<<Disclaimer: Verify this information before applying it to your situation.>>

"My advice is don't tell.   I feel this disease does not need to be disclosed. 
Are we to be punished because we live a healthier lifestyle???   I think not."

"more states require insurers to have an "open enrollment" period each 
year...though the insurance companies hate this and don't publicize it.
 
this is a period during which (to the best of my knowledge) anyone can sign up 
and has to be "taken"...
 
Each state usually has an department of insurance with a website...and it is 
there you may find the relevant information, though it is also true that many 
state bureaucrats know nothing of these special provisions.
You have to get the number of the relevant agency and call them..be persistent.
 
I live in NYS...which thank goodness passed a law which requires insurance 
companies to sell insurance, usually two types (one in net work only, one in 
network and out of network benefits)...they are expensive...but without this 
law, I likely would not be able to buy insurance either.
 
I know folks who have moved to NY for this reason...there are some other 
states which also have laws of this sort...though not nearly enough."

"My husband is a licensed health insurance agent in CA. He sells United 
American Insurance. UA doesn't deny health insurance coverage if someone has 
celiac - they will rate up the person so the premiums are a bit higher, but 
they will not deny for CD. Have your friend look up a United American 
Insurance agent in your area  -- the agent can discuss how UA can cover their 
health insurance needs."

"My son had the same problem with Blue Cross/Blue Shield when he tried to get 
his first policy after college.  BC/BS said that they would cover him for 
everything, except celiac, even though he told them he had no medical expenses 
or problems since his diagnosis 19 years earlier.  He was able to get medical 
insurance through State Farm.  He already had auto with them, so maybe that 
helped, but there were no exclusions for health with them."

"I was denied coverage as well even though technically (my biopsy was clear) I 
could only medically be classified as gluten intolerant.  I forgot to mention 
mine was from Humana."

"I suppose you know about the Health Portability Act..a federal law.  This 
prevents any insurance company from denying you insurance for previously 
existing conditions for a period of up to as long as, I think, 18-36? 
months....if you previously had insurance either thru an employer, thru 
marriage (could be other provisions..)
 
When you read most policies, insurance companies virtually hide this in their 
material or state it so oddly that you would never know...
 
But it is plain and simple...and they CANNOT turn you down...
 
However the rub is you must do this within I think 63 or 67 days of coverage 
ending with other insurer..."

"I'm a health insurance broker in Las Vegas, NV, and unfortunately a lot of 
companies are declining health insurance for someone newly diagnosed with CD. 
Anthem had been in the process of changing it's underwriting guidelines, so I 
wasn't sure where they stood."

"Do you have PacifiCare or EAMS? Also try Golden Rule/United Health Care, 
their guidelines for CD are not bad here in Nevada and I would assume that 
underwriting guidelines are the same for them throughout the nation since 
their underwriters are all in Wisconsin I believe... Humana & Unicare might 
have stricter guidelines, Assurant and Celtic can sometimes be expensive but 
offer waivers for certain health conditions. I hope this helps in her search. 
Have her try a brokerage if she has a hard time, it SHOULD NOT cost her 
anything."

"Perhaps she should tell them she has an intolerance to wheat/gluten, but
leave out the celiac DISEASE."

"This is one argument for NOT getting a firm diagnosis.  When I had
suspicious blood work in the beginning of my search for the problem, my
family doctor told me that if I go on the diet without  the rest of the
testing it would be much simpler for me in the long run.  He said, "If the
diet works, stay with it."  It did, so I stayed with it.  If I'm admitted to
the hospital I tell them I have celiac disease to make it easier for the
dietician to help me.  Otherwise, I don't officially have celiac and can
truthfully say 'no' to that question on insurance applications."

"Unfortunately, I doubt that they will back down.  I recently went 
through the same situation.  I had switched jobs and Highmark denied 
my insurance application.  I had my doctor write a letter explaining 
that CD was completely controlled with a gluten free diet and that I 
was doing fine but they still denied the application."
 __________________________________________________

"When I started my job here about a year and a half ago, I had coverage from 
another insurance company.  The company I work for now has bc/bs.  I wasn't 
denied coverage but they wouldn't cover anything that was celiac related for a 
year because of a "prexisting condition".  I had to wait a year before I could 
get anything done and have it covered by bc/bs.  They shouldn't have denied 
her coverage.  She can appeal the decision and might have to take 
the "prexisting condition" clause and wait a year.  I know that's not fun and 
can be expensive but it's better than not having any insurance at all."
____________________________________________________________________

"I had heard at one time that if you have already been covered by someone else 
for the same thing for a certain amount of time-sorry to be so vague-that 
another insurance company could not turn you down, but what they charge you is 
a totally different thing.  I was sure that there were laws to protect people 
in those circumstances.  
I would find out your state laws regarding this.  I don't know, there might be 
a federal law that protects people from this."
________________________________________________________________________

"I work in HR and manage insurance for over 3,500, so I'll try to help here 
even though I haven't read the whole thread.
   
  I'll try to make this simple and not throw in all the situational caveats.
   
  If you have insurance at one job and go to a new job, the new job can put a 
1 yr pre-ex exclusion in place that would deny coverage for anything related 
to celiac or any other pre-existing condition, BUT as long as there is a break 
in coverage of no more than 63 days between the time your last group (through 
an employer) coverage ended and when you were hired as an insurance eligible 
employee at your new job, they will use each month of this "credible coverage" 
to reduce your pre-ex period.  So if you had coverage at your last job for 
more than 12 months, and you turn in proof of such, they can not access a pre-
ex exclusion against you.  
   
  Often times even individual (not through your employer) coverage will 
satisfy the requirements to serve as credible coverage.
   
  The federal law that protects this is called HIPAA (Health Insurance 
Portability and Accountability Act).
   
  This link is to information from the govt that explains in detail.  It is 33 
pgs long, so if anyone has any specific questions, just let me know.  
http://www.dol.gov/ebsa/pdf/consumerhipaa.pdf
___________________________________________________________________________
This was a conversation between several people:

Person #1   "At the Int'l Celiac Symposium, Dr. Marsh asked the Dr.'s in the 
symposium what they will do when they are sued because their patient died of 
cancer and also had Celiac Disease that was not diagnosed.  Apparently some 
patients are requesting CD not be listed in their medical records for 
insurance concerns."

Person #2  "I'm a bit disturbed by your message, probably because I do not 
quite understand it.  Why would these doctors be sued.because they missed the 
CD diagnosis?  I ask this because I had adenocarcinoma two years ago, and have
suffered from seizures for two years with no diagnosis.  When one neurologist 
asked if there were any wheat allergies in the family, I was stunned.  My 
father, daughter and several cousins have CD.

Anyway.I'm aware that the CD may have caused the cancer and am convinced it
caused the seizures.  My blood work came back `within normal limits', but I
started the CD diet anyway. It's been about five or six weeks, and I've been
seizure free for a week now.  What a celebration!!!!

Crossing my fingers that I've found the solution and looking forward to
driving again soon."

Person #3  "I'm a bit disturbed by it, because I think I do understand it.... 
It seems to have doctors working more on behalf of the insurance companies and 
legal interests than on behalf of their patients' health.

Given this thread, it's easy to understand why people would want to keep 
celiac disease off of their medical histories. Do you always want to be 
locked in to working for a corporation that can [sometimes] guarantee 
you medical coverage? Do you want that for your kids?"

And finally, this was from Andrea at the American Celiac Disease Alliance:

"I saw your recent post to the listserv regarding the member of your support 
group who had been denied insurance.
 
The ACDA is working with insurance companies on several issues.  I would be 
interested in learning more from the member of your support group regarding 
her denial of coverage, perhaps we can be of assistance to the individual."


I hope that this summary has been helpful.  I am so glad to see that the ACDA 
is working on issues with insurance companies.  It appears that some celiacs 
are having problems getting both life and health insurance.  

Thank you again for taking the time to respond.

Barbara in SW Missouri

*Support summarization of posts, reply to the SENDER not the Celiac List*
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