Author: Rida Hassan
Dealing with insurance companies consistently and seeing a way to deny the claims is one of the toughest things about any long lasting illness. In case of fibromyalgia, it is true as many insurance providers are doubtful about it. When you want to get fibromyalgia covered, you need to suppose that insurance provider is finding reasons to negate your claim. So, if you want to get the coverage that you deserve, you have to figure out what you should avoid to say to your insurance provider when you are having fibromyalgia. Why fibromyalgia is not covered by insurance providers? What are the things you should avoid saying in front of them?
Why insurance companies avoid fibromyalgia warriors
In the past, if you have ever talked to an insurance company, you know then that it’s not easy to get them paying out for benefits of fibromyalgia. MONEY is the reason for this. Usually, insurance companies are working by collecting more money in percentages and investments from those percentages. So, keeping in mind all the money that they were taking from you so that you can relax about being able to afford fibromyalgia treatment? It still turns out that they will give preference that you have fibromyalgia. The insurance company will find reasons to negate your claims for something as in disability.
Fibromyalgia is something that doesn’t have any outward symptoms and is easy to negate. And also this disease is different for everyone. Some people are completely disabled if they have fibromyalgia, and some people can still do work. So if you want to get an insurance claim for fibromyalgia, it not just depends on proving that you are having fibromyalgia, but also a severe need for an intensive treatment.
That is the reason why you should know what to say or not to say to your insurance provider when you are having fibromyalgia.
When you make an insurance claim, it is good that you are truthful about your symptoms, and you are so specific about what these symptoms are. An insurance provider can interpret in a way if you leave some space for the interpretation, which denies your coverage. Also, if you try to overstate your symptoms, intentionally or unintentionally, then insurance company will prove that your symptoms are not so worse than you have told and then they will use that to deny you.
So what you say to them and what you avoid saying in front of them are the things you have to be careful about. Following are the examples of things you should avoid when you’re claiming:
I have a hurt everywhere
You face a fair amount of pain on daily basis if you’re having fibromyalgia. But on 18 points in your body specifically, the pain is focused. Technically, the pain doesn’t spread in all over your body (and yet those 18 points amount to the similar thing). But these 18 points are used in diagnosing fibromyalgia by doctors. So if you tell them about the pain other than these 18 points, they will tell you that this is not fibromyalgia.
The pain comes and goes.
Probably, you know that fibromyalgia comes with good days as well as bad days. Or you also know that the pain can be worse than usual with the fibromyalgia flare-ups. But when you say to the insurance provider that your pain comes and goes, he will assume that your illness is not so severe. You are not totally disabled, if there are some days when you are not hurt. So, clear it first that your pain is constant.
I can’t walk around.
Avoid saying this to your insurance provider that you can’t walk. You may have a lot of difficulty while walking and even it can be so much hard for you to go to bathroom. But if you tell them that you can’t walk and then they see you walking, they can declare that you have fake disability and will decide that you were lying to them.
I can’t move out from bed.
Avoid saying this to your provider that you can’t get out from bed or you slept whole day due to pain. The provider will proves that you have spent some day out of the bed, like going to kitchen to get something and they will then use it to deny you.
My doctor doesn’t understand.
A lot of doctors are not so up to date about fibromyalgia. And a lot of doctors don’t know how to treat fibromyalgia effectively. You shouldn’t say this to provider that your doctor doesn’t know how to treat your disease.
An insurance provider always give priority to the doctor’s words when you tell them that you medication is not effective. And the will suppose that you don’t want this treatment that your doctor is recommending it to you. Or they will assume that your symptoms just exist in your head. As a result, they will deny your claim.
Just be honest when you’re telling them about your disease. It will be so risky when you lie about your condition just to make sure that it is covered. And if your claim is valid and still is denied, you can sue. So, just be honest while telling about your fibromyalgia and it will be covered.