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Health Insurance Question

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fireproof posted 6/4/2013 19:18 PM

I have been to the doctor a few times and my insurance won't cover due to a preexisting condition. However they have asked my doctor to state my diagnosis.

I am switching insurance without any preexisting condition clause. If the doctor writes something regarding my diagnosis which they won't cover anyway then there is a chance that my new coverage will a. Know and b. Might not cover me fully.

Should I just eat the costs with the old insurance? I also don't want my new employer to be aware of the diagnosis. It is like seeking a condition and paying out of pocket despite having insurance there is no record of the visit.

Thanks!

Amazonia posted 6/4/2013 19:21 PM

Wait, the new insurance won't cover it, despite the lack of a pre existing condition clause? Is this specific diagnosis just not covered on that insurance?

Can you just tell your doctor not to bill insurance, and treat you as a no-insurance patient?

I don't think your employer gets to know what you are billing the insurance company for. I think that's protected by HIPAA. I could be wrong though.

fireproof posted 6/5/2013 04:58 AM

With the old insurance I need to medically put a diagnosis because there is a gap in insurance. They also won't cover it so I don't see the point. That being said I am required to give my new insurance different company to them and not sure even if they will pay per existing I want my diagnosis on record or known about in my new job. I should just eat the cost but it is quite a bit for me right now. Also my diagnosis is a soft diagnosis.

My gut says to eat the cost.

sadcat posted 6/5/2013 06:12 AM

Your employer will have no access to your diagnosis. The insurance company cannot disclose any personal health information to them. All the employer knows is the amount of the premium.

The new health insurance will find out about the diagnosis if there was ever a claim filed on it- regardless of if the claim was paid. They pull records from doctors, insurance companies, pharmacies, etc. when they do the underwriting. They will know any and all diagnosis if a claim was made with it on the form.

But again- your employer has NO access to the information. It is protected by law.

KeepCalm_CarryOn posted 6/5/2013 08:34 AM

Like sadcat said, your employer has no access to your medical records. It's covered under HIPPA.

And I believe- don't quote me- that a. if you don't have a preexisting condition clause with the new insurance, they will have to cover it and b. with the new ACA insurance can no longer deny preexisting conditions anyway.

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