Does valve choice influence future insurability?

[Andrew01]

I am 41 years old needing an AVR so I have been viewing the site looking at the different arguments for the mechanical vs. tissue valves. While I am leaning towards an On-X mechanical, I am wondering if the choice of valve will influence whether I will be able to qualify for health insurance in the future other than an open enrollment employee plan etc. Will the insurance industry consider the problem ?fixed? if a mechanical valve is implanted or will it foresee enough probability of future complications to render me uninsurable regardless?

If anyone has any experience with this, I would appreciate reading any input.

Thanks,

 

[tobagotwo]

Whatever insurance you have now, keep. Very few companies will write a policy for someone who has had a valve operation (or even has active valve disease). Really exasperating, when you realize that once treated, you have the same lifespan as everyone else.

Never let health or life insurance drop, as you won't get it again, due to the preexisting condition clauses. If you change jobs, make sure the insurance transitions all the way before letting go of your old insurance. COBRA (continuing job-supported insurance after leaving the company by paying on your own) if necessary.

If and when your life insurance offers an "exam-free" insurance level hike choice at your company, take it.

Maybe someone has some good news to share from some insurer on this front. If so, please share, as we'd all love to hear about it.

Best wishes,

 

[Ross]

This is something you really don't want to hear. You have now, even though you've not had it replaced yet, been branded with the term Heart Valve Disease. From here on out and for life, it would be difficult to find someone to insure you or it would be so expensive that it would be cost prohibitive. Hang on to what you have for dear life. Having it replaced or "fixed" will never change this status.

 

[Superbob]

I concur with what Bob and Ross are saying. By all means, hang on to any insurance that you already have. The situation with obtaining new insurance is not logical or fair, but it is what it is. I agree with Bob, if anyone has experience to the contrary with getting new insurance, post-VR, please do share it.

 

[dick0236]

I fully agree with Bob H. and Ross. Heart surgery, regardless of valve type, will cause problems for any new life or health insurance. Life insurance will probably be available, after a while, but at a higher premium. Health insurance will be very difficult to get except thru "guarantee issue" employer plans. With medical costs "exploding", no insurer (as far as I know), would issue a policy knowing the potential for a future major claim.

I was in this business for a long time. I never could find a way to buy it at a favorable cost, if I could find it at all, except thru employer programs. As was advised, DO NOT let life or health coverage lapse UNTIL you have a replacement in place. If this country ever goes to some kind of National Health Insurance this problem of insurability may become less of a problem...but don't hold your breath.

 

[sanmore]

Hi There
Good luck, I had health insurance when I had my mital valve replacement. But after my cobra ended, because of my valve replacement I had a high premium. I was paying 500.00 month with 4,000 deductable. The only way I got this ins I went through what is called hepa, which means i was a high risk,this ins Blue Cross, I did not go through an underwriter, i would have I would have been deined this sucks, I explained that my valve was replaced and had to problems since I had surgery which was about 3years ago. A valve replacement is flagged. Now I do not have ins because we can't afford it anymore. I buy my med which only cost 8.00 for both. Hope every works out for you.
Frances

 

[westie]

southern cross

southern cross

.
my personal experience is you can get health cover for existing heart and other problems if you have access to a large industry scheme.

i had no health insurance when i was diagnosed with mitral valve prolapse etc and mrs westie jumped up and down and told me we were going to sort out health insurance for both of us.

my industry body has a group scheme with southern cross ( a co-operative health company ) and 4 months before my operation i got full cover for nz$175 per month, with cover for declared pre existing illnesses, heart and skin cancer, subject to a 3 year standdown. this scheme covers all doctors, specialists, xray, operations etc etc.

from september 2010 i will be fully covered for all heart problems; oh how i wish i could have delayed surgery till then!

obviously i had to take one of the most exspensive schemes to qualify for existing illness cover, mrs westie who is 40 got full cover for nz$55 per month.

so the point of all this is give it a go; if you are a member of a big trade body or have access to a big company scheme, make inquiries, you might be in luck.

 

[bahlvarun]

Here is the deal for you.

1. Type of Heart valve (Prosthetic or not) will definitely involve the premium amount.
2. You'll mostly be excluded from any replacement unless its part of the scheme from your employer.
3. Please do not loose any coverage you have as this may render you without any insurance in the future.

Hope this would clear some doubts for you

 

[pamela]

It's really unfair when you consider that my valve surgery disqualified me for disability benefits under my mortgage life insurance policy but when my mortgage was renewed (as we all know happens frequently over the amortization period) my life insurance policy was amended to only include the principal amount and that amount will only be paid when I die. I was disqualified for disability insurance, which I'd been paying for 10 years. Can you say Catch 22 Mr Heller?

With that kind of attitude, no wonder Canadian banks still show substantial profit even in the midst of a global recession.

 

[Jkm7]

Who ever promised us fair? Is there 'fair' in life?

I'm not trying to be rude or fresh mouthed, it's just reality. Sadly.

 

[Ross]

Who ever promised us fair? Is there 'fair' in life?

I'm not trying to be rude or fresh mouthed, it's just reality. Sadly.

It's not. Who ever dies with the most money wins!

 

[skeptic49]

We may get some help with this if health care reform is passed by Congress later this year and includes coverage options for pre-existing conditions. I believe the bill written by Sen. Kennedy provides this coverage. Obviously, this is not certain at this point.

Jim

 

[sue943]

For those in the UK with private health insurance it is worth checking to ensure that you are still covered. I found that BUPA stopped permitting any claims for annual cardiac checks and related tests as they said that they only cover acute or new issues, not chronic conditions. If I developed a completely different heart problem, unrelated to my valves then they might entertain the claim.

Also they won't cover any additional costs for treatment unrelated to a chronic condition so if for instance I needed surgery which involved them taking me into hospital earlier and discharging later than a 'normal person', and consultations with say my cardiologist then they would only pay what a person without a chronic condition would pay. So if the treatment would normally be done on a daycase then that is what they would pay.

Effectively this meant that I was paying for nothing as I couldn't afford to pay the additional charges myself so wouldn't be able to use private health insurance. I gave up my private health insurance so saved myself over £2,000 per year.

I hasten to add that this relates only to the UK, and other parts of the British Isles and you need to check your policies, or with your insurer. Obviously for us it is only a case of having to 'go public' so we lose the nice rooms and better food. I will still see the same cardiologist as before, still have the same tests performed by the same technicians and if further cardiac surgery is required will be sent to the UK and will probably have the same surgeon as before - just free.

 

[Jkm7]

There is no free healthcare, is there?
It's just a question of through which route we pay for it.
Pay private insurance premiums, pay doctors, hospitals etc privately or
pay through taxes. We all pay for our healthcare with our hard earned dollars.... unless independently very wealthy.

 

[pamela]

Ok... I guess my post came across as self-centred but apart from my using the broader we, us and yous guys I was simply projecting a personal spin on a situation where some families really suffer great loss.

It's unfair and sad and no, I don't expect anything out of life other than what I put into living it. Rest assured, your fresh mouth has made me realize that I have moved forward and maybe I should find better words to encourage others to go that way as well...


sheesh... spearmint toothpaste, casanova breath spritzes ... fresh indeedy.

 

[ALCapshaw2]

It's not. Who ever dies with the most money wins!

I thought the expression was
"Whoever does with the most Toys wins".

Then there is the guy who said
"I hope my Last Check (Cheque for the UK readers) Bounces"

 

[Jkm7]

Pamela..... I meant my comment as a general statement and in no way specific to you or anyone. We all recognize each of us have 'life done to us' in one way or another and No, it is not fair that this is being done to you. I agree it isn't fair but I, seemingly unfeelingly, dismissed this concern of yours. I was thinking in the broad sense and not individually. Sorry.

 

[Lorimacm]

Good question. I did not think about that yet, but now I see that this can definitely be an issue. Thanks for asking the question!