(I shouldn't have to say this by now, but healthcare reform debates go thataway *points to Fratching*. Limit discussion of Affordable Healthcare Act to the logistics of how it's meant to work, not on your opinions of it.)
My husband went to a new doctor a month or two ago for a few medical questions that had been bugging him for a while. He had a surgery several years ago (before we were married) that required several deep incisions and required the wound be repacked twice a day until it healed rather than be sutured. Another lingering concern was a rash he'd had for a while that turned out to be a fungal infection, for which he was told to swap out a couple of different antifungal creams, which cleared it right up within a couple of weeks.
He submitted his insurance and went on his way. We get a bill last week. It says "these are non-covered services because this may be a pre-existing condition." Husband calls the doctor and they mumble something and eventually say the rash was considered pre-existing.
First of all, I looked up pre-existing. It's something you've received treatment for in the past. He's NEVER been treated for this rash. And second of all, as of January in the US, isn't "pre-existing condition" generally a moot point? This is insurance through his work, and from my understanding of the law, if they're covering him they cannot deny a claim based on "pre-existing condition."
Apparently the person we really needed to speak with wasn't there today, so he made sure it was okay if I called about it tomorrow (he's notoriously bad at asking the correct questions in these situations). Gonna try to clear things up with the doctor's office and remind them about AHCA and make sure I'm understanding this right. Then I might need to call his insurance and possibly the insurance commissioner for my state. I'm sure they'd be VERY interested to know what's going on and in investigating how many people the company has tried to screw over that aren't as aware of their rights under the new healthcare laws as we are.
Unless I'm completely wrong and misinterpreting the act. Which is entirely possible.
Anyone else have any experience with something similar?
My husband went to a new doctor a month or two ago for a few medical questions that had been bugging him for a while. He had a surgery several years ago (before we were married) that required several deep incisions and required the wound be repacked twice a day until it healed rather than be sutured. Another lingering concern was a rash he'd had for a while that turned out to be a fungal infection, for which he was told to swap out a couple of different antifungal creams, which cleared it right up within a couple of weeks.
He submitted his insurance and went on his way. We get a bill last week. It says "these are non-covered services because this may be a pre-existing condition." Husband calls the doctor and they mumble something and eventually say the rash was considered pre-existing.
First of all, I looked up pre-existing. It's something you've received treatment for in the past. He's NEVER been treated for this rash. And second of all, as of January in the US, isn't "pre-existing condition" generally a moot point? This is insurance through his work, and from my understanding of the law, if they're covering him they cannot deny a claim based on "pre-existing condition."
Apparently the person we really needed to speak with wasn't there today, so he made sure it was okay if I called about it tomorrow (he's notoriously bad at asking the correct questions in these situations). Gonna try to clear things up with the doctor's office and remind them about AHCA and make sure I'm understanding this right. Then I might need to call his insurance and possibly the insurance commissioner for my state. I'm sure they'd be VERY interested to know what's going on and in investigating how many people the company has tried to screw over that aren't as aware of their rights under the new healthcare laws as we are.
Unless I'm completely wrong and misinterpreting the act. Which is entirely possible.
Anyone else have any experience with something similar?
Comment