3 cm at time of diagnosis -  April 9, 2008
2 cm at time of surgery
SSD right side translabyrinthine July 25, 2008
Mt. Sinai Hospital, New York, NY
Extremely grateful for the wonderful Dr. Choe & Dr. Chen
BAHA surgery 1/5/09
Doing great!

sgerrard

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Re: Should I get extra insurance BEFORE I am diagnosed?
« Reply #2 on: March 14, 2009, 10:21:40 am »
Whenever possible, everyone should have adequate medical insurance, including enough coverage for a major medical incident. If your current insurance doesn't provide that, then I think it would be wise to get more, if you can afford it. That is really independent of whether or not you have something serious developing right now. 50% seems unusual to me for major medical coverage; are you sure there isn't another provision for major events? Not many people can afford half of a 100,000 dollar tab.

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

microsoftfree

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Re: Should I get extra insurance BEFORE I am diagnosed?
« Reply #3 on: March 14, 2009, 11:52:21 am »
Thank you both.

Yes, I am sure...it's with the Union ( in their case, they don't care about us at all, IMO ). In fact, when I went to the emergency room a month ago I was lucky that the heart doctor happens to be on my plan so he will be paid in network. Doesn't matter that I went to the correct network hospital. If this does turn out to be an AN, insurance will be a huge problem also because I have a lifetime cap.

I'm thinking maybe I should cancel my appointment on Tuesday so the doc doesn't even get involved yet.

sgerrard

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Re: Should I get extra insurance BEFORE I am diagnosed?
« Reply #4 on: March 14, 2009, 12:03:52 pm »
That's a tough call. You don't want to neglect your condition, but you don't want to get caught up in an insurance wrangle either. Hmm... ???

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

microsoftfree

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Re: Should I get extra insurance BEFORE I am diagnosed?
« Reply #5 on: March 14, 2009, 12:38:30 pm »
Yea, this is always an ongoing problem. The company I work for tried at the last contract time to get the Union to turn over the insurance to them, but the members balked and threatened to strike because our "insurance" has always been free and...until now...has always been really good. The company backed down and as soon as the contract was signed, we now pay for our "insurance" and they cut our medical benefits covered under it.

The contract comes up again next year in April and I'm hoping that #1 we won't lose our pension and #2 we will get company insurance. The company offered us several different plan options, too, so you could choose which best fits yours needs where we are all the same under this one.

Because of the lack of hospitalization insurance, I am having to wait until I retire and get Medicare to have my knee replaced. There just HAS to be a better way to set up health plans for this country, but don't know what it would be.

I'm old enough to remember when all a person had was hospitalization insurance and wonder if that was something that should never have been changed. I wasn't, however, old enough to know if it was a good thing, though. LOL

Jim Scott

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Re: Should I get extra insurance BEFORE I am diagnosed?
« Reply #6 on: March 14, 2009, 01:30:17 pm »
MSfree ~

Your medical insurance situation is a tough one.  I have to agree with our judicious moderator, Steve, that signing up for increased coverage now (ASAP) would be a good idea.  To avoid being ensnared in the 'pre-existing condition' coverage trap, I would cancel your doctor's appointment at this time. 

However, be aware that HIPPA (Health Insurance and Accountability Act of 1996 ) states that a preexisting condition can only be classified as a condition that was in effect six months prior to the effective date of the policy and it can only be excluded for one year after the effective date of the policy.  However, HIPPA protection only applies to employer sponsored plans and government sponsored individual programsIndividual health insurance policies (that you purchase on your own) are not protected by HIIPPA.  Individual plans (not under HIPPA protection) are allowed to exclude a condition permanently.  Thus, if you take out a 'private' health insurance plan, it could (but not necessarily would) exclude an acoustic neuroma that you've had for some years prior to your becoming a policyholder.  There is a huge medical database insurance companies use (the 'Medical Information Bureau') that will help the insurance company find out whether you knew that you had this condition before you took out the policy.  If so, they can deny your claim, raise your rates (and still exclude the condition from coverage) or, in some cases, rescind (cancel) the policy based on your (alleged) misrepresentation when you originally answered the medical questions required to apply for the policy.

It's a tricky business and you have to be careful or risk paying good money for medical insurance that you won't be able to use if and when you need it.  I would consult a trusted insurance agent or someone who works in the insurance business for advice on what company to apply to and be sure to know exactly what their 'pre-existing' rules are.  I would assume that, being near 60 years old, the cost for a 'private' medical insurance policy will be fairly steep, although, because it would be a 'secondary' coverage policy (your employer's policy would pay, first) that might hold down the expense.   

I used to work in the insurance business for a time, but handled auto and home.  My wife was a senior supervisor in the claims division of a major insurance company (The Hartford) and handled auto and homeowner claims, not medical, so although I understand the insurance business in a general way (especially auto and home) I'm not an expert in medical insurance coverage but I offer what I can in the hope that the information is of some help to you in your situation. 

Jim
MS captive (with no regrets)  :)
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

microsoftfree

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Re: Should I get extra insurance BEFORE I am diagnosed?
« Reply #7 on: March 15, 2009, 06:46:47 am »
Well, it's probably already blown then not only with the obvious hearing test results but the trip to the hospital that I thought was my heart and ended up being not related. It seems AARP doesn't offer supplemental now until you hit 65. They are also plain about not covering pre-existing.

Dog Lover

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Re: Should I get extra insurance BEFORE I am diagnosed?
« Reply #8 on: March 20, 2009, 06:06:42 pm »
YEah, the private insurance is a joke. I got it several years ago when I got laid off. They accepted me, because at the time I had no medical conditions, but they wouldn't cover my daughter because she had migrains! I even suggested the opt out of anything related to her migrains (which was some medicine a few times a year) and they wouldn't even go for that. What a racket.

Cathy
Cathy
9mm x 3mm Left Side AN
Mid Fossa Aug. 21, 2008
Dr. Gantz / Dr. Woodson
Univ. of Iowa Hospitals and Clinics
No facial issues, hearing saved, I keep active and feel back to normal.