Pre-existing condition.....???

spinn

Active member
This post may seem paranoid but I am not sure how to handle it and need to be careful.

I have been telling anyone that would listen for twenty years that I feel absolutely horrible and need help. Every doctor I saw said I was fine and my parents said "its just depression". I know the difference and always knew my issues are legitimate.

No dr has ever really told me anything was wrong because my numbers are within range. As we all know.....being at the low end of the testerone range is not healthy. There has been high cholesterol for a while but that was only mildly addressed.

After seeing numerous drs who said I was fine, I eventually lost the ability to work and then lost my insurance.

I have just started up insurance which I put on a credit card. I am now with Kaiser Permanente.

My question is....if I tell drs at Kaiser that I have felt lousy for years....can they then turn around and deny me care because I felt bad before I had insurance with them?

Keep in mind I have never been officially diagnosed with anything anything other than high cholesterol. I ask this becasue I just got a recent round of tests with several problems and want to tell them the whole story.

I am very concerned about this.
 
spinn said:
This post may seem paranoid but I am not sure how to handle it and need to be careful.

I have been telling anyone that would listen for twenty years that I feel absolutely horrible and need help. Every doctor I saw said I was fine and my parents said "its just depression". I know the difference and always knew my issues are legitimate.

No dr has ever really told me anything was wrong because my numbers are within range. As we all know.....being at the low end of the testerone range is not healthy. There has been high cholesterol for a while but that was only mildly addressed.

After seeing numerous drs who said I was fine, I eventually lost the ability to work and then lost my insurance.

I have just started up insurance which I put on a credit card. I am now with Kaiser Permanente.

My question is....if I tell drs at Kaiser that I have felt lousy for years....can they then turn around and deny me care because I felt bad before I had insurance with them?

Keep in mind I have never been officially diagnosed with anything anything other than high cholesterol. I ask this becasue I just got a recent round of tests with several problems and want to tell them the whole story.

I am very concerned about this.
Click to expand...

GEt a new dr and examine your endocrine system mainly thyroid issues. many people go undiagnosed for several years. MY gf works at mayo clinic and they are the best in the US but i got her test back and looked over it. Her thyroid was was just one number above the lowest range of t4, ferritin levels were 20, liver enyzmes off the charts, but they said she was normal..I flipped my stack when i heard this. i put her on a tightly regimineted diet and still not losing weight and I was banging my head against the wall why. It was her thyroid behind it the whole time. I am working on correcting her thyroid with natural supplements and bumping up her iron intake...
 
Thanks for the response...but for this post I am just trying to make sure that I do not say anything that will allow them to classify my condition as pre-exixting.

Am I being paranoid?
 
spinn said:
Thanks for the response...but for this post I am just trying to make sure that I do not say anything that will allow them to classify my condition as pre-exixting.

Am I being paranoid?
Click to expand...

I had same thing. I called the previous dr and got the diagnostic codes. You can not have the same pre existing diagnosisi for one year prior thats for blue cross blue shieild. My current dr made new diagnosis and used new codes that way new insurance can not ever deny you. You need to consult with the dr to make him aware of this and he can work with you.

Example
low testosterone = erectile dysfunction
my personal opinoin would be checked for blood sugar imbalnces if nothing is found. Glucose tolerance test will reveal it and it revealed hidden reactive hypoglycemia for me and 3 of my clients I sent to have it done and drs could not find anything wrong with them either. Well they finally got there answer. Im sure this is only part of the puzzle because they have never had thorugh hormone testing done and that is the next step the cortisol salvia and I am sending them to my current dr that like dr john leaves no stone unturned..
 
Youre good. Just got my Glucose and it is 101 range 70-99. Triglycerides are 200 and top of range is 150.

So basically anything I was diagnosed with in the past year will not be covered. I wonder how they handle it if I wasnt insured...anyway that is still encouraging.
 
Clincial hypothryoid and glucose intolerance/ inuslin resistance are staring right at you..You got 2 of the 4 identifiers look at total cholesterol and then hdl and you may have your answer. reasearch syndrome X I bet your dhea is in crapper too and your free cortisol level may be high !! First - 2nd stage of adrenal fatigue. It technically one year from date of when you where last diagnosed. I would be more concerned with diagnosis codes that matter not if you had insurance or not.
 
spinn said:
This post may seem paranoid but I am not sure how to handle it and need to be careful.

I have been telling anyone that would listen for twenty years that I feel absolutely horrible and need help. Every doctor I saw said I was fine and my parents said "its just depression". I know the difference and always knew my issues are legitimate.

No dr has ever really told me anything was wrong because my numbers are within range. As we all know.....being at the low end of the testerone range is not healthy. There has been high cholesterol for a while but that was only mildly addressed.

After seeing numerous drs who said I was fine, I eventually lost the ability to work and then lost my insurance.

I have just started up insurance which I put on a credit card. I am now with Kaiser Permanente.

My question is....if I tell drs at Kaiser that I have felt lousy for years....can they then turn around and deny me care because I felt bad before I had insurance with them?

Keep in mind I have never been officially diagnosed with anything anything other than high cholesterol. I ask this becasue I just got a recent round of tests with several problems and want to tell them the whole story.

I am very concerned about this.
Click to expand...


Your rights vary from state to state. Under HIPAA, the insurance carrier can exclude a pre-existing condition for up to 12 months, but that is subject to an involved set of conditions (what type of plan were you covered under b4, how long were you covered, how long is the gap in coverage, etc.)

Many states have enacted their own laws that operate along side of HIPAA. For example, in California, carriers can only exclude pre-existing conditions for 6 mos in most cases.

The above is an extremely general statement of the situation. In reality, the picture is pretty cloudy because the rules and their application are so complicated.
 
My DHEA is 1.1 range 0.5-2.3 done by urine test. My estradiol is 2.0 range 0.5-2.0 (too high and a concern).

My temps are generally steady in low 97s although often lower during stress. Temps do not vary much during day so adrenals seem ok. I am taking low dose of Armour but hoping to increase soon.

The dr who gave me ARmour is not covered by insurance so I if they dont recognize him I doubt they will ever know.

This is actually encouraging insurance wise. Every conventional dr I see says "Its just depression, but watch that cholesterol". No dr has diagnosed me with anything.
 
spinn said:
My DHEA is 1.1 range 0.5-2.3 done by urine test. My estradiol is 2.0 range 0.5-2.0 (too high and a concern).

My temps are generally steady in low 97s although often lower during stress. Temps do not vary much during day so adrenals seem ok. I am taking low dose of Armour but hoping to increase soon.

The dr who gave me ARmour is not covered by insurance so I if they dont recognize him I doubt they will ever know.

This is actually encouraging insurance wise. Every conventional dr I see says "Its just depression, but watch that cholesterol". No dr has diagnosed me with anything.
Click to expand...

Estrogen drive insulin and vice versa
hypothyroidism witho out adrenal fatigue will cause elevated cholesterol.
Estrogen going to alter t4 to t3 conversion over time will cause free cortisol/testosterone to drop due to increasing cortisol binding hormone which is rarely tested. your thyroid binding hormone is probably also elevated clogging up the thyroid even more. As you can see its one vicious cycle !! Which needs to be choked off from 2 sides, Controling estrogen and treating under active thyroid will also help to correct the cholesterol problem. I have seen cholesterol drop 30-40% when thyroid properly adjusted and all other imbalnaces corrected

Priority exam lifestyle and make changes to reduce stressful situations. Your profile is that of some one that is dealing with a phyiscal or mental trauma. Go back to when you were first feeling bad and to see if you can find the trigger (mental phyiscal chemical) and work from there. If you have unsolved issue mentally you can not just sweep it under the rug because that information is implanted into DNA and is transfered from cell to cell and over time. IT builds up and one day wacks us so hard it knocks us on our ass and all it takes is one trigger to do it..

1. address thyroid/estrogen/insulin imbalances
2. Check for underlying adrenal prblems via salvia or cortisol testing.
3. check testosterone/free test/shbg/estrodia/ferrtin/ft3/ft4/tbg
4. Check homocystein its probably above 9 or more and need TMG, b-12, folic acid this will also help to metabolism the estrogen. Add in 60 mgs zinc with 2 mgs of copper a day for now
5. with estrogen problems check serum copper they usually go hand and hand.
6. Bump up magensium glycinate to 400-600 before bed with 30 mgs zinc this will help to aid in anxiety and mental exhaustion
 
spinn said:
This post may seem paranoid but I am not sure how to handle it and need to be careful.
Click to expand...

Just find friendly doctor, preferably ostheopath, and ask him to do blood test listed below.
If you are near zip code 07410, you are in luck.
Latter, with your tests in hand he could take a next step, and get you right treatment (possibly).
Below blood tests I will give you some ICD-9 codes, they are diagnostic codes, if they are right your insurance will most likely pay at least for the blood test. Make your doc put all of them (and more) on your script for the blood test.
Post here any new ICD-9 numbers that you will learn in the process.
Post your complete test here, plus any medicine or supplements you were taking , plus your complaints.
Do the tests at Quest Diagnostisc, you can find close one here:
Patient Service Centers
Invalid Link Removed
.
Complete metabolic Panel
Hepatic Function Panel
Lipid Panel
CBC

Total Estrogens
estrone
Estradiol, sensitive
Progesterone
Pregnenolone
Total Testosterone
Free Testosterone (calculated)
Bio-available Testosterone (calculated)
Albumin
sex hormone–binding globulin (SHBG), serum
DHT (dihydrotestosterone)
Hematocrit
prolactin, serum
FSH (3rd Generation)
LH
Thyroid Stimulating Hormone (TSH)
Free (T3) triiodothyroxine
Free T4
Total T4
Total T3
DHEA Sulfate
Cortisol, AM/PM
SOMATOMEDIN C (IGF-1)
IGF-BP3
C-reactive protein (high-sensitivity)
Fibrinogen
Hemoglobin A1C
Lp(a)
Bilirubin
AST (SGOT)
ALT(SGPT)
VLDL
Homocysteine
Insulin, fasting
Glucose, plasma
Magnesium
Vitamin D, 1, 25-Dihydroxy
Folate
Vitamin A
Ferritin
B12, selenium, zinc, copper
Free PSA
FreePSA/Total PSA
aldosterone
Estradiol, Bioavailable
=================================
Invalid Link Removed
257.2 Other testicular hypofunction
272.4 Other and unspecified hyperlipidemia
601.9 Prostatitis unspecified
780.4 Dizziness and giddiness
780.79 Other malaise and fatigue
788.41 Urinary frequency

Invalid Link Removed
255 Disorders of adrenal glands
For coding adrenal fatigue, I just use the code for Other Specified Disorders of the Adrenal Glands - which I call Adrenal Fatigue
255.8 Other specified disorders of adrenal glands
http://anabolicminds.com/forum/male-anti-aging/56511-hgh-insurance-coverage.html#post685212
Dr. John 12-17-2006, 06:25 AM
ICD-9 253.3 Adult Onset Growth Hormone Deficiency
.
 
JanSz said:
Just find friendly doctor, preferably ostheopath, and ask him to do blood test listed below.
If you are near zip code 07410, you are in luck.
Latter, with your tests in hand he could take a next step, and get you right treatment (possibly).
Below blood tests I will give you some ICD-9 codes, they are diagnostic codes, if they are right your insurance will most likely pay at least for the blood test. Make your doc put all of them (and more) on your script for the blood test.
Post here any new ICD-9 numbers that you will learn in the process.
Post your complete test here, plus any medicine or supplements you were taking , plus your complaints.
Do the tests at Quest Diagnostisc, you can find close one here:
Patient Service Centers
Invalid Link Removed
.
Complete metabolic Panel
Hepatic Function Panel
Lipid Panel
CBC

Total Estrogens
estrone
Estradiol, sensitive
Progesterone
Pregnenolone
Total Testosterone
Free Testosterone (calculated)
Bio-available Testosterone (calculated)
Albumin
sex hormone–binding globulin (SHBG), serum
DHT (dihydrotestosterone)
Hematocrit
prolactin, serum
FSH (3rd Generation)
LH
Thyroid Stimulating Hormone (TSH)
Free (T3) triiodothyroxine
Free T4
Total T4
Total T3
DHEA Sulfate
Cortisol, AM/PM
SOMATOMEDIN C (IGF-1)
IGF-BP3
C-reactive protein (high-sensitivity)
Fibrinogen
Hemoglobin A1C
Lp(a)
Bilirubin
AST (SGOT)
ALT(SGPT)
VLDL
Homocysteine
Insulin, fasting
Glucose, plasma
Magnesium
Vitamin D, 1, 25-Dihydroxy
Folate
Vitamin A
Ferritin
B12, selenium, zinc, copper
Free PSA
FreePSA/Total PSA
aldosterone
Estradiol, Bioavailable
=================================
Invalid Link Removed
257.2 Other testicular hypofunction
272.4 Other and unspecified hyperlipidemia
601.9 Prostatitis unspecified
780.4 Dizziness and giddiness
780.79 Other malaise and fatigue
788.41 Urinary frequency

Invalid Link Removed
255 Disorders of adrenal glands
For coding adrenal fatigue, I just use the code for Other Specified Disorders of the Adrenal Glands - which I call Adrenal Fatigue
255.8 Other specified disorders of adrenal glands
http://anabolicminds.com/forum/male-anti-aging/56511-hgh-insurance-coverage.html#post685212
Dr. John 12-17-2006, 06:25 AM
ICD-9 253.3 Adult Onset Growth Hormone Deficiency
.
Click to expand...

Just got the insurance bill for those tests $5200 lab charges they get 1150 of it
 
spinn said:
Thanks for the response...but for this post I am just trying to make sure that I do not say anything that will allow them to classify my condition as pre-exixting.

Am I being paranoid?
Click to expand...
Don't say anything and when you see the Dr. tell him this just started if you tell him you have see many Dr.'s and felt like this a long time he may think you are depressed. Just start fresh.
 
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