Do Insurance co consider something a pre-existing cond, if there is no diagnosis!
Question: Do Insurance co consider something a pre-existing cond, if there is no diagnosis, just symptoms!?
I have been suffering for almost 2 yrs with what feels like a severe UTI, but all urine cultures come back negative!. I may have Interstitial cystitis, but have not been diagnosed!. There is no cure for this only trial and error trying mulitple treatment methods, some of which are pretty invasive!. I got laid off from my job right before my symptoms got really bad, and I just got re hired at the same job!. My insurance is going to start again on Sept 1st and I need to see a urologist ASAP!. Im just so afraid that they are going to consider this pre-existing and not pay for anything!. This could be a lifelong condition and can be very dibilitating without treatment!. the pain is so bad I can hardly go to work now, i can't wait to see the DR!. Whar exactly is considered a pre-existing condition!. Since there is no diagnosis yet, and will the fact that I have had this insurance in the past with no claims help me!?Www@Answer-Health@Com
Answers:
I hope I can explain this properly!.!.!.
When a doctor's office sends a "bill" to an insurance company, they bill for the service and any labs, X-rays, etc!. Also on the bill, the doctor's office lists the things you have been diagnoses with (in order to support the services rendered)!. If you have not been diagnosed with the condition, the insurance company doesn't know about it!. They might know about some of the symptoms (as an example: abdominal pain or painful urination) but they don't have any record of Interstitial cystitis or UTI b/c the results have come back negative and you have not been diagnosed with it therefore the doctor's office would not have reported it!.
The fact that you have had this insurance with no claims could help and hurt you!. It will help in that they have absolutely no record of anything!. It will hurt you for the same reason!. Because they have no record of any claims the ins co will probably question whether you have had the diagnosis in the past by requesting medical records!. This shouldn't matter, though b/c since you have not been diagnosed yet they will not find anything by reviewing your chart (only the symptoms not the diagnosis)!.
Oh, and to answer what IS a pre-existing condition!?!.!.!.a pre-existing condition is a condition that you have been diagnosed with AND have been receiving treatment for (prior to the coverage start date on your insurance)!.
hope this helps!.!.!.Www@Answer-Health@Com
When a doctor's office sends a "bill" to an insurance company, they bill for the service and any labs, X-rays, etc!. Also on the bill, the doctor's office lists the things you have been diagnoses with (in order to support the services rendered)!. If you have not been diagnosed with the condition, the insurance company doesn't know about it!. They might know about some of the symptoms (as an example: abdominal pain or painful urination) but they don't have any record of Interstitial cystitis or UTI b/c the results have come back negative and you have not been diagnosed with it therefore the doctor's office would not have reported it!.
The fact that you have had this insurance with no claims could help and hurt you!. It will help in that they have absolutely no record of anything!. It will hurt you for the same reason!. Because they have no record of any claims the ins co will probably question whether you have had the diagnosis in the past by requesting medical records!. This shouldn't matter, though b/c since you have not been diagnosed yet they will not find anything by reviewing your chart (only the symptoms not the diagnosis)!.
Oh, and to answer what IS a pre-existing condition!?!.!.!.a pre-existing condition is a condition that you have been diagnosed with AND have been receiving treatment for (prior to the coverage start date on your insurance)!.
hope this helps!.!.!.Www@Answer-Health@Com
Depends on the insurance!. I would however imagine if it's all documented that it would be covered!. Give them a call!.Www@Answer-Health@Com
Having worked for an insurance company for over 13 years, I can tell you that Rachel is absolutely correct with her answer!. A pre-existing condition is something that you have been dx'ed with in the past that ultimately might cost the insurance money!. The reason behind such a clause is so that folks don't run out and get insurance once they have a costly illness!.
The only thing I would add, is that sometimes large group insurance policies do not have a pre-existing clause and you are eligible for any condition as a basis of employment once eligible to receive benefits!. Check with the insurance carrier what (if any) pre-existing clause your policy contains!. Also, I have included the link to the Dept of Health and Human Services which will give you more info about pre-existing conditions and how to help yourself in the future!. The Health Insurance Portability and Accountability Act (HIPAA) regulates pre-existing conditions and how long a plan can not cover them!. Also some good info should you leave this job in the future!.Www@Answer-Health@Com
The only thing I would add, is that sometimes large group insurance policies do not have a pre-existing clause and you are eligible for any condition as a basis of employment once eligible to receive benefits!. Check with the insurance carrier what (if any) pre-existing clause your policy contains!. Also, I have included the link to the Dept of Health and Human Services which will give you more info about pre-existing conditions and how to help yourself in the future!. The Health Insurance Portability and Accountability Act (HIPAA) regulates pre-existing conditions and how long a plan can not cover them!. Also some good info should you leave this job in the future!.Www@Answer-Health@Com