<<Disclaimer: Verify this information before applying it to your situation.>>
Sorry for the delay in posting a summary, but I've been away on
Christmas vacation in balmy (not) Buffalo! I received 29 responses to
my question regarding whether or not a diagnosis with gluten
intolerance/Celiac as a child presented problems with health care
insurance later in life, or if this diagnosis presented problems for
anyone regardless of age at diagnosis in obtaining insurance. The
question arose when my daughter was recently diagnosed with gluten
sensitivity with malabsorption problems. She also carries the same two
genes that I carry that predispose one to CD. One of my three
grandchildren is exhibiting symptoms of CD, including Scoliosis which I
understand can (or not) be related to CD. My daughter is considering
whether or not to have my granddaughter tested or merely follow a GF
diet due to future insurance concerns.
Some people merely requested a summary as this was a concern to them as
well. Others provided their experiences as listed below.
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I had, at one point, inquired about switching my son's policy because
mine at work had gotten so costly and Farm Bureau had a good policy that
was affordable. However, they said that they would not cover him. So
consequently, he is staying on my policy at work. [I confirmed that her
son was diagnosed with CD.]
--------------------------------
In my experience, being diagnosed as celiac has caused problems in
obtaining insurance. For life insurance, my application had to go
through an extra review and, with help from an understanding and
knowledgeable agent, it was approved and the rate is reasonable. As
you've probably found, not many people outside those of us affected, are
familiar with CD. For health insurance, this has posed several
obstacles for me. I left a job with a relatively large company and am
now self-employed. My applications for health insurance were rejected
by a couple of commercial insurers, leaving me to obtain coverage
through a state-run insurance program for those of us who can't get
other coverage. It's better than nothing, and it will be a help if
something catastrophic occurs. But it is very pricey and doesn't cover
much of anything for routine exams, prescriptions, and so forth. Also,
I had a few interviews with a very small company and they were very
concerned about whether they would be able to afford coverage for me &
my condition, since their 'group' is not sizeable.
--------------------------------------------
I've been diagnosed about 5 years, and am 65 years old. We have health
insurance through my wife, who is still working. The insurance company
is not aware of the diagnosis, and I have not yet had any claims
identified as due to celiac disease. My doctors and dentist know about
it, but have not had to treat me for celiac disease.
------------------------------
I have had no problems with health care insurance. I have been
diagnosed for 11 years and have had no major problems with celiac
disease.
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I never told any insurance company when we changed companies that I had
CD. I never had any problems. I also have/had cancer and that made it
almost impossible with a pre-existing condition. If they find out that
you have cancer, you only qualify for an individual policy which is
quite expensive but had no choice.
----------------------------
We recently moved and had to pick up new insurance. We are self-
employed, and we were concerned about getting health insurance for me.
(I am the celiac.) My husband has acid reflux, which has been controlled
with medication for many years, and had never been as much of a health
problem as my celiac. However, the insurance company excluded coverage
of his problem, but made no mention of my celiac. In fact, we ended up
putting me as the primary insured, because it was cheaper. This was with
Mega Health and Life Insurance Co., purchased through the National
Association of the Self Employed.
------------------------------------
I was rejected for the best risk category for term life insurance from
State Farm. They placed me in a higher risk category with higher
premiums, but say they will review it in a year. I applied for coverage
within the first year of diagnosis-I had been hospitalized with severe
anemia that required a blood transfusion. I will be applying for new
health insurance soon, and will be interested to see if they
exclude coverage for celiac related claims.
------------------------------------
All I can say is that I have an official diagnosis. When I got a new
job they just started my insurance. No guestions about pre-existing
conditions. It may depend on state laws and the insurance company.
------------------------------------
I had a major hassle getting disability insurance about five years ago
after telling them I had CD. I finally convinced them that all the nasty
symptoms listed in their medical encyclopedia under CD only applied to
undiagnosed celiacs, and not to someone on a GF diet. But it took
months, several letters, and a few phone calls.
-----------------------------------
I absolutely can NOT get individual health insurance. Have been
uninsured for this entire year that my husband's been unemployed (I'm a
student). It's a nightmare.
-----------------------------------
In New York State it is illegal to deny anyone health benefits due to
illness. It is also illegal to deny someone COBRA benefits if you cover
them under you health plan at work and you are terminated, or resign
from the position and wish to maintain benefits at your own expense. If
you do allow insurance to lapse and then seek to obtain it, sometimes in
some states they can deny you coverage for a particular illness for a
period of time as a preexisting condition. I believe there is some
federal regulation governing this. I would check under government
documents on the web. Find out if your state is affected by any of these rules.
--------------------------------------
Since it is not a terminal illness, fortunately, we see no reason to
divulge this info to an insurance provider.
-------------------------------------
Diag. last year at 57 yrs. old. No problems with ins. coverage.
--------------------------------------
To add to that, I'm wondering if insurance will pay for another biopsy
to see if there's been improvement, once already biopsy-diagnosed with
CD.
--------------------------------------
I have had no problems with insurance. I have even changed jobs. I
don't think insurance companies can deny a person if they have been
diagnosed for anything anymore. However, They may be able to put you on
a waiting period like months if you have been UN insured for any length
of time. But moving from one insurance program to another simply
because of a job change or the employer changes insurance should not
affect your benefits or eligibility.
--------------------------------------
My insurance didn't change a bit when I was diagnosed, but she [my
daughter] may have one of those horrible HMO's that give you all the
trouble they can to NOT insure you.
--------------------------------------
My husband is a school teacher, and a couple of years after our daughter
was diagnosed they changed insurance. When asked if anyone had a pre-
existing or long term condition we answered yes (since we had a VERY
FIRM diagnosis). The new carrier is an HMO, they offered us a case
manager-we refused. It is my understanding that group insurances/HMO
must accept all or none of the eligible patients. You may run into
trouble trying to obtain private individual coverage-either denied, or
treatment of your condition excluded. In my opinion, if you do not have
a confirmed, documented case of celiac disease-blood tests positive,
biopsy positive, improvement on GF diet-then I would NOT disclose your
"perceived"condition, many vague illnesses and allergies mimic true
celiac, including some MD's that consider it a mental condition.
----------------------------------
I went back and forth on this one with my own doctor. We decided that
it would be better to not put anything on record as it could create
problems with insurance down the road. (I was diagnosed at 6 months
many years ago--long before centralized medical record computer banks).
It is noted that I have "gluten intolerance". No reference to having
Celiac Disease, which may raise a flag.
---------------------------------
Under the Health Insurance Portability and Accountability Act (HIPAA)
persons with preexisting conditions (this would include a child covered
under a parent's policy) cannot be discriminated against in terms of
coverage or cost of insurance. If the employee were to change jobs, and
the new employer also offers health insurance, no preexisting condition
limitations may be imposted -- so long as the employee has had 18 months
of prior health insurance coverage. This might become an issue is if
the family purchases insurance through the individual market, i.e. not
through a an employer group. The preexisting conditions would have to
be disclosed. Given that the only treatment is a gluten-free diet,
which is not something which the an item covered under the policy, there
should not be problems.
------------------------------
We had no problems with either myself or our daughter. I even got Life
Insurance - they didn't care at all about it, and they knew what it was.
They said that although if undiagnosed it may "cause" things that would
disqualify me, or increase my rates, I had to actually "have" those
things to worry about it. And that most people that know that they have
this stick to the diet and end up healthier than the rest.
-------------------------------
I recall seeing something posted a while back about this so you can
probably find some discussion about this subject in the archives.
--------------------------------
Would also like to know so please inform us because when we took our
grandson to a doctor of Rainbow Babies in Cleveland, she said you don't
want to dx him with Celiac as he will never be able to get insurance.
-------------------------------
Based on the above responses, it seems as though insurability varies
greatly state-to-state. My daughter is in New York which appears to
have comprehensive coverage based on the response above. I'll encourage
my daughter to check out health insurance requirements through the
state's insurance board.
Also, the terminology of the diagnosis (gluten intolerance vs Celiac)
seems to make a drastic difference regarding insurability.
Thanks to everyone for the helpful information.
Sandra
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