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Friday, July 21, 2017
Print and post everywhere
Print and post everywhere-
The return of pre existing conditions and deniable medications:
The return of pre existing medical conditions and medications:
AIDS/HIV Lupus
Alcohol abuse/ Drug abuse with recent treatment Mental disorders (severe, e.g. bipolar, eating disorder)
Alzheimer’s/dementia Multiple sclerosis
Arthritis (rheumatoid), fibromyalgia, other inflammatory joint disease Muscular dystrophy
Cancer within some period of time (e.g. 10 years, often other than basal skin cancer) Obesity, severe
Cerebral palsy Organ transplant
Congestive heart failure Paraplegia
Coronary artery/heart disease, bypass surgery Paralysis
Crohn’s disease/ ulcerative colitis Parkinson’s disease
Chronic obstructive pulmonary disease (COPD)/emphysema Pending surgery or hospitalization
Diabetes mellitus Pneumocystic pneumonia
Epilepsy Pregnancy or expectant parent
Hemophilia Sleep apnea
Hepatitis (Hep C) Stroke
Kidney disease, renal failure Transsexualism
SOURCE: Kaiser Family Foundation review of field underwriting guidelines from Aetna (GA, PA, and TX), Anthem BCBS (IN, KY, and OH), Assurant, CIGNA, Coventry, Dean Health, Golden Rule, Health Care Services Corporation (BCBS in IL, TX) HealthNet, Humana, United HealthCare, Wisconsin Physician Service. Conditions in this table appeared on declinable conditions list in half or more of guides reviewed. NOTE: Many additional, less-common disorders also appearing on most of the declinable conditions lists were omitted from this table.
Our analysis of rates of pre-existing conditions in this brief focuses on those conditions that would likely be declinable, based on our review of pre-ACA underwriting documents. Our analysis is limited – and our results are conservative – because NHIS and BRFSS questionnaires do not address some of the conditions that were declinable, and in some cases the questions that do relate to declinable conditions were too broad for inclusion. See the methodology section for a list of conditions included in the analysis.
In addition to declinable conditions, many insurers also maintained a list of declinable medications. Current use of any of these medications by an applicant would warrant denial of coverage. Table 3 provides an example of medications that were declinable in one insurer prior to the ACA. Our analysis does not attempt to account for use of declinable medications.
Table 3: Declinable Medications
Anti-Arthritic Medications
Adalimumab/Humira
Cyclosporine/Sandimmune
Methotrexate/Trexall
Ustekinumab/Stelara
others
Anti-Diabetic Medications
Avandia/Rosiglitazone
Glucagon
Humalog/Insulin products
Metformin HCL
others
Medications for HIV/AIDS or Hepatitis
Abacavir/Ziagen
Efavirenz/Atripla
Interferon
Lamivudine/Epivir
Ribavirin
Zidovudine/Retrovir
others
Anti-Cancer Medications
Anastrozole/Arimidex
Nolvadex/Tamoxifen
Femara
others
Anti-Psychotics, Autism, Other Central Nervous System Medications
Abilify/Ariprazole
Aricept/Donepezil
Clozapine/Clozaril
Haldol/Haldoperidol
Lithium
Requip/Ropinerole
Risperdal/Risperidone
Zyprexa
others
Anti-Coagulant/Anti-Thrombotic Medications
Clopidogrel/Plavix
Coumadin/Warfarin
Heparin
others
Miscellaneous Medications
Anginine (angina)
Clomid (fertility)
Epoetin/Epogen (anemia)
Genotropin (growth hormone)
Remicade (arthritis, ulcerative colitis)
Xyrem (narcolepsy)
others
SOURCE: Blue Cross Blue Shield of Illinois, Product Guide for Agents
Time magazine spoke with Kaiser’s associate director Cynthia Cox, who suggested the list could be far more expansive. “There are plenty of other conditions, even acne or high blood pressure, that could have gotten people denied from some insurers but accepted and charged a higher premium by other insurers,” Cox told the outlet.
Here are more illnesses you should magically avoid, lest you run the risk of being monetarily punished for getting sick.
Acid reflux
Acne
Asthma
C-section
Celiac disease
Heartburn
High cholesterol
Hysterectomy
Kidney stones
Knee surgery
Lyme disease
Migraines
Narcolepsy
Pacemaker
Postpartum depression
Seasonal affective disorder
Seizures
“Sexual deviation or disorder”
Ulcers
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