My family looking into purchasing Helath Insurance for a family member;

When she went in to a check-up, the doctor found something odd, and said it might be cancer. They performed a screening, and it came back inconclusive. No one she went to locally knows what it is, and she was told she would have to go to a larger medical facility for a more advanced screening.

The procedure/screening was quoted at being $900+, and the screening appointment wont be for almost another 2 months.

Coming up with the funds for the procedure is sadly difficult, but obviously necessary.
One of the fears we have is multiple screenings would be required; 1 screening is too expensive, it would be impossible for us to afford a 2nd screening.



Would it be considered fraud to obtain health insurance for her knowing that information?
I have heard insurance companies don't like it when people purchase insurance when there is knowledge of an expensive prodecure in the future

kshif

It is only fraud when you complete an application and it is asked and you deny. Most applications will ask if "you have ever been diagnosed with?", or "Have you ever been treated for?" Tests without a dx mean nothing. Seems the sooner you go, the better off you will be. Most hospitals will work with you. They look at your financial status and offer reduced rates for procedures. You need to tell them up front though. I wish you the best.

Noviceplaintiff

Per my insurance license and background, an APS (Attending Physician's Statement) is always requested and the notes from the physician regarding health conditions and referrals will be in the report. Ergo, the health insurance company will know. However, with all individual health insurance policies, there is a 90-day waiting period before benefits may be used without pre-existing conditions being a factor. So just be honest b/c if the company finds out later, then the insured can be dropped.

Parajr

sometimes you have to do what you have to do. the company may cancle the policy if they find out that you had previous knowledge of the disease, but at the same time it will be next to impossible to get insured with a possible cancer diagnosis.

Universal Truth

Fraud is a black and white definition. If your doctor said the diagnosis was inconclusive, then the report will show it. You have no disease to disclose at the moment. Therfore, you are not being fraudulent. However, some companies fail to cover pre-existing conditions or work in process. Basically, if you get insurance and get through the "90 day probationary" period, the condition is probably not going to be considered a pre-existing condition.

You also might want to consider the costs of health care at the moment. $900 bucks is a significant amount of money to us, but to doctors and insurance companies, it's a rather small amount. These guys pay out thousands of dollars for hospital vacations and overpriced jello. I say get the insurance, pay your deductable and complete the paper work as acurate as possible. If you don't know what your "inconclusive" disease "may" be then you don't really have anything to report do you?

Fr_Chuck

First I can say this very clear, all privately purchased health insurance do not cover pre-existing conditions for at least 12 months,

You will be asked on all major medical policies and most hospital policies, to list every doctor you have been to in the last 3 years. You will have to list any medical procedure you have been told to do but have not done yet.

they will get all the medical records from all of your doctors,

so although it is actually fraud, not to tell them, ( I sell health insurnce) about 1/2 the people I sell to never tell me all of thier medical issues, so when the policy comes back costing 20 or 30 percent more, they act like, oh I forgot about that.

If they had cobra and are within a specific period, they can be insured without the preexisting, and have to be insured.

Also that 900 dollar procedure can often be reduced by some of the medical discount. Most agents can sell medical discount ( if you look at a doctor or hospital bill, if you have a major insurance company, and they bill 200 dollars , the insurance company has a set rate, lets say 150 for that procedure and the doctor has to accept that instead of 200.
The discount cards done by some of the major groups work that same way. These should cost no more than 50 dollars a month for an entire family ( if you see some costing more keep looking)

If you tell us the state, I may have some recommendations