Hypothetically Speaking

[lorrieduke]

My sis and I are having a debate. I'm sure I'm right here's the question..

Hypothetically, let's pretend someone (her) has had individually purchased medical insurance and while covered was diagnosed with a health condition. This condition required her to take meds all of which she side stepped her insurance company and paid for them herself.
Now, she's going to switch to a new provider and doctor. She is also applying for supplemental disability insurance through a separate company. This company has a one year waiting period for preexisting conditions but she's not going to disclose her preexisting condition to the supplemental insurance company because in her words, "how will they find out."
Well, how would they find out? I mean she kinda makes sense because she'll have a new doctor to go with her new insurance and since she paid for her prescription meds herself, it's not going to be in the prescription reporting companies database should they run a prescription report on her.

 

[rousemark]

My sis and I are having a debate. I'm sure I'm right here's the question..

Hypothetically, let's pretend someone (her) has had individually purchased medical insurance and while covered was diagnosed with a health condition. This condition required her to take meds all of which she side stepped her insurance company and paid for them herself.
Now, she's going to switch to a new provider and doctor. She is also applying for supplemental disability insurance through a separate company. This company has a one year waiting period for preexisting conditions but she's not going to disclose her preexisting condition to the supplemental insurance company because in her words, "how will they find out."
Well, how would they find out? I mean she kinda makes sense because she'll have a new doctor to go with her new insurance and since she paid for her prescription meds herself, it's not going to be in the prescription reporting companies database should they run a prescription report on her.

Is she going to hide her medical history from her new doctor?

 

[lorrieduke]

Is she going to hide her medical history from her new doctor?

She says yes. Lol I know, I know!

 

[WinoBlues]

Somebody wrote the script and she used it to buy the meds.

 

[Newby]

My sis and I are having a debate. I'm sure I'm right here's the question..

Hypothetically, let's pretend someone (her) has had individually purchased medical insurance and while covered was diagnosed with a health condition. This condition required her to take meds all of which she side stepped her insurance company and paid for them herself.
Now, she's going to switch to a new provider and doctor. She is also applying for supplemental disability insurance through a separate company. This company has a one year waiting period for preexisting conditions but she's not going to disclose her preexisting condition to the supplemental insurance company because in her words, "how will they find out."
Well, how would they find out? I mean she kinda makes sense because she'll have a new doctor to go with her new insurance and since she paid for her prescription meds herself, it's not going to be in the prescription reporting companies database should they run a prescription report on her.

Tell her she doesn't need to lie anymore. Obamacare is here to make an honest woman out of her.

Problem solved.

Except for the problem about your sister being a lieing sack-O-$h1T

 

[benefits365]

The answer to your question is called an APS.

That stands for "attending physician statement".
I
The insurance company may order one of these prior to issuing the policy.
Or, they may not. And if she ever files a claim, they will deny the claim, as she withheld "material information".

They can and will find out if they wanna. Lying is probably the worst thing you can do. Not because its dishonest, although that is bad. But because the insurance company now gets a free ride on you. If you never file a claim: great! They just cash your check. If you ever need the insurance, they'll bail in you because you lied.

Do. Not. Do. It. You will not win. Multi million dollar insurance companies don't lose because you thought of something they haven't.

And, as if that isn't enough: prescription drug checks are NOT based on whether you use insurance or not. They use name, dob, ss#, an other identifying characteristics. The fact that you didn't use insurance to pay does NOT circumvent the system.

And finally, doubly disappointed that someone thought they could "game" the system with such a basic scam. Really?!? An insurance company never thought of this?!?! C'mon!

 

[lorrieduke]

The answer to your question is called an APS.

That stands for "attending physician statement".
I
The insurance company may order one of these prior to issuing the policy.
Or, they may not. And if she ever files a claim, they will deny the claim, as she withheld "material information".

They can and will find out if they wanna. Lying is probably the worst thing you can do. Not because its dishonest, although that is bad. But because the insurance company now gets a free ride on you. If you never file a claim: great! They just cash your check. If you ever need the insurance, they'll bail in you because you lied.

Do. Not. Do. It. You will not win. Multi million dollar insurance companies don't lose because you thought of something they haven't.

And, as if that isn't enough: prescription drug checks are NOT based on whether you use insurance or not. They use name, dob, ss#, an other identifying characteristics. The fact that you didn't use insurance to pay does NOT circumvent the system.

And finally, doubly disappointed that someone thought they could "game" the system with such a basic scam. Really?!? An insurance company never thought of this?!?! C'mon!

Actually you are wrong.. Insurance companies use third party companies such as Argus to process prescriptions for their customers. They are called "Pharmacy Benefit Managers" and they supply prescription reporting companies like "Intelliscript" with prescription info on Insurance company members. That information is electronically supplied to a member company for a fee and is use to weed out fraud.
You, are the liar and should really have the facts before spewing off at the mouth.
By the way, no APS will be required since it's guarantee issue. Dick.

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Tell her she doesn't need to lie anymore. Obamacare is here to make an honest woman out of her.

Problem solved.

Except for the problem about your sister being a lieing sack-O-

Uh, I wasn't asking a question about "medical insurance." Obamacare will not affect supplemental disability insurance. You guys on here are really ignorant. I'm doubly disappointed.

 

[WinoBlues]

Just to be clear, are you defending your sister lieing ?

Actually you are wrong.. Insurance companies use third party companies such as Argus to process prescriptions for their customers. They are called "Pharmacy Benefit Managers" and they supply prescription reporting companies like "Intelliscript" with prescription info on Insurance company members. That information is electronically supplied to a member company for a fee and is use to weed out fraud.
You, are the liar and should really have the facts before spewing off at the mouth.
By the way, no APS will be required since it's guarantee issue. Dick.

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Uh, I wasn't asking a question about "medical insurance." Obamacare will not affect supplemental disability insurance. You guys on here are really ignorant. I'm doubly disappointed.

 

[anonymous1]

Usually in the discloser of the applications it says it will not pay for any conditions that a normal prudent person would have sought medical attention for with in the last year to 5 years depending on the company. So they will not pay out they'll check the health history. Insurance companies are not in the habit of loosing money

 

[lorrieduke]

I became upset when debenefits365 didn't tell the truth. You guys on here are quick to judge because my sister wants to lie but yet, debenefits365 lied. That's the pot calling the kettle black and a lie is a lie.
But my moral compass, regardless of which way it points is not your concern.

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Usually in the discloser of the applications it says it will not pay for any conditions that a normal prudent person would have sought medical attention for with in the last year to 5 years depending on the company. So they will not pay out they'll check the health history. Insurance companies are not in the habit of loosing money

Thank you anonymous1.