It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Health Insurance Issues Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 03-27-2011, 05:41 PM   #1
Junior Member
(female)
 
Join Date: May 2001
Location: Friendswood
Posts: 46
JS43 HB User
Denial of coverage question?

My son has had problems with vomiting and a month ago anemia. He applied for insurance and they denied him saying he had ulcers. In fact, he had an endoscopy and there was nothing, no ulcer, nothing.

Unfortunately, the day before he received his denial, he had to go to hospital and they diagnosed him with pancreatitis.

This was the first time, he was ever given any other diagnoses other than IBS. Can he be denied coverage for something he was not diagnosed with when he applied? I understand them not covering any GI related problem for a year, but to totally deny coverage to him for an ulcer which he did not have?

 
Old 03-28-2011, 10:03 PM   #2
Facilitator
(female)
 
SpineAZ's Avatar
 
Join Date: Oct 2005
Location: Wisconsin
Posts: 5,097
SpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB User
Re: Denial of coverage question?

If denied coverage ask the insurance company for proof of the reason - you want to see the actual documents that led them to the decision. Often it's based on notes such as "patient was seen today for gastric pain, may be ulcer" and then the insurance company sees the possibly treatment/diagnosis of an ulcer. And then if he was given a medication to take for ulcers, but later it was found not to be an ulcer, that makes it even more difficult.
__________________
Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Sponsors Lightbulb
   
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Acute Pancreatitis -Denial of Coverage-Pl help Shahnaaz Health Insurance Issues 3 03-17-2011 06:59 PM
Denial of coverage for cronically ill son past age 25 curious4444 Health Insurance Issues 2 07-24-2010 10:30 AM
Had a 6 months lapse in coverage and now needing surgery, ? regarding pre-existing JT76 Health Insurance Issues 1 04-28-2010 09:27 PM
question about coverage mustlovecats Health Insurance Issues 12 02-26-2010 01:05 PM
Finding short term coverage with pre-existing condition? Yelena07 Health Insurance Issues 1 06-08-2008 05:48 PM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added








TOP THANKED CONTRIBUTORS



Whynowthis (44), youtoo1955 (29), SpineAZ (20), vann04 (17), dismama (10), magicssd (8), Titchou (8), sandiemas (7), Jacki345 (6), minnieme1982 (6)

Site Wide Totals

teteri66 (1164), MSJayhawk (997), Apollo123 (898), Titchou (832), janewhite1 (823), Gabriel (758), ladybud (745), sammy64 (666), midwest1 (665), BlueSkies14 (610)



All times are GMT -7. The time now is 10:17 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!