Back in July 2021 I started having ear and neck pain, and by September it was unbearable. After going to 3 doctors and my dentist, I was then referred to a maxillofacial surgeon. He diagnosed this as a problem related to my wisdom teeth.
At this stage, I had figured I should get health insurance. Not for the removal of wisdom teeth as I knew this wouldn’t be covered, but more so for future issues. My “anniversary date” for insurance is officially the 15th of October 2021, and this existing condition was under “wisdom teeth” and “ear pain”. I had my teeth removed on the 30th.
About 1 month later (November) the pain started again, and it came back even worse. My maxillofacial surgeon apologised for his misdiagnosis and referred me to a Head and Neck Specialist. I have since had multiple sessions, blood tests and an MRI, and turns out the pain is potentially autoimmune related, causing gland swelling for which I will need surgery.
My insurance provider has declined to cover everything relating to this, which I (very reluctantly) accepted. However, I brought this up with my Head and Neck doctor and he was furious! He disagreed with the premise rejection, that it was a misdiagnosis and re-diagnosed in Jan of 2022 – after my “anniversary”. He has offered to write a letter defending me.
What are your thoughts? Do you think I have a chance of appealing this?
**should add I am not based in the US but I’m assuming the premise of (pre)existing conditions is relatively similar!
submitted by /u/milkinac4n
[link] [comments]Back in July 2021 I started having ear and neck pain, and by September it was unbearable. After going to 3 doctors and my dentist, I was then referred to a maxillofacial surgeon. He diagnosed this as a problem related to my wisdom teeth. At this stage, I had figured I should get health insurance. Not for the removal of wisdom teeth as I knew this wouldn’t be covered, but more so for future issues. My “anniversary date” for insurance is officially the 15th of October 2021, and this existing condition was under “wisdom teeth” and “ear pain”. I had my teeth removed on the 30th. About 1 month later (November) the pain started again, and it came back even worse. My maxillofacial surgeon apologised for his misdiagnosis and referred me to a Head and Neck Specialist. I have since had multiple sessions, blood tests and an MRI, and turns out the pain is potentially autoimmune related, causing gland swelling for which I will need surgery. My insurance provider has declined to cover everything relating to this, which I (very reluctantly) accepted. However, I brought this up with my Head and Neck doctor and he was furious! He disagreed with the premise rejection, that it was a misdiagnosis and re-diagnosed in Jan of 2022 – after my “anniversary”. He has offered to write a letter defending me. What are your thoughts? Do you think I have a chance of appealing this? **should add I am not based in the US but I’m assuming the premise of (pre)existing conditions is relatively similar! submitted by /u/milkinac4n [link] [comments]Read Morer/HealthInsurance