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candieboo02

Denied Insurance Coverage because of Epilepsy?

First of all let me say HI to everyone at the forums! :-) I am new here, after spending hours of searching through google.

I wanted to share my story with you to see if anyone has experienced similar insurance problems and maybe someone can shine some light and help me.

I am 22 years old. I was on insurance with bluecross on my dad's policy, but got pregnant and since I was a full time student I had to switch to medicaid since my fiance had lost his job at the time. He started working again and I applied for BlueCross insurance in May of this year. I was on medicaid for 1 year prior to that, and on bluecross before that. Bluecross only wrote in their explanation that they had denied my insurance application because of my epilepsy since it has not been 5 years (i only had 2 occurences of seizures august 2002).

Now I am without insurance and need some help. I tried calling many insurance companies but they all are 2,500 or 5K deductible, with 60-40 or 80-$2,500 out of pocket and small prescription pays etc. which are still around $200/month. If I could get on some insurance policy and pay $200 I would do that, but the problem is are they going to deny my application as well? Am I going to have 12 month pre-exisiting condition apply and have to pay around $500/month for medications for 1 year? I live with my fiance and he works and that's why I don't have medicaid any longer. My fiance has insurance but since we are not married I can't get on his insurance. My fiance works so I can't be on medicaid right?

My real questions that trouble me are: Why did BlueCross deny my application? Should I try to keep calling them and hope to speak to someone who doesn't read their script in front of them and acually listens? Did they have the right to terminate my application even though I was never without insurance, and my seizure happened while I was on BlueCross? If that is all YES then is there any other insurance that I can get on?

Thank you all in advance!

Comments

Re: Denied Insurance Coverage because of Epilepsy?

If an insurance company has denied your claims do not relent and watch your benefits vanish, resort immediately to legal advocacy because you have a strong good chance to recover your denied insurance claim. You should know that insurance companies enrich themselves if they did not pay claims. Based on the strategy of McKinsey a consulting firm, the insurance companies has formulated and applied an aggressive deny... delay... and defend approach to keep away from paying claims popular known as "three Ds".

Dan Jones

Re: Denied Insurance Coverage because of Epilepsy?

IT IS ILLEGAL to be denied insurance coverage due to a pre-existing condition! Plain & simple, the insurance company is breaking the law. Contact a lawyer; free legal advice is available from most with just a phone call. I'm sure you can find one in your area who would like to have the opportunity to take this on. Best of Luck to You.

Re: Denied Insurance Coverage because of Epilepsy?

Nobody covers pre-existing conditions.   Even this stupid Obamacare is not going to work.  High premiums.   It is all a racket and I don't feel like I want to live here anymore in the United States.     Sorry about this for you.

Re: Denied Insurance Coverage because of Epilepsy?

I had not heard of this. There is information out there on the Pre-Existing-Conditions-And-The-Affordable-Care-Act 

 

 

 

Re: Denied Insurance Coverage because of Epilepsy?

FYI...An insurer can deny a policy for pre-existing reasons. I see it all of the time.

However, for 1-1-14 effective dates, if you apply through Open Enrollment, you can not be denied and pre-existing conditions will be covered. You may also qualify for a federal tax subsidy.

www.majormedicalhealth.com will give you a free quote as will the .gov website, although there are many glitched and delays with the .gov website.

Re: Denied Insurance Coverage because of Epilepsy?

Hi,

I would keep contacting them and keep on their case. They didnt have the right. I am currently on bluecross and I am pregnant now I am scared to switch to medicaid. I am currently in school but I know I will take the next semester off. Also, bluecross informed me that if you have documentation of having seizures that your father can cover you for the rest of your life. that is what they told me. I know i Wasnt of any help but I do feel for you.

Good luck.

Heather

Re: Re: Denied Insurance Coverage because of Epilepsy?

i am wondering if anyone has anything insightful to add on the topic of insurance. how are the majority of adults getting coverage? i do read certain interesting suggestions here and there but they don't seem to apply to the masses. bluecross simply denies pre-existing conditions. it is interesting to know that your father can carry you if you can document epilepsy. i never knew that. however, that doesn't solve the problem for those of us without a working father with insurance.

it's great for young folks in school, they are covered. but even they will get older and the problem is not solved. those of you with dads will one day have to face the noise alone. we need solutions. does anyone have one? some states, very few, but some have an option. but what about the rest?

Re: Re: Denied Insurance Coverage because of Epilepsy?

Are you just covered by Blue Cross because you are in school or are you covered just because you have seizures?

Re: Denied Insurance Coverage because of Epilepsy?

I can tell you that I was added to a pre-existing policy with Aetna Ins about 4 months ago after being without health ins for about 7 years. I was able to get the policy with the sz's, however, no sz's or injuries resulting from them will be covered for 18 months. Basically, I can get the coverage, but nothing resulting from sz's will be covered for a year and a half. I guess it's not TOO bad, but most of the reason we would want health ins. is because of the E, so it does somewhat defeat the purpose of getting it at all.
I am actually in the process of beginning to write and petition the legislature to change these laws, and make the insurance companies take better care of people with E, and I would love more feedback in this forum, because I know laws differ somewhat from state to state, and my info is coming from Florida.
I hope this helps a bit,
Susan

Re: Denied Insurance Coverage because of Epilepsy?

when I was first diagnosed with epilepsy I was covered under my step dads insurance. When I turned 22 blue cross blue shield dropped me like a bad habit even though I was still a full time student. Without insurence I cut back on neurologist visits and got my meds through Canada. The meds were almost one third the price through Canada. I was only having seizures once a year, which isn't too bad. Now that I am out of school I got a job that gives me health insurance. The only problem is that they don't cover preexisting conditions, except for the meds.
I have tried finding coverage for a long time and the only solution I could find is to get a job with health insurence that covers preexisting conditions.

Re: Re: Denied Insurance Coverage because of Epilepsy?

Luna

Hi I find all this very interesting, I worked with a company and was covered under their insurance, then laid off... I didnot take the COBRA... I was uninsured for 4 years, then when I went back to work I was covered under my employer's insurance without any restrictions at all. It should not matter if you are applying for coverage under a group plan (with an employer) or under an individual plan. You should contact your State Insurance Commission and seek assistant, also contact your local state representative to assistant you if have any problems. Further, you should not have to pay a higher premium for your coverage or have limitations on when the coverage begins. Limitations on coverage usually only apply to late entrants on group plans. Since you had coverage before, you should probably just show proof, and for all those who don't have coverage, what I did during those 4 years of unemployment, and when I chose not to use COBRA, I contacted my drug company and used their Patient Assistant Program and received my meds for free, and my neuro provided his care for free as well. Look into it. Any good Neuro will provide his services for you or will give you a referral to get your regular medical visits.

good luck

Re: Denied Insurance Coverage because of Epilepsy?

Hello, and this is a shame, we have HORRIBLE health coverage here.
Simply put, if I am not covered by someone else's policy (I'm on my boyfirend's but they won't cover pre-existing for 18 months) I had to pay for it. The last time I had insurance was in the early 1990's and it was $480.00 a month.
This is why I didn't have ins or meds for 8 years.
Susan

Re: Denied Insurance Coverage because of Epilepsy?

Hi, I don't know about the insurance, but you can obtain your medication through various Patient Assistance Programs. A lot of pharmaceutical companies give medication for free.  This site has more information on this site about "Patient Assistance Programs." It should help you remain on your AEDs. Stopping them at once can cause nonstop seizures called Status Epilepticus, which can be deadly.