Is there a way to get around pre-exsisting conditions with ins. gap???

[The Mystery Machine]

I should clarify what I meant, they appear to be trying to get insurance and find a way "to get around" the previous diagnosis.

Oh. I don't know anymore. Even our group policy insurance is getting hairy.

Scary stuff. My 18yo has a repaired heart defect. I dread the day she is out of school and has to find a job to cover her.

 

[mum4jenn]

OP here...WOW Y'all make me sound like some Wall Street Crook!!! LOL!!!

I WAS covered under my Dh's group policy. The place he worked closed down because they sent most of the work to China.

The end of his coverage was the beginning in November. We had HOPED to be able to get COBRA but we just did not have that extra money because we were behind on some things because his actual work ended in June.

He found a new job in November that also has a group coverage policy BUT the coverage did not begin until last week.

We received a letter referring to pre-exsisting conditions. I looked at the letter today and it says that in November the pre-exsisting conditions will be included.

I have high blood pressure,migraines,acid reflux. I can make it until November with OTC migraine medication and for the reflux but there is nothing OTC for blood pressure.

I have been skipping pills in hopes that the supply I had before the other insurance ended would last me until the new insurance began.

My simple question (that I was trying to ask) was that if I went to a different doctor and was diagnosed with high blood pressure would that be covered or would they know by SS# that I already had this condition.

I suppose my question has been answered so now I will look at other ways to get discounted medicine or free samples from my Dr.

 

[Barbossa]

I have been skipping pills in hopes that the supply I had before the other insurance ended would last me until the new insurance began.

I would advise against skipping blood pressure meds. It can cause dangerous BP surges.

 

[Nancy]

OP here...WOW Y'all make me sound like some Wall Street Crook!!! LOL!!!

I WAS covered under my Dh's group policy. The place he worked closed down because they sent most of the work to China.

The end of his coverage was the beginning in November. We had HOPED to be able to get COBRA but we just did not have that extra money because we were behind on some things because his actual work ended in June.

He found a new job in November that also has a group coverage policy BUT the coverage did not begin until last week.

We received a letter referring to pre-exsisting conditions. I looked at the letter today and it says that in November the pre-exsisting conditions will be included.

I have high blood pressure,migraines,acid reflux. I can make it until November with OTC migraine medication and for the reflux but there is nothing OTC for blood pressure.

I have been skipping pills in hopes that the supply I had before the other insurance ended would last me until the new insurance began.

My simple question (that I was trying to ask) was that if I went to a different doctor and was diagnosed with high blood pressure would that be covered or would they know by SS# that I already had this condition.

I suppose my question has been answered so now I will look at other ways to get discounted medicine or free samples from my Dr.

Not every medical condition will trigger a pre existing investigation. I would check with the insurance carrier and see if high blood pressure is on their list and if the medication would be covered.

I also think asking the doctor if he can get you some samples is a good idea to hold you over.

 

[kidzmom3]

OP here...WOW Y'all make me sound like some Wall Street Crook!!! LOL!!!

I WAS covered under my Dh's group policy. The place he worked closed down because they sent most of the work to China.

The end of his coverage was the beginning in November. We had HOPED to be able to get COBRA but we just did not have that extra money because we were behind on some things because his actual work ended in June.

He found a new job in November that also has a group coverage policy BUT the coverage did not begin until last week.

We received a letter referring to pre-exsisting conditions. I looked at the letter today and it says that in November the pre-exsisting conditions will be included.

I have high blood pressure,migraines,acid reflux. I can make it until November with OTC migraine medication and for the reflux but there is nothing OTC for blood pressure.

I have been skipping pills in hopes that the supply I had before the other insurance ended would last me until the new insurance began.

My simple question (that I was trying to ask) was that if I went to a different doctor and was diagnosed with high blood pressure would that be covered or would they know by SS# that I already had this condition.

I suppose my question has been answered so now I will look at other ways to get discounted medicine or free samples from my Dr.

some pharmaceutical companies also give free or reduced medications. It would be worth looking at their website or giving them a call. especially since its not for too long of a time. Also, please tell your doctor your skipping pills. They will be concerned and will most likely try to help you in any way that they can. Even if it means a temporary switch to a cheaper medication.

 

[phorsenuf]

Have you looked into the cost of the HB meds without insurance? Also if you have walmart near you ask them if any of their $4.00 meds are comparable to what you are taking now. I was prescribed a med once and the cost even with insurance was a lot of money. They cross referenced the list for me and found one compatible. The only difference was I had to take 2 instead of 1 to equal the dose. They called the Dr and got approval for it.

Might be worth looking into. That's one med I wouldn't mess around with.

Here's the link to Walmarts med list. http://i.walmartimages.com/i/if/hmp/fusion/customer_list.pdf

 

[Mickey's Minion]

Have you looked into the cost of the HB meds without insurance? Also if you have walmart near you ask them if any of their $4.00 meds are comparable to what you are taking now. I was prescribed a med nice and the cost even with insurance was a lot of money. They cross referenced the list for me and found one compatible. The only difference was I had to take 2 instead of 1 to equal the dose. They called the Dr and got approval for it.

Might be worth looking into. That's one med I wouldn't mess around with.

Here's the link to Walmarts med list. http://i.walmartimages.com/i/if/hmp/fusion/customer_list.pdf

I use this. My insurance covers my bp meds, but I hate the mail-in pharmacy you are required to use for long term meds.

So, I just get my bp meds for $4.00 a month and completely bypass my insurance. It is actually cheaper than my co-pay would be for the exact same meds.

 

[Wish I lived in Fl]

CVS also has a program, 400 generics that are 9.99 for a 90 day supply.

Also, I thought Health Insurance companies were sharing information on their customers somewhat like a credit reporting agency. Anyone else hear this?

 

[The Mystery Machine]

I use this. My insurance covers my bp meds, but I hate the mail-in pharmacy you are required to use for long term meds.

So, I just get my bp meds for $4.00 a month and completely bypass my insurance. It is actually cheaper than my co-pay would be for the exact same meds.

Absolutely. OP, you may have to pay full price for your doctor visit however I am sure they can prescribed you something that is in the "4.00 med range" at either WalMart, CVS, etc..

Plus, high blood pressure may not even be one of those things that are "pre-exisiting".

 

[WDWorBUST]

OP here...WOW Y'all make me sound like some Wall Street Crook!!! LOL!!!

I WAS covered under my Dh's group policy. The place he worked closed down because they sent most of the work to China.

The end of his coverage was the beginning in November. We had HOPED to be able to get COBRA but we just did not have that extra money because we were behind on some things because his actual work ended in June.

He found a new job in November that also has a group coverage policy BUT the coverage did not begin until last week.

We received a letter referring to pre-exsisting conditions. I looked at the letter today and it says that in November the pre-exsisting conditions will be included.

I have high blood pressure,migraines,acid reflux. I can make it until November with OTC migraine medication and for the reflux but there is nothing OTC for blood pressure.

I have been skipping pills in hopes that the supply I had before the other insurance ended would last me until the new insurance began.

My simple question (that I was trying to ask) was that if I went to a different doctor and was diagnosed with high blood pressure would that be covered or would they know by SS# that I already had this condition.

I suppose my question has been answered so now I will look at other ways to get discounted medicine or free samples from my Dr.

Call your current insurance carrier ASAP and see if they will give you credit towards the time period you have the pre-ex. Some carriers will instead of not covering for the full 12 months of the pre-ex will give you "credit" for the time in the previous year that you did have coverage lessening the amount of time they won't cover services related to the pre-existing condition. So you could end up with only 3 or 6 months that they won't cover your pre-existing condition. As far as going to another doctor they will do a look back usually of 6 months (I'm sure some carriers may look longer...but 6 is pretty standard) and will see that you have been treated previously and deny claims relating to those conditions. Definitely look into cheaper meds but call and see if they will give you some credit so you don't end up not having it covered for the full year.

 

[golfgal]

CVS also has a program, 400 generics that are 9.99 for a 90 day supply.

Also, I thought Health Insurance companies were sharing information on their customers somewhat like a credit reporting agency. Anyone else hear this?

They have always done that.

 

[TaraPA]

I worked in claims for a major health insurance comany for 13 years. At one time I was the investigator for PECE (pre-existing condition exclusions.) There are entire teams devoted solely to this (to reduce insurance fraud), and yes we did share info between other health insurance companies, health systems, doctors offices, etc. Now there have been some new HIPAA laws since I have been out of this line of work that may make it more difficult to get info, but previously we could find out anything on past medical history, even if not disclosed. It's not that difficult at all, espeically in health networks that have patients linked by computer. If you've ever been treated in-network, anything else in that same network is on file. My job was especially to dig & find out medical history that had been treated previsouly, yet not disclosed when applying for insurance. So even way back when, this was treated very seriously, and information was readily available.

I agree that the doctors can try & get you some samples to hold you over. I know I take Treximet for migraines which is astronomical even with insurance, and they have a free trial going right now - 9 pills for free at the doctor's office, then a $50 off coupon on your next rx. I think that expires the end of March but it's worth looking into if that's what you use.