Re: Medical Insurance / A Horror Story

[Guest guest]

I don't mean to upset anyone, but while they cannot remove your policy all together, they can do what happened to me about 3 years ago: they can begin to deny your claims. Which is basically just denying you coverage without canceling your policy. Unfortunately, with Celiac, it's hard to disprove 'pre-existing' even on something you've never had.

Case in point: I 'lost' my insurance in 2003 when I went in for an exploratory laparoscopy due to abdominal pains after a miscarriage. I had suffered a severe infection (I had no idea I was pregnant until it miscarried, some time after the fetus had actually died) and it had caused my intestines to develop adhesions and basically sick together and to everything else they could grab. My doctor went in because he thought it was Endometriosis. Never had endo in my life. Never had adhesions in my life. There was a very clear timeline on all of this and likely cause and effect scenario (can't prove 100%, since it was all done after the fact). My claim was denied for pre-existing.

I attempted to fight this. I got all of my medical records. The problem with undiagnosed celiacs and all of their medical records is that no matter what's wrong, you probably had an opportunity to tell the doctor about it at one point. So, suddenly, my 'IBS-like symptoms' that turned in to Celiac became the initial visit for 'abdominal pain,' though it had been years in the past.

Sad, but true. Now, I wasn't cancelled outright, but suddenly, my insurance claims weren't being paid and it became too expensive for me to keep the self-pay insurance and continue to pay 100% for everything.

I don't think that all insurance companies do this, my mother has very good self-pay that she got before she started developing symptoms of Celiac and they never deny her anything. But, do be aware that these things happen. My insurance was a higher (not highest) risk type because I had diagnosis of Insulin Resistance and Asthma and no one else would touch me.

I am now completely uninsurable due to all of these multiple diagnosis that were probably related directly to Celiac (there were more... many, many more... I was probably the only 20 year old around that was on blood pressure medication... at one point, if I had had to pay for them myself, all the medications I was prescribed totaled almost $1200/month).

I've applied for insurance recently and have been told that these things don't just 'go away.' I explained to the nice man that they were not diseases in and of themselves, but symptoms of something else and was basically called a liar.

I've been told I can't get coverage (Missouri does not allow riders, apparently) because I was treated for depression over 5 years ago. I've been told I can't get coverage because of the last Asthma inhaler I was on (they claimed it was too expensive), I was told I can't get coverage because I'm NOT using the last Asthma inhaler I was on. I've been told I can't get coverage because of multiple 'hospitalizations' which were actually overnight ER visits after my miscarriage (I started bleeding and couldn't stop for over 60 days during a period when I was between doctors... OBGYNs are hard to start fresh with 'round these parts).

The short and skinny of it is this: No insurance provider in the state of Missouri will cover me as a self-pay. I can't even get one of those health savings accounts because you have to have a high deductible insurance policy to go with it. The Missouri Pool is my only option, and it's not much of one since the highest deductible still carries a $500/mo payment that is half of my current income (been GF a month and things are finally starting to pick up, but it's hard to recover if you've been basically dead for a while... )

If only we had socialized medicine in this country, we wouldn't have to worry if the insurance would pay or not, or even if we could get the insurance to begin with.

Keep trying, keep fighting... but always know what your opponent looks like.

Love and Light,

Kristi in MO