Will Insur Cover

     My previous coverage was 18 months of Cobra, and before my 63-day grace period expired, I bought an individual health care policy on Oct. 1.  Because I was HIPAA eligible, I did not have to answer any medical questions and I had no waiting limit for pre-existing conditions. However, during my original phone conversation with the agent,when he asked me what I was currently being treated for, I told him that I was being treated for depression.  At this time, I had some minor symptoms of shortness of breath and  a strange anomally with my hearing that I wasn't too concerned with.  However, in a short period of time, my symptoms piled on and escalated into various mysterious and frightening symptoms of illness.  I am worried that my symptoms may be complications of blood infection from gum disease.  My new plan does not have dental coverage, so any complications from dental problems will not be covered, so I worry the insurance company may use this as an excuse to deny claims regarding my current symptoms.  Also, my policy has a clause that says "You policy may be invalid  if you have misrepresented yourself."  So I also worry that they will be suspicious of how I got so sick so quick and try to deny my claims that way.  Now, I find myself in a quandry...I am terrified by my symptoms and I'm equally afraid my new insurance will not pay.
     However, this policy has such crappy benefits, I'm pretty much stuck paying  the first $2,500 of medical expenses myself anyway, before they kick in and start sharing expenses. I bought a low premium, high deductible plan because it was the only premium I could afford, and that is $400 a month,   And on top of that, I have a $2,500 out-of-pocket expense limit.  So if I end up in the hospital, I am probably going to be looking at an accumulation of bills of $5,000.  I would appreciate any comments.

[Amir Mostafaie]

Dear tabingins911,

If you have had continuous coverage for over 18 months & have not sought any advice or treatment for symptoms, similar to what you have now, why are you concerned about your new insurance carrier getting "suspicious of how you got so sick so quick"? Whether your plan covers dental or not, your primary care physician would be the best judge of what needs to be done next.

Sometimes one can be equally disturbed by possibilities of conditions causing the symptoms as the actual symptoms.

Sincerely,

Amir Mostafaie

[tabingins911]

Thank you so much for your answer.  To answer your question, I have chronic depression that always causes me to see the "worst case scenario."  My therapist once told me I had a "**** filter," meaning I only see the negative side of a situation.

Regarding your last comment about being "disturbed by possibilities of conditions causing symptoms," my sister told me just about the same thing.  She said I was just freaking out because I am on disability with very limited income.

[Amir Mostafaie]

Dear tabingins911,

You are very welcome. Feel free to share what your primary care physician finds after you see him/her.

Sincerely,

Amir Mostafaie

[tabingins911]

Saw general practitioner yesterday for basic physical.

Had a nice long talk with him about my symptoms and my life situation, and he said, "You have a lot of worries," (major depression-anxiety, getting laid off from an 18-yr job, taking a really crappy job, disability, lost income, lost job benefits, worries about retirement, etc.)  

Didn't get any tests yet because my crappy insurance will not pay for them.  Nurse said temperature, blood pressure, and pulse were good.  Doctor said heart and lungs sounded good.  This was good news as my most recent nagging symptoms had become the feeling of a pounding heart all day and night, and tightness/ tension in chest at night that had started to keep me awake all night.

I started on "the Patch" today to quit smoking, as nicotine can increase heart rate and blood pressure.  My pack-a-day smoking habit has recently morphed into a  2-pack-a-day habit with some chain smoking thrown in.  I have wanted to quit smoking for about a month now, because I know these nasty cigarettes are killing me.

The doctor also said I need to get a mammogram because I have a small lump in right underarm.  Also need to see dentist because I have something going on in front side of front bottom gum.  It's in the middle of 2 teeth, near the base of them.  I have periodontal disease and these particular teeth are a tiny bit loose.  The strange thing is that there's no pain with this.  This is scary news.

[Amir Mostafaie]

Dear tabingins911,

I am glad you were able to consult your primary care physician & discuss some of your concerns.
I am especially excited about your decision to quit smoking. Take advantage of the “Smoking Addiction” Forum of MedHelp. Support groups are a great way to help you with this initiative.
Just think about all the money you will save. If you were smoking 2 packs of cigarettes per day, that is over $200 a month. You can then take some of that savings & contribute it to your health insurance premium & upgrade your current plan.

Keep us posted.

Sincerely,

Amir Mostafaie