health insurance won\'t cover PA

Posted on: Fri, 10/01/2004 - 1:08pm
PAnut's picture
Offline
Joined: 09/29/2004 - 09:00

Hi,
Has anyone else been refused coverage for their PA child? We just purchased new health insurance and received a note back from them stating that they will cover us 100% after our deductable has been met unless it deals with my son coming in contact with peanuts! Is this outragious, or is it just me?

------------------
Safety before popularity,
PAnut

Posted on: Fri, 10/01/2004 - 1:14pm
lalow's picture
Offline
Joined: 03/24/2004 - 09:00

I havnt had trouble with that specifically but if you are getting a private policy they will often preclude preexisting conditions.

Posted on: Thu, 10/07/2004 - 2:14pm
ElleMo's picture
Offline
Joined: 06/19/2003 - 09:00

Have you had continous coverage or is was there a gap in your coverage? If there is no gap, you cannot be refused coverage for a pre-existing condition.
Regardless, contact the insurance company and find out why exactly they feel that they can refuse to cover this. Then check with state laws and see if it is legal. It may not be legal but perhaps no one has challenged them yet.
Good luck.

Posted on: Thu, 10/07/2004 - 2:33pm
California Mom's picture
Offline
Joined: 07/14/2000 - 09:00

I think this is absolutely outrageous!!! [img]http://uumor.pair.com/nutalle2/peanutallergy/mad.gif[/img]
Chrikey (borrowing Cindy's word [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]), now not only do you have to worry about your son coming into contact with peanuts for his own safety, you also have to worry that if (G0d forbid) this should happen; you won't even have coverage to pay for the hospital bills, which could be enormous, I would think.
I am truly floored by this one.
Take care, Miriam

Posted on: Thu, 10/07/2004 - 3:50pm
nancy023's picture
Offline
Joined: 12/12/2002 - 09:00

That Canadian health system is looking better and better.

Posted on: Thu, 10/07/2004 - 9:39pm
Mary Kay's picture
Offline
Joined: 01/25/1999 - 09:00

Yes, in the U.S. if this is an individual policy rather than a group policy, they can deny coverage on pre-existing conditions. There is a HIPAA law (P for Portability not Privacy). You can find some info at [url="http://www.cms.hhs.gov/hipaa/hipaa1/content/qa-con.asp?"]http://www.cms.hhs.gov/hipaa/hipaa1/content/qa-con.asp?[/url]
I talked with a woman who has a daughter that was being denied coverage for asthma and allergies. But since it was an individual policy the HIPAA laws did not apply and there was no advice I could give her except always stay with a group policy if at all possible.
And as someone mentioned above, don't let insurance coverage lapse for more than 60 days because if there is a gap then the HIPAA laws don't apply, even if it is a group policy.
Not good news, but it is a reality in the U.S.
------------------
Mary Kay

Posted on: Mon, 10/11/2004 - 10:29am
deegann's picture
Offline
Joined: 07/27/2003 - 09:00

.
[This message has been edited by deegann (edited February 09, 2005).]

Posted on: Mon, 10/25/2004 - 2:04pm
mamakat21894's picture
Offline
Joined: 10/23/2004 - 09:00

I'M HAVING SOOOOOOOOOOO MUCH TROUBLE AS WELL
WE ARE SELF EMPLOYED AND WE HAVE AN INDIVIDUAL POLICY. THE INSURANCE SALES MAN TOLD ME THAT IF WE HAD A GROUP POLICY THEN THEY WOULD ACCEPT. I'VE SERIOUSLY BEEN THINKING OF GETTING A JOB AT A LARGE COMPANY THAT OFFERS INSURANCE. BUT THAT IS A DOUBLE EDGED SWORD. WHO CAN I LEAVE MY SON WITH, THAT IS GOING TO KEEP HIM AS SAFE AS MY FAMILY DOES. I'M ALSO HAVING TROUBLE WITH THE INSURANCE CO THAT I HAVE NOW WITH EPI PEN COVERAGE. AND WE ALL KNOW HOW EXPENSIVE THEY ARE. $$$$$

Posted on: Tue, 10/26/2004 - 1:58am
Suzy Q's picture
Offline
Joined: 05/20/2004 - 09:00

I work for a big company and do appreciate the health insurance that we have. However, my premiums keep rising and coverage decreases as the cost of health services continue to rise and companies increase amounts that employees have to pay out of pocket.
This year, they decided that they were not going to pay for non-sedating antihistamines since so many are available over the counter. It is an extra $55 per month for my son's Zyrtec. I don't mind trying different medicines on others in the family (because not all medicines work for all people), but I do get some level of comfort with my son being on Zyrtec daily. I did try Claritin, which did nothing for his environmental allergies.
I believe you could find someone to keep your child that you would eventually feel comfortable with. I enrolled my son in an MDO program last year before I found out about his PA. I had panic attacks for a month prior to school starting because I was so worried about him. Education is the key and the school is very allergy aware and very willing to work with us. They have approximately 25 kids with food allergies - about 8%. There are also many daycares that are becoming nut free, as I have seen from postings here.
Good luck. I know that insurance is frustrating.

Posted on: Tue, 10/26/2004 - 8:24am
mcmom's picture
Offline
Joined: 06/15/2004 - 09:00

mamakat, all you need to qualify as a small group business is two employees. That's all we have, and we have a group policy - maybe this would work for you?

Posted on: Tue, 10/26/2004 - 9:50am
deegann's picture
Offline
Joined: 07/27/2003 - 09:00

Mamakat,
You could also try to hook into one of those programs that links small businesses with other small businesses to get health coverage like the "big companies". Try contacting the small business association in your area to find out waht is available.
[This message has been edited by deegann (edited October 26, 2004).]

Pages

Forum

Click on one of the categories below to see all forum topics.

Peanut Free Store

More Articles

It Is Easy To Buy Peanut Free Chocolate Online

Ask any parent of a child with a potentially life-...

Seeds, such as pumpkin or sunflower, make great peanut or tree nut substitutes in recipes, and roasted soy or garbanzo beans are tasty snacks and...

So many wonderful recipes call for peanut butter. These recipes can still be enjoyed by experimenting with peanut butter replacements.

...

Peanuts and peanut oil are cheap and easy additives to food and other commercial goods. It is surprising (and alarming if you have a...

Those with severe peanut allergies soon learn to look for the 'peanut-free sign' on any packaged food purchase. This is a notation found on a wide...