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Old 04-21-2010, 07:45 AM   #1
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I got denied. Now what?

I got denied for health insurance. They said it was due to pre existing conditions. I dont know what to do. I cant lie on the application but no one will give me insurance. Its really upsetting. I may have my problems but I consider myself to be in really good shape. Im not going to apply for disability. I know some people have too but Im not disabled. There may be bad days but MS sure hasnt slowed me down. The only thing that keeps me from doing what I want is having to worrie about health insurance. I just dont understand. I may have pre existing but I almost guarentee Im more active than alot of people that insurance companies classify as healthy. What can I do now? I have to have some kind of coverage. Any advice on what I should do now?

 
Old 04-21-2010, 12:25 PM   #2
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Re: I got denied. Now what?

Speak with the state agency which regulates your insurance. There are states which will assist you, including handling your denial of insurance.
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Old 04-21-2010, 02:27 PM   #3
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Re: I got denied. Now what?

They cannot deny you if you had coverage in the past 6 months...did you? If you did, you need to contact whomever you had coverage with and ask them to contact whomever you are trying to get coverage with....
If they DO deny you, they cannot deny you for anything NON RELATED TO MS. Meaning, you should be covered for an emergency or accident, but they do not have to cover your MS related issues for the first year. After the first year, they cant deny you at all. And, they can charge you out the ying yang for that first year.

Now as far as MS help....Most MS drug companies offer help for underinsured or un-insured....they charge you as little as 50$ a month for the first year to get MS drugs....all the regular drug companies have programs to help you if you have no prescription coverage. You just have to research this further. also the MS society can help you with MRIs for awhile....start reaseraching your options...there is help out there!


And no, disability isnt for everyone! I agree with you. I have lousy days too, but I also work 50+ hours a week and go to school fulltime. Im not ready to take disability and will refuse to consider it until I need to....for those who need it, Im glad its available, but if you can still work, then consider putting your efforts into finding a job which will give you coverage, even if it means no MS coverage the first year.
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Old 04-21-2010, 04:28 PM   #4
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Re: I got denied. Now what?

Ive had coverage for the last 2 years straight. The crazy thing is its with the same company that denied me! They are covering me right now. The problem is I graduated in December but havnt been able to find a job in my field that offers health insurance. So Ive been going back to school full time so I can stay on my moms insurance. I cant go to school forever and I love the field I have a degree in and I want to use it. Right now I dont even have to mark MS as a pre existing condition beacuse my doctor told me he likes to do another MRI 6 months after the first before he comfirms it 100%. The problem is one of the symptoms I had first was bladder problems but it was diagnosed as interstitial cystitis. Im on meds for it and had to mark it on the application. My neuro thinks the problem is more related to the MS. I think the other reason they denied it is because I had to mark that I saw a neuro within the last 6 months and had a MRI. Then it had questions about dizzy spells and tingling/numbness. Right now Im lucky because I dont have to be on any MS meds. My doctor said he likes to hold off on them if he can so Ive been exercising and doing what he told me and most days Ive been ok. I just dont understand why they wont cover me on my own plan but yet they are covering me right now under my moms work insurance. Im just worried because I know I cant afford appoitments without insurance.

 
Old 04-21-2010, 04:48 PM   #5
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Re: I got denied. Now what?

you should be able to get insurance with any company if you have been covered for the past 2 years. They cannot deny you coverage if you do not have a definative pre-existing condition. All of us have seen a doctor or had an infection or even surgery in the past, and its illegal for an insurance company to deny you coverage. Have you checked around for other companies? The fact that youre no longer a student, sure- its going to go up in cost, but they still cannot deny you.

you need to do some research and find out who the insurance regulator in your state is...then ask the right questions.

I know for a fact that no state can deny you insurance (they can make it terribly expensive but not deny it- they can withhold coverage for a preexisting condition for up to a year, but not deny you entirely) so you need to check out some other companies! Something isnt right here.
Good luck!
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Old 04-21-2010, 04:56 PM   #6
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Re: I got denied. Now what?

Im definatly going to be making some phone calls. They said the interstitial cystitis is a pre existing condition so I was denied. Im going to apply for some other companies but I really needed that one because the neuro I saw only takes that insurance for some reason and their is no way I can afford to see him out of pocket. If I get accepted with another company I guess Ill have to find another MS specalist.

 
Old 04-22-2010, 04:48 AM   #7
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Re: I got denied. Now what?

most MS specialists do not take any insurance. Youre lucky to find one who does....I have to pay out of pocket for mine, and then I get back 85% of it from my insurance company until I reach my deductible, and then I get back 100% because they consider mine to be "out of network". Hes out of everyone's network! He takes no insurance at all!

Make the calls, and maybe next time dont list the cystitis. Theyll find out by doing your background check if you have been treated for anything. Thats not a terminal disease- they cannot deny you based on it. They can just raise the premiums!

Let us know what happens...and do your research. You will find insurnace brokers in your local phone book who can do that for you. For a small "broker" fee, they will find your insurance and set you up with good coverage, even knowing your situation.....then, they actually do the billing thru their office not directly thru the insurance company. Youll pay an extra 10$ a quarter or so for the convenience, but it might be worth it. It reduces the stress and you get a bill quarterly which you pay. I found my insurance that way once and once they set me up, I called the company and went on their direct pay program, thus eliminating the broker fees and the broker entirely.
Good luck!
Nikki
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Old 04-22-2010, 07:08 AM   #8
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Re: I got denied. Now what?

Thanks for the advice! It does ease my mind to know that some insurance comanies will pay you back for the out of pocket expense. That would definatly help cause I really dont want to change doctors. Ill let you know what I find out.

 
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