insurance question

Get help finding a doctor or discuss questions about/difficulties with your insurance or employer.

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insurance question

Postby samib » May 29, 2008 8:24 am

Hey there,

I am trying to get insurance for my family. Now that I am not working outside the home, my wonderful insurance is gone.

They have asked the following question.

Have you ever been treated for any other medical condition disease or disorder not mentioned above
during the last 36 months?

Another broker I spoke with thought they may consider it a pre-existing condition, and so would not cover it.

Can I answer no? HG is not a disease, and I don't think it would be classified as a disorder. I don't want to lie, but I'm not about to expose myself unnecessarily. Anyone else had to answer this question before?

I asked my insurance broker if the insurance would cover off-label indications and he didn't even know what I was taking about. I asked if I need a special authorization and he wasn't sure. I don't know how to make sure I can get covered for Zofran if I need it!

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Postby aaronsmommy » May 29, 2008 8:45 am

If you try and keep something from them on the application, they could decide to retroactively cancel your insurance after you have accumulated a lot of bills (even if they are not hg related, like even if it wasn't even you who got sick) Not a good idea!

You could see if you can get a copy of their medication formulary - however, they tend to change frequently. Even when insurances don't automatically cover zofran, they can usually be convinced. It would be good to make sure they cover home health services too.

Aaron 12/4/02
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Postby bibliojo » May 29, 2008 9:54 am

Do you have a program where drugs are covered by the provincial drug plan when you hit a certain level of spending in ON like we have out here in BC? Obviously you do have to have spent a bit on medication to get covered, but it's worth looking into too. Also, Zofran is not covered by our Pharmacare program for other than cancer treatment but there is provision for your doctor to apply for it to be covered. Just check out what is available through provincial funding.

As for filling out the forms, I'd have to agree with Aimee. It'd be a worse situation to think you have coverage only to have it pulled out from you than knowing you've been denied at the outset and then can try applying to other insurance companies.

Also I think I'm going to move this thread to the insurance folder - this info may serve helpful to someone else and they probably wouldn't be looking in the ttc folder for it! :)
2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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