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What is my risk should I opt to accept a health insurance exclusionary rider on uterine fibroids?


Posted by veghealth

I have a uterine fibroid that is about 6.5 cm. My doctor seems to think it's not serious and has not recommended treatment, but he has me get a yearly ultrasound to "keep an eye on it." I am applying for individual health insurance. The underwriter has placed an exclusionary rider on uterine fibroids and fibrocystic breast disease. I can go with this reasonably priced plan and accept the riders or take the same plan without exclusions under HIPAA and double my monthly cost. Sadly, I'm currently out of work and have only a couple of days to make this decision before I'm no longer eligible for HIPAA. Can you offer guidance to help me assess my risk? (Note: I am in Florida)
 
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I assume from your question that your real concern is whether you are likely to incur any medical expenses related to the fibroid in question, since the exclusionary rider would not pay for those costs.  The answer to that depends on your age, your overall health, and whether you have any condition(s) that led to the diagnosis in the first place.  Certainly the yearly exam and ultrasound to "keep an eye on it" would not be covered by insurance.

It seems to me that you should ask two questions:

1.)  How long does the rider last?

     A one year rider is certainly better than three, five, or more years.

2.)  Can I afford insurance WITHOUT the rider?

    If the choice is insurance with the rider for the fibroid or no insurance, you are better off in the long run to have the insurance.

 

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