This is topic Health Insurance in forum General Support at LymeNet Flash.

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Posted by littlebit27 (Member # 24477) on :
I think we are going to lose the current health insurance plan we have now-it's medicaid.

I need to look into paying for a health insurance policy-if I can afford it. But I am wondering how this is going to work.

I've been going to the doctor for symptoms but don't have a DX that is accepted, only Lyme. Of course since Lyme doesn't exist in this form or in GA how do I go about answering the questions on the health insurance application?

I know they can look back and see that I've been to the doctor for symptoms and have been treated for pain. So then will they drop me or deny my coverage for symptoms related to this crap?

I don't know how to answer without lying, but if I lie then they have more of a reason to drop me. It's technically not a condition that is recognized so....

Help, what would you do?
Posted by LightAtTheEnd (Member # 24065) on :
You know you have Lyme, but has your doctor officially diagnosed you with Lyme?

Don't lie on the form. They can see your former and future medical records and find out, and dump you altogether. But if you have not been diagnosed, then you can tell the symptoms for which you have been to the doctor rather than Lyme itself.

Many insurance companies will turn you down if you have any pre-existing condition, or will tell you that everything is covered except that, or maybe you have to wait a year before they will cover it. That is supposed to change in a few years, but I think they can still get away with it right now.

And the further problem some people here have reported (hasn't happened to me yet, so far so good) is that their insurance that they already have decides to deny coverage for their ongoing treatments for Lyme after the first month or two, calling long term antibiotics "experimental" because they don't comply with IDSA guidelines, so successfully getting the insurance may help, or it may not.

Luckily Lyme is not considered by insurance companies to be a common disease, so I have never seen a direct question on an insurance form that says "Have you been diagnosed with or treated for Lyme disease?" They usually list heart disease, diabetes, cancer, etc.
Posted by littlebit27 (Member # 24477) on :
Right-I've been DXed but by a doctor whom I pay out of pocket. He's not going to be covered.

I know if I say that then any med I'm on now won't be covered and some of my meds are expensive. The craziest thing about it is medicaid has covered every med for the lyme. The months worth of abx I've been on and everything.

So maybe I'll just list the pain symptoms because those are the meds I'm on other then abx.

This is really horrible timing-seriously.

Oh and yeah they can still get away with denying treatment and yada yada-I don't think some of the health care plan goes into effect until like 2011 or 2014 or something.
Posted by greengirl (Member # 25316) on :
Why are you losing medicaid?
Posted by Aniek (Member # 5374) on :
First, do not withold information. If you do, the insurance plan can rescind your coverage. Even under the new reform law, a plan can rescind coverage if there is an intentional misrepresentation of material fact.

Second, on July 1, there will be a new website with health insurance options, It is a new web portal and will have info on individual insurance plans in each state so you can compare. There are also new preexisting condition insurance plans starting, but you need to be uninsured for 6 months and have been turned down for insurance.

The bad news is that is usually doesn't matter of you have a diagnosis or not. For individual market insurance, all they care about is when the condition began. I know of people who had cancer treatment denied because insurance said it took 3 years for a tumor to become detectable so the tumor must have existed when the person enrolled.

I would recommend contacting somebody with the Medicaid program and see if they can offer any advice or if there are any other programs or guaranteed issue plans in your state.
Posted by littlebit27 (Member # 24477) on :
GA is horrible with help for people. The amount you have to make to qualify is not enough for a dog to live off in most counties.

We are most likely going to lose coverage for atleast my husband and I because the income went up $300 which (I'm pretty sure) is going to put us over the limit.

Well-I mean do I put Lyme Disease. Because they don't believe in it. I was going to list my meds-because I will have to get them. I mean whether they pay for it or not I need them. I would just like the office visit to be covered.

I will check out that page. I can't stay uninsured for 6 months. I would end up paying the whole deductible amount in that time. So I might as well be paying towards a deductible.

Aren't they going to deny me anyway if I put Lyme? Or are they going to say oh ok-treatable in a month-she's good.

I just read on humana-ones website that they usually automatically deny someone with fibro-and many other diseases. Insurance is biggest load of crap known to man.

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