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Asked: May 02, 2010

Application Declined - Please someone Help me

I was declined major medical insurance. The reasons listed came from my Doctors records. The records indicated history of hypertension, carotid bruit, aortic valve murmur and arthrosclerosis. I was shocked. ( I got a copy of my medical records) I am 55 years old and do not take any meds. However, back in 2005 - due to a stressful job, aging parents and major hurricane. My blood pressure was high. The doctor recommended meds the first time I went to him. I decided not to take the meds but lose weight and change diet. In reviewing my records he noted diagnoses hypertension, carotid bruit, aortic valve murmur and arthrosclerosis - before any actual tests were performed. This was our first visit. He wanted me to get ultrasound of my carotid and echocardiogram. I did and both came both normal. normal transthoracic echocardiogram read by heart doctor and the ultrasound for the carotid bruit was negative within normal limits in both systolic and diastolic readings It did state minimal plaque. I am 55 years old - should have some. I thought that was good - all I needed to do was reduce my blood pressure. I lost 15 pounds and watch diet my last three visits with this doctor 11/05, 1/05 and 2/8/06 blood pressure was normal 120/80 range. Present blood pressure normal. I am on cobra now - but need health insurance. If you look at my records - it may appear I have a lot of problems. But the test came back fine. I plan to change doctor. I think this doctor wanted to run tests to increase revenue in his office. How far back do insurance companies look at your medical records? I plan to go to a different doctor. Any suggestions on what I can do to fi this problem. I do believe Iam healthy. '

Categories: In Georgia
Plan Types: In Other

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Answers

You have a couple of options in this situation. The first would be an appeal with the insurance company that declined your application. If possible, this appeal should include a letter from your new physician, in which he describes your current state of health. Then, add your own comments, very similar to what you have done here. You should also try applying with other health insurance companies. Not all insurance companies have the same underwriting guidelines, so just because this insurance company denied your application, does not mean that they all will. Along with the new application, you will want to include an eplanation of the decline with this insurance company, as well as the letter from your new physician. The new insurance company will probably be aware of the decline by this insurance company because it may have been reported to the Medical Information Bureau and will part of your health history. All application for insurance will also ask you if you have been declined by any other insurance company, and you will need to answer that question honestly. If you are successful in your appeal, or unable to secure coverage with another insurance company, there may be options available to you under federal HIPAA regulations. All states have guaranteed issue options available to persons that are ehausting their COBRA coverage and are unable to secure Individuals. We can help you understand the options in your state, if you reply to this commentary with the state in which you reside. Also, when does your COBRA terminate? The look-back limits regarding pre-eisting medical conditions also vary from one state to the other.

Answered: May 02, 2010

 

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