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I Got Approved for Health Insurance!!


ethansmom
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I just had to share some good news...I got a letter from Blue Cross/Blue Shield today approving me for health insurance coverage. I am so excited, as this has been a long year without it. I lost my insurance under my parents last November, the company dropped coverage one I reached their age limit. I've been denied by two other companies and was not eligible for Medicaid, so I am really happy. There is a 24 month pre-existing clause (and I'm paying a higher premium) but I figure it will be worth it all round- $144 per month is not bad.

I have one question, though. I am seeing a new doctor next month- an internist who specializes in CFS and Fibromyalgia. I have NOT been diagnosed with anything except POTS, but I know CFS, Fibro, and POTS are closely related in some cases. What do you think the odds are of them covering the charges at this doctor, due to the pre-existing clause? He does not treat POTS that I'm aware of- I am seeing him because my problems are leaning more in the direction of autoimmune/chronic fatigue this past year. I am seeing a new cardiologist for the POTS next week which I know won't be covered for 2 years. But I am glad to have coverage for the basic stuff at least.

I am so relieved today, the insurance battle has been won!!

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That is wonderful news. I know I was battling the same thing. My doctor had ony gave me a diagnosis listed as dysautonomia , not the particular such as pots or ncs, which he said I have both to me verbally but never listed them. I think there would be a fight about your two such things being the same, they do have two seperate names. I really don't think they could call both of them pots..........I know how insurance can be but also we have to be our own advocate. Congratulations on getting the insurance.

paige

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Katherine-

Wow! That's about what my company quoted me when I was on my parents coverage, to continue the insurance benefits...but I just couldn't afford it, so I waited until we got settled into our new house and then I started applying at different places, until finally I got approved (got denied twice first, though). I was really shocked because this company said that they would automatically deny me if I was denied by any other company. I stood my ground and told them that I felt that was not fair, and I would appreciate if they would at least look over the case before they made that decision, and they said okay but the chances were they'd stand their ground on the denial policy. But next thing I know, I get an approval letter in the mail! The premium went from $116 to $144 because of POTS (plus the 24 month pre-existing clause) but for a BC/BS PPO plan I consider that to be quite reasonable.

It's worth a try, all the companies have different policies. I would say that the trick is to apply for several at one time, that way when they ask if you've been denied in the last year (or whatever the time frame) you can say no- if you haven't. I still have one pending application with another company, so if they offer me a better rate I might have to choose. But chances are they will deny too...not a problem now! I'd say go for it!!

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jess,

whew!

what a huge relief!

i still think it is unjust that you can't get covered for pre-exisiting conditions, but that is a whole different story...

mostly, i am relieved to hear that you have some insurance now! it is a little nerve-wracking without! and i know that you aren't a fly-by-the-seat-of-your-pants kind of person! :D

thanks for sharing the good news, as many of us have followed yoru struggle with insurance companies and doctors offices from the beginning!

i think the $144 will be well-spent and give you some peace of mind!

take care alligator!

emily

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Jess, first, congratulations! That's great news!!! :)

Second, the price is absolutely amazing to me. Astonishing, really. When I was paying my own health insurance in the mid/late 80s, I paid a heckuva lot more than that a month. I had a high deductible too; I referred to it as my "hit by a truck" insurance, knowing that I'd be paying out of pocket for pretty much all the care I'd (hopefully) need for the year unless I got hit by a, you know, truck.

Do you have a high deductible? At any rate, that's great you have insurance now. And to be honest, I hope you won't need it much this year! (I know you have some appts scheduled, but I'm hoping you'll have a stable, quiet year. :D )

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My deductible is $500 per calendar year...and $200 on prescriptions.

My plan at this point is to basically try to avoid seeing the doctor as much as possible until next January, when it will apply to next year's deductible!! Unfortunately it just so happens that I had already scheduled appointments with these two new specialists before I even got approved, so I will have to pay a bunch for those...but I've been saving up!! I want to at least get established with some physicians down here in FL "just in case". I also hope that it will be a quiet year!!

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Jessica,

Congrats on getting your insurance! I have looked into this beacuse I need to switch insurance at the end of the year. Whether or not your condition is covered depends on your state's insurance law, as well as the specific terms of your insurance policy. Unfortunately, in some states, a pre-existing condition would also include any condition for which a prudent person would seek treatment, whether or not you are actually getting treatment at the time that you get the policy. I am not sure if you feel comfortable calling the insurance co., but this would be the best way of finding out whether the other conditions would be excluded. (You might be able to do this without specifying your name.) Your state's insurance law should be available online, and your state insurance office might be helpful too.

-Rita

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Jessica try Ward White and Associates in Tarpon Springs, Fl. I had no insurance and no help until I went to them. I am now permanent Disability and SSI, so insurance will never be a problem. I've been unable to work since 1999, and this was alot of pressure of me and the kids. Now my kids are getting the same thing, so we can go anywhere in the country for medical attention. You may want to consider this, plus you can still work and go to school. :)

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Jess, I'm so glad you got coverage--and 144$ is quite a nice price. When I had to pay out of pocket, it was more than 400$ a month...same as your deductibles too.

Nina

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