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ECHOES
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Default Oct 20, 2010 at 02:56 AM
 
The repurcussions are that they won't approve you or your policy may have a time period where it can be rescinded if they determine during that time period that you really didn't qualify based on the eligibility requirements.

Some things can be a matter of perception. "Serious" mental health issue? What might be serious to you might not be to me. Having suicidal thoughts is something that might be serious to them, but to me might be something to notice as a way of identifying internal struggles. What I'm saying is that it's a vague idea and can't be solidly defined in this context. "Serious" to me might mean so serious there are legal/criminal issues or a history of lengthy hospitalizations or something like that. Serious is different things to each person.
Surgery suggested in the last 10 years? Don't recall. Also, many surgeries are only one option of treatment. Actually they are most likely wanting to know if someone is buying the policy because they have an immediate need for an expensive surgery like heart bypass.
Meds? I forgot to mention this med? Oh, sorry.

Insurance companies want to only insure people who won't cost them anything, who don't seem likely to need to actually use the policy and receive the beneifts they are paying for--how fair is that?

They will also look at medical records, by way of paying to receive a report of your public medical records. So there might be information that they get from there rather than from your physical. The phone interview is to verify what you said on the application with a little more depth and yes to see if a person was truthful on the application.

I hope you get what you need so you can have peace of mind and medical and mental health care that you need. Read the policy to see what the time period is for contestability. This is the time the insurance company can contest your eligibility and they will use claims filed during this time. In my work, if a person files a claim for a diagnosis that was asked on the application (chronic kidney disease, for example) and it is inpatient or is over a certain dollar amount, benefits are pended until an in depth review is done that involves obtaining medical records from the current providers and any doctor that was seen in the previous 5 years. Even when that happens, the focus is not on whether the person was 'truthful' on their application, but simply whether the person was eligible for the policy. If the review suggests the person was not truly eligible, then the policy can be rescinded. (Taken back, as if never issued) This is done only for policies that have this provision. And to be honest, I don't know what effect the new healthcare laws have on this.

I hope you get approved. We all need good healthcare.
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Thanks for this!
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