Re: adenomyosis and US
From: Meenan, Anna (annam@uic.edu)
Wed Feb 14 12:56:09 2007
Yeah, it's the pits for people looking for individual coverage.
Eventually the government is going to have to step in to the
individual health insurance market in a big way.
Anna Meenan, MD
>But the point is - she should not be rated at all. Adenomyosis is
>technicallyh NOT an ultrasound diagnosis. Therefore it is a BOGUS
>reason for the insurance company to get more money - when the only
>medical care in the last 18 months has been birth control pills and 2
>visits to a dermatologist - for a funny mole and for facial hives
>(allergy to mango sking due to cross reaction with a case of poison
>ivy). NOt a "utilizer of services" - and the quoted reson for denial to
>consider any policy (not even a rated one) was the adenomyosis.
>
>Seh thought she was going to be in California for several years so was
>changin her NH insurance (also BCBS and not rated) to a California one.
>Now that she knows she is leaving she wants to cancel the application
>but to NOT have it on record that she was denied any insurance.
>
>She will keep her unrated NH insurance and see where her graduate school
>takes her and look again there.
>
>If the "portability" provision is only if you go from group to
>individual - then that is ludicrous. at least 35% of the people in NH
>have individual policies: there are a LOT of very small companies and
>self employed individuals who have to buy the individual policy because
>that is all that is available.
>
>Joanne
>
>At Wed, 14 Feb 2007, Anna Meenan, MD wrote:
>>
>>My understanding of the portability provision of HIPAA is that it only
>>applies to people transitioning from group to individual coverage, and
>>does not apply when transitioning from one individual policy to another.
>>California has a high risk pool, so she should be able to get insurance,
>>though the rates will be higher. The rates are capped in the California
>>pool though, so they won't be astronomical.
>>
>>--
>>Anna Meenan, MD
>>
>
>--
>Joanne Bulley, MD, FACOG
>Solo gyn
>Keene, NH USA
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