I lied in my insurance interview..?

So I applied for personal health coverage (I was formerly in entertainment and never paid the union dues for benefits and now am no longer working [basically not functional] so am pretty much unemployed and paying out of pocket). I applied online with Blue Cross and picked a basic low-cost plan that would cover meds and co-pays for visits.
When I answered the questions online (to my ''full and complete understanding of the truth'') I was pretty much completely truthful. The only health concern I had really was an MRI report three years ago suggesting surgery on my left shoulder. (And three years apparently was the cut-off) and being as how I never had been diagnosed with any illness nor prescribed any medication by a doctor; so despite a fib about my weight not being under, I was pretty much able to supply an honestly written application as a seemingly very healthy applicant.
However, shortly after this application, I have seen a doctor. Since my ED symptoms have been worsening over the past six months and having experienced a relapse in suicidal symptoms very recently, I went to a doctor for the very first time to discuss these issues. I've since then been put on three different meds, received blood work, and been seen twice by the doctor.
Now flash to this afternoon when Blue Cross calls me for my ''Phone Interview" regarding my application for insurance. Not only are the answers I supplied on the written application no longer applicable, but they are drilling me with even more details to my health which I'm feeling would greatly sabotage my eligibility. Am I taking meds? Was blood work ever suggested? Has surgery been suggested anytime over the past ten years? Are there any concerns regarding serious or mental health issues?Oh holy hell!
So... As is one of the skills mastered by many of us inflicted with an ED, I went into the art of LYING mode. I was the PICTURE of perfect health. However, I'm lying about stuff that's basically on record- like the phantom extra pounds, and obviously lied about being on meds. So if they ask for me to come in for a physical, I'd have some explaining to do about the 48hrs of some pretty hefty weight loss and a quite a substantial load of drugs I'm not actually taking that are floating around in my blood work.
I guess I'm just really nervous about being denied. I have very little money and I am very afraid of getting put off from continuing with treatment. It took so much for me to go into a doctor for the first time. I can't begin to put it into words (but if it helps to describe it what it was, I have starting crying since typing just that last bit). I just know that part of me fights to stay away from getting help. I don't have the money to keep going in to the dr without insurance, though he has been very supportive with samples and reduced fees, I just don't know how long I could milk something like that).
I guess what I'm asking is: how likely is it that I will be caught? And what are the repercussions? What exactly will they find out? Will it just be a higher rate, or will it be hard for me to find insurance anywhere? I don't know if I just made a big mistake and I'm pretty freaked. The nurse on the phone said it would be sent to a (something?) department (don't rembr) and I should hear back in seven days. I just wonder what they'll find out.
Anything anyone knows about this would be greatly appreciated.
Thanks so much.
Oceansend

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.

Can't you just go onto the government's all-inclusive coverage, when does that kick in?

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thanks guys!
I really appreciate all the details and insight, echos! so i guess i'll just keep my fingers crossed. so my records are mostly good (minus i guess the mri that's over 3yrs old for the surgery im not intending to get should they even stretch back that far), so then i suppose it's just a matter of how long it takes for this weeks' visits to go on what you said would be 'public record'. (shoulda just held tight i guess for a couple weeks on that dr visit. didn't think about a phone intv) and if they do i will try that ''oh yeah, forgot bout that med'' thing.
'don't know about when that gov stuff kicks in either jd- good q. (would i be crazy if i said i had a couple doubts about that one?) and i appreciate your earlier point btw, and I do understand that it certainly can be considered unethical not to be completely honest about one's condition, however i can't say with any complete sincerity that i feel too badly about my discretion to the whole truth (so to speak), being that should the option arise again to be honest, though at the chance of denial, I can't truthfully say I wouldn't likewise repeat my responses in the former manner. (Though if we were going back and all... i sure would have held off a week on seeing that md!) )
Thanks again, I really appreciate the input!
<3
ocean

ECHOES, what are public medical records? Is it like a credit report? I have never heard of this. Seems like it would violate HIPAA, wouldn't it? I would like to pay to see my "public" records to see what is on there, so any information you can provide on this would be appreciated. I am worried what I might find there.

http://www.insure.com/articles/healt...they-know.html

http://patients.about.com/od/yourmed...ords/a/mib.htm

http://www.mib.com/

sunny, here are a few links for you. The last one is the site for the Medical Information Bureau Group and has a link under "consumers" for requesting a copy of what is in your file. One important note is that the information remains in a person's file for 7 years, like a credit report. That was something I didn't know. Thanks for the opportunity to learn that!

I don't know what state you are in but many states have mandatory plans you qualify for if not for a "regular" plan. That's what I'm in because I'm not working and am obese and no one will issue me a private plan.

I don't know how much research you did before looking at actual plans online but I'd go to your State's Insurance page first and see how your state does things and what they suggest. The "guaranteed" plans they can't turn you down for.

This one's good on public medical records too: http://www.privacyrights.org/fs/fs8-med.htm

Basically, you pay insurance bills, use credit cards, etc. and none of that is covered by HIPPA; there's a lot of information out there they can get.

Hi Oceansend,

I do appreciate how anxiety-inducing filling out an application for health insurance can make us! We want, we need the health insurance!

The only things that underwriting can go by is your application and scrupulously pouring over any medical information (as of the date of your application) that they can get their hands on.

I always think that it is wise to have a Plan B and a Plan C in the event our first choice does not pan out. You may want to consider applying for other coverage as well. HMO's, although generally more expensive are usually more inclusive.

Good Luck! Hugs, Laurie

i too hope all goes well for you in this age of desperate measures to assure our health. think all the sites above will help you. when i signed up this past year i just didn't reply to their calls...course that may bite me in my butt but the info is out there anyway so i chose not be be.."this is a recorded conversation"..etc. they are looking for anything to re-interpret.
there's entirely too much they want to know and so many options. it's so confusing anymore the only thing i do know is they will save every buck they can! grrr.

Wow, Everyone!

I can't begin to thank you ALL enough for all this amazing input! I am still new to PC and still everyday am so continuously impressed, humbled, and inspired by all the compassion, care and assistance that is out there and which is being shown so graciously to one another here each and everyday
I am happy to report that I have in fact been 'approved' (at least according to my current online status as of today) for the insurance plan I applied.

So as of currently, I will be able to alleviate some expenses and continue on with my treatment (though perhaps with some added efforts of inconspicuousness as might be needed )

I will, however continue to look into the sources so graciously provided to me, to both explore all my options, as well as ensure an avoidance of any repercussions from my application responses; and will report back with any findings I feel should be shared and/or beneficial to any other readers.

Thank you all again so very, very much!

Gratefully,
Oceansend

Quote:

While you may never have heard of anyone going to jail it, insurance industry lobbyists were influential enough to get legislators to make it a felony to lie on an insurance application.

http://ezinearticles.com/?Lying-on-a-Health-Insurance-Application&id=2237190

Good luck with that. If you are found out, it goes onto your record and if you apply elsewhere and lie again, well... ????

Believe in Him or not --- GOD LOVES YOU!

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I know how it is to not have insurance, i have been uninsured for the last 4 years and have been going to the clinic at my local hospital but i was struggling trying to get meds (thank god for walmart). I always worried about needing some expensive meds or tests that i wouldn't be able to afford. I am on disability now so i will get medicare, although i have to pay for it and not sure how much it will cover. I hope everything works out for you, we all need to be able to have decent health care and not have to be stressed out about how we are going to pay for it. Thats just my opinion.

Hi,

Thanks very much for this comment. It help me to think about my ideals.

Tks again and pls keep posting.