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Denied For Health Insurance

Kattyatty

By Kattyatty
in Doctors

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Kattyatty Newbie
Kattyatty
Posted

Just an FYI that I am currently shopping for health insurance. I was sortof diagnosed with celiac's 18 months ago, my testing was all negative, but gluten-free diet has changed my life. I reported to the health insurance company that I had been tested (had to divulge the upper GI) and that I had celiacs, even though the medical tests were negative. Big mistake. I was denied coverage. Denied. I am now appealing the denial.

I just want people to know that this can happen

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Fiddle-Faddle Community Regular
Fiddle-Faddle
Posted

Thank you for posting this. This is one of the reasons I have turned down further testing for myself. We all know that the health insurance industry's primary concern is $$, not health.

If you have not reported anything in writing, but only over the phone, your best bet might be to ask to speak to a supervisor and say that you were given erroneous information by the doctor's office, which you then passed on to whomever you spoke to at the insurance company, and that [i]you do not in fact have celiac, and that your medical records will support this.

Even if you did fill out and sign a form in writing, write another, and tell them that you just found out that you had been given wrong information by the doctor's office, that they told you you had celiac so that you would stop eating wheat, which gives you problems, but that your bloodwork (attach a copy) was negative, so, by current medical standards, you don't in fact have it.

Good luck, and please keep us posted!

mef Newbie
mef
Posted

Thanks for the heads up.

Were you previously on health insurance?

Also, typically I've heard that conditions that are developed w/in the year that are not covered. I could be wrong. I've been fighting with my insurance company too....

  • 1 month later...
Jaimepsalm63 Rookie
Jaimepsalm63
Posted

FYI to all, if you have Celiac and are trying to get LIFE insurance...you'll be denied and told you only have 10 years left after the date of diagnosis. I know that's bogus, but that's what I was told. Maybe they'll tell you that you have more time...good grief!

luvthelake21 Rookie
luvthelake21
Posted

I have worried about this all the time with my 12dd. Husband has it but never had him tested, did not want it on his medical records. If you cannot get insurance should you not be eligble for disability?

WW340 Rookie
WW340
Posted

How were you "sort of diagnosed"? Did your doctor diagnose you as celiac and put it in your medical record?

Vamonos Rookie
Vamonos
Posted
Just an FYI that I am currently shopping for health insurance. I was sortof diagnosed with celiac's 18 months ago, my testing was all negative, but gluten-free diet has changed my life. I reported to the health insurance company that I had been tested (had to divulge the upper GI) and that I had celiacs, even though the medical tests were negative. Big mistake. I was denied coverage. Denied. I am now appealing the denial.

I just want people to know that this can happen

If I understand you correctly, you were shopping for health insurance and provided a diagnosis that you gave yourself and were subsequently denied coverage? Can I ask what company you were trying to purchase a health insurance policy from? Is there any reason why you cannot obtain health insurance through an employer? Aside from stating the obvious, choosing a job which will provide you with health coverage "no questions asked" is a good reason to do a job you might otherwise not be interested in. Not that there are alot of costs associated with Celiac disease from a testing or hospitalization stand point.

I am concerned that you basically "self-sabotaged' your application for insurance. Thankfully, there are many companies who offer health insurance and you will find one that will cover you.

I think the lesson here is to only offer what information is actually asked for or that they could discover themselves by calling your md.

I encourage you to call your doctor's office and ask point blank if celiac disease is on your chart. Remember also, if you have other co-morbidities, that will also impact their decision about whether to offer you coverage at a reasonable rate. Good for you for taking the next step and filing an appeal. I will keep my fingers crossed for you.

To illustrate my point,I have a friend who was asked on an application if she had any specific health issues (including cancer) with in the last 5 years. Since her leukemia had been treated successfully more than 10 years prior to her application, she truthfully answered NO. she got the coverage. Only answer what they ask you, ok?

In case you are wondering, I am an RN who has worked in the insurance industry.

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  • 2 weeks later...
Crystal Brown Rookie
Crystal Brown
Posted
I have worried about this all the time with my 12dd. Husband has it but never had him tested, did not want it on his medical records. If you cannot get insurance should you not be eligble for disability?

According to a conversation that I had with the SDI folks, they stated that Celiac in itself is not considered disabling. They require for you to submit all medical records and then they take an overall look at your situation. So, if you have enough qualifying events THEN you become eligible.. Once you receive SDI, then you have to submit doctor notes every so often to update them of your situation.

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