A word of caution

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A word of caution

Postby garym on June 11th, 2004, 11:50 am

I just wanted to take a minute and tell everyone about one of the terrible side effects BFS has had on my bank account. It is something people should consider before adopting a plan of treatment.

As most of you know, I've been suffering for nearly a year. After my first emg, my dr. offered to "treat" my sx's with trileptal and from there I went to neurontin. All that was good, but I didn't really experience much benefit from either of the drugs, but it was worth a try. Or was it!

Now here is where the story turns. I am the owner of two companies and have been for ten years. Although I own these companies, I have always had health insurance through my wife's work. In January '04, my wife wanted to leave her high stress job, and start spending more time with our young daugther. Being the wonderful and supportive husband I am :oops: , I quickly agreed. The problem was that we would lose our insurance coverage. Now being naive, I didn't think I would have a problem getting coverage eventhough I suffered from this "benign condition", I was wrong. None of the insurance companies we applied to would write me (unless they excluded everything that made insurance worth having) because of the condition and the MEDICINE. We were able to finally get insurance through a group policy with one of my companies. Here is the kicker, I pay $890.00 a month for health insurance. That covers me, my wife (who is never sick), and my two year old.

I called my insurance agent this morning and wanted to apply for personal coverage as it is cheaper than group insurance. He is an honest man that goes to my church, and told me the truth. He said I could not get personal health insurance until I had been off the medicine (neurontin) for atleast a year and had a letter from my dr. saying that the BFS had gone away.

So my final word on all of this is, be careful and consider the consequences before starting drug therapy for BFS. It is my understanding that if the condition had not been treated (i took trileptal and neurontin), and did not require ongoing medical care (which it wouldn't have) I would not be in this position. Now I have to report that I was on an anti-convulsant on all health insurance apps. for the next several years. Kinda sucks considering that the meds. didn't even really help. I'll be paying for that trial therapy for many years :cry: .

Just something to think about.

Last edited by garym on June 11th, 2004, 1:35 pm, edited 1 time in total.
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Postby dwpierce on June 11th, 2004, 12:23 pm

Thanks for the Heads up.

That is the main reason when I went to my internalist over a year ago I did not press for a nuro visit. He told me I was fine. He was a twitcher himself. I own a business also and don't need another mark on our record come time for new rates. And trust me they look though the claims and adjust the rates for the business yearly. Once you are marked for problems it is like a criminal record for the insurance guys for life.
If I had a major problem time would tell and the fact is there is little they could do anyway. Reading this forum and other forums few people even after all the tests relax and move in while still twiching. SO I might as well worry with a clean medical record compared to one the insurance guys find alarming. It is funny as the medical field looks at our condition as nothing but the insurance people find us a liabilty. Go figure.

This is a sore spot for me sorry to ramble.
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Postby jcavan4125 on June 11th, 2004, 1:10 pm

Hi Gary,

I just wanted to let you know that I was able to get individual coverage with no restrictions due to the BFS. The insurance company did want a letter of explanation from my neurologist though.

I went thru Fortis Health (recently changed their name to Assurant Health). I have a high deductable policy with a Health Savings Account attached. I pay about $225 a month and I'm 45 years old. All the money that I put into the HSA is pre-tax (this is in addition to the monthly premium), and can be used to cover my deductable expenses. Whatever money is left (if any) at the end of the year, rolls over to the next year. At age 65 it essentially becomes an IRA.

I thought you might want to look into this.
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Insurance companies

Postby Bradford on June 11th, 2004, 6:42 pm

Don't tell me its because the insurance companies see it as an anti-convulstant thus they automatically assume you are having siezures?

When I was undergoing my EMG/NCS, my neuro and I got into a discussion about an insurance company he was trying to get payment from. Apparently, his paper work only justified the EMG and they wouldn't pay him for the NCS. Of course he was flipping out because in the real world, neurologists know that its the entire electrodiagnostic study that counts and you wouldn't just order and EMG without the NCS.
But the insurance company in their vast knowledge in the medical profession felt that you could, thus its a separate line item for billing and the doctor has to justify both proceedures.

I own my own business and we get covered through my wifes group plan at work. This post opened up my eyes a bit in the event I have to look for coverage. I was on Carbatrol for 30 days and quit it because the side effects are worse than the twitching symptoms. I hope that I don't have some narrow minded insurance company call me on this in the future.
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Insurance companies



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