Is untreated/undiagnosed SA considered preexisting condition

The irony of this situation is that if you continue to ignore symptoms that are most likely SA and you have a very expensive heart attack, stroke, or develop diabetes, you'll be covered. But if you admit the symptoms and seek treatment before obtaining the insurance or too soon afterward (and by that I mean some arbitrary "too soon", since the insurance companies will play any game they can not to cover you), you could be denied coverage for the very treatment that will prevent the more expensive downstream effects of untreated apnea.

What you may want to do is buy a cpap with data capabilities of Craigslist and start treating yourself. Others have done this for the same reason.

BlackSpinner wrote:What you may want to do is buy a cpap with data capabilities of Craigslist and start treating yourself. Others have done this for the same reason.

Where can you purchase a CPAP without doctors orders?

cake321 wrote:

BlackSpinner wrote:What you may want to do is buy a cpap with data capabilities of Craigslist and start treating yourself. Others have done this for the same reason.

Where can you purchase a CPAP without doctors orders?

Craigslist - people sell used machines or if they flunk it they want to get rid of it. Buyer beware - don't hand over money until you have seen it work.

Look up restedGal's posts. She did it all her self. Others on the board have done it too. Educate your self as to the different machines, their names (the pro/plus issues, the "Escape vs Elite terms), the humidifiers, the masks. When you are well into the insurance then just get a doctor, PA or dentist to write you a prescription so you can buy online new stuff.

Uncle_Bob wrote:Just a word of advice. if you are considering purchasing term life insurance, purchase it before you get diagnosed with OSA.

Can you elaborate a bit more on this. I travel somewhat regularly for my full time gig and I work as an EMT part time (always a risk of death from that job) and have been thinking of getting some as extra insurance for my family's financial stability/future should something very wrong happen at either of my jobs. I have the opportunity to add a term life policy at a great rate and I was thinking of doing it.

Thanks

inkdesigner wrote:

Uncle_Bob wrote:Just a word of advice. if you are considering purchasing term life insurance, purchase it before you get diagnosed with OSA.

Can you elaborate a bit more on this. I travel somewhat regularly for my full time gig and I work as an EMT part time (always a risk of death from that job) and have been thinking of getting some as extra insurance for my family's financial stability/future should something very wrong happen at either of my jobs. I have the opportunity to add a term life policy at a great rate and I was thinking of doing it.

Thanks

I'm an agent...there are several factors that can come into play, such as how severe the apnea is, how well you are responding to CPAP therapy, your height and weight, BP, and other related health factors. It's possible your policy could come in at a standard rate, or it could be denied or rated (higher premium for the added risk factors). One of my clients was recently 'rated' for sleep apnea, and our underwriters said if he lost weight he could get back down to a standard rate.

And underwriter once emailed me: "If the Sleep Apnea is controlled using CPAP or Bi-PAP machine and the person is faithfully using the machine each night – We would offer at standard not preferred. If not, it could be rated depending on the severity of the disease. Would probably never be Preferred."

cake321 wrote:

avi123 wrote:

cake321 wrote:I have searched around, but was unable to find someone in the exact situation that I am in. Based on everything I have read online, I am convinced that I have sleep apnea. I have all of the symptoms. I have NOT been treated, or diagnosed for sleep apnea. I have never gone to a doctor about this issue. I will be getting health insurance next month, and have not had health insurance for about 2 years (so there is a gap). I plan to see a sleep doctor once I am enrolled. Could my insurance claims be denied, with sleep apnea being considered a pre-existing condition? I live in the state of Louisiana, if that helps. Again, I've NEVER been to a doctor about it before this.

Thanks in advance for any replies.

IMO, an insurance company can deny you insurance for pre-existing conditions regardless if you know or knew about it.


"Many Americans have health-related problems that insurance companies define as pre existing conditions. A pre-existing condition is a health problem that existed before you apply for a health insurance policy or enroll in a new health plan."


See also:

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

But, how could something like this be enforced, with me having no documented medical history of sleep apnea? How could an insurance company determine when the conditions arose?

In my case a chest X-Ray can show that I had COPD years ago (from smoking). So, an insurer could set up an X-Ray test for me before insuring me. Same with heart problems and other medical conditions which take years to develop.

Insurers have easy access to medical data centers. Same story as for credit ratings.

Janknitz wrote:The irony of this situation is that if you continue to ignore symptoms that are most likely SA and you have a very expensive heart attack, stroke, or develop diabetes, you'll be covered. But if you admit the symptoms and seek treatment before obtaining the insurance or too soon afterward (and by that I mean some arbitrary "too soon", since the insurance companies will play any game they can not to cover you), you could be denied coverage for the very treatment that will prevent the more expensive downstream effects of untreated apnea.

Yes, it seems pound foolish doesn't it? The insurance company is on the hook for complications of sleep apnea that could cost far more than your treatment for OSA. You'd think they'd be beating down your door to get you on the hose. The only way they'll come out ahead is if the first heart attack or stroke kills you before you get to the hospital, but odds are against that. What are they thinking?

BlackSpinner wrote:

cake321 wrote:

BlackSpinner wrote:What you may want to do is buy a cpap with data capabilities of Craigslist and start treating yourself. Others have done this for the same reason.

Where can you purchase a CPAP without doctors orders?

Craigslist - people sell used machines or if they flunk it they want to get rid of it. Buyer beware - don't hand over money until you have seen it work.

Look up restedGal's posts. She did it all her self. Others on the board have done it too. Educate your self as to the different machines, their names (the pro/plus issues, the "Escape vs Elite terms), the humidifiers, the masks. When you are well into the insurance then just get a doctor, PA or dentist to write you a prescription so you can buy online new stuff.

That is what I did. My GP had never heard of APAP, but was happy to write the scrip once I connected her with an RT who explained how it works. I bought a used machine from secondwindcpap.com, and a new mask from CPAP.com. It cost me about $1000 altogether, including all the little nickel and dime stuff like mask wipes and filters.

My apnea is simple OSA, hence titrating myself was simple too. I did spend some time looking at detailed data, and still do, because I figure someone should do that, and I've never had a sleep study. But basically, I just turned the pressure up until my apnea stopped. While a sleep study is a great diagnostic tool, I'm not sure it would have told me anything I didn't know, and I think I'd still have had to fine tune my titration when I got home anyway. So that was three or four thousand dollars I didn't need to spend, and a month or two I didn't need to wait. You might need polysomnography at some point if your apnea is more complex or you have other problems, but if you're trying to keep costs down, titrating at home with APAP is a good place to start. You can always get fancy later if that doesn't work.