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Health Insurance & Chiari

Hello Everyone! I am so sick of health insurance companies its ridiculous!! My only idea of what to do next is go to their office and stomp up and down and scream at them to kiss my A**! I am at wits end... so I was hoping if i posted my insurance dilemma here.. maybe someone else has some insurance knowledge that they could share with me and a more appropriate plan of action than my stomping and screaming approach :) lol

Heres my issue.... when i got out of college i got health insurance through one of our local hospitals because it was cheaper than going with Wellmark BlueCross (a nationally recognized company). And being young and naive... i didnt think anythign bad would happen to me and i wanted the cheapest insurance i could get.  I got that insurance in Jan 2010. In March 2010 i was dx'd with lovely chiari.  I wanted to see a specialist but since i have ins thru a local hospital... i coudlnt go. I can go to the local hospital or the local hospital! and the NS and NL i have seen there are LESS than impressive! The NS has done about 4 surgeries a year and said i have a 10mm herniation and i can do whatever i want and not to worry about it. yea okay!
soo.. in June i was very upset about my insurance so i applied to BlueCross for the heck of it... but i didnt go thru an agent... i just printed an application off the net and filled it in myself. I got a letter and a membership card showig they accepted me. I planned on letting my local insurance and Blue cross overlap for a month cuz i was worried that bluecross woudl deny my chiari claims... as i wasnt sure if it was considered a pre existing condition. This was back in july. i am still having over lapping insurance cuz im still not sure if its safe to drop my local ins.  My mom saw my application and on it... i listed i have a congenital condition-chiari . One question asked "are you currently receiving treatments"  i put no... as i took 'treatments' to mean things like therapy or shots or something liek that. I am not doign anything besides waiting and being pissy @ the doctors! lol  my mom said she thought the question was asking if i had been seeing a doctor for it.. and i had been recently. soooo she thinks it may come off to bluecross that i lied to them and in the future if i have more claims to do with chiari, they may drop me and not cover me... theni woudl be sitting with NO insurance and we all know that that woudl b a bad thing for a chiarian.  this post got long.. and mite not make much sense.... but im hoping somone reads it and has some advice or more insuranc eknowledge than me! I obviously dont know inurance well if i got myself into this MESS!  
i know the safe thing to do is drop BlueCross and stick with my local ins.. but iw oudl really like to see Dr. Heffez or Dr. Menezes for an opinion!! Thanks guys for reading, as always!!!
3 Responses
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620923 tn?1452915648
COMMUNITY LEADER
HI...call the new Blue Cross insurance and pose the questions u have, if nething u drop it...and u still have the other one, but to continue to pay both premiums will get costly.

While on the phone ask about a pre existing condition and how they categorize it  so u know where u stand and when u could potentially begin to use it......

The safe thing is call Blue Cross and ask questions b4 u do nething else.

"selma"
Helpful - 0
1435895 tn?1304291241
Was the question asked "have you seen a physician, received treatment, or has treatment been recommended for this condition"?  This is normally the way questions are asked.  If you have a question about how they will treat claims for Chiari call them and ask them. (BCBS) that is.  Make note of who you spoke with and the date and time.  I dont believe you have to worry about preexisting unless you have been without coverage for more than 63 days because of HIPPA portability and assuming the coverage you have thru the hospital is "credible coverage"  I think the biggest concern here is will BCBS rescind (take back) your policy if they receive Chiari claims and I would clarify that with them.  If you dont have credible coverage and BCBS will not cover Chiari treatment,  then I would direct you to the Insurance High Risk Pool in your state.  Call the department of insurance and inquire.  There is now a federal option that has no preexisting exclusions, I am not sure how it is set up state to state and if the requirements are the same.  

I hope all this helps.  I am an insurance broker so this is one area I can help in.  
Helpful - 0
Avatar universal
The best thing to do is to call BCBS and ask them if you have a Preexisting waiting period. They will be able to tell you if you do, and what the preexisting coverage claus says.
Helpful - 0
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