Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test


Frank007FFrank007 Posts: 12
edited 06/11/2012 - 8:45 AM in Back Surgery and Neck Surgery
I need 2-level cervical ADR very soon. I am unemployed with Cobra coverage that is about to expire. As you know most insurers are still refusing to pay for the surgery. Others now seem to cover it. Aetna is one of the ones that do cover adr as a matter of policy(Intervertebral Disc Prostheses).

Unfortunately my Cobra insurer is United Healthcare which does not cover it. I cannot simply purchase an individual policy from an insurer such as Aetna. When I tried I was told that my preexisting condition precluded me from qualifying.

Then I learned of a State of Florida(where I live) HIPAA (Overview Health Insurance Reform for Consumers) program for which Aetna is the provider. Apparently I can purchase the “same” policy that is unavailable to me directly as a “Guaranteed Issue Health Insurance plan”. The only difference is the much higher cost. However I have read that companies selling HIPAA policies will simply place what is called an "Exclusionary Rider" on your policy and/or change the preexisting condition clause in the boilerplate of the policy to exclude your prior medical problems. Here is a great article about this: Florida Health Insurance - preexisting conditions

1. Are they really the same policy? Is there any way I can know ahead of time what is actually covered by my HIPAA Florida Aetna policy before I buy? How can I know for sure if the policy I buy will have any Exclusionary Riders?
The Aetna HIPAA agent could not definitively answer this question. Believe it or not, she told me I would have to purchase the policy in order to then read the details of the coverage! If it turns out that something I need is not covered I have 10 days to cancel the policy and receive a refund. Ten days is not enough time to put in a request for preapproval and wait to see if it’s accepted or denied.

2. Is this a good idea? Am I missing something?


Sign In or Register to comment.