Chronic low back pain

toc3 · 09-09-2008, 03:15 PM

I have a prospect that has been turned down by bcbs and aetna due to low back pain in which she has been prescribed hydrocodone. United HealthOne is my last option. Any agents familiar with Arkansas? Any suggestions?

somarco · 09-09-2008, 03:29 PM

Back pain can be ridered (at least by carriers that do that). The hydrocodone is an issue. Good chance UHC will turn her down as well but do a pre-screen and save some time.

Mr. Bill · 09-09-2008, 05:33 PM

I know this doesn't answer your question, but a very good friend of mine who has a very severe back injury is able to manage it with hypnosis. When he had the accident, it just led to a whole lotta problems and he got a referral to a hypnotherapist/MFCC through his EAP program. Might be something for her to look into.

mariemerganser · 09-09-2008, 06:40 PM

I just had one approved with Golden Rule (United Healthone). The girl was taking Vicodin on a daily basis to relieve pain from a back surgery 7 years ago. They accepted her, gave her a standard rating, and excluded her back. It is what it is.

InsuranceBenefitsGroup · 09-09-2008, 07:46 PM

Carriers aren't too crazy about opiates or opioids. The term 'pain management' usually is an indicator. The underwriters feel that the prospect is an increased risk due to the relaxed state they are in...mix it with a few beers and you're blotto! UHC has more liberal underwriting than most carriers...give them a try.

somarco · 09-09-2008, 09:24 PM

The concern with pain management is the very real possibility of addiction. I have had very limited success getting folks covered who are taking serious pain meds.

joshril · 09-09-2008, 11:46 PM

What about Aetna? Pre-screens are your friend in these situations...

indmedins · 09-10-2008, 08:41 AM

Originally Posted by somarco

The concern with pain management is the very real possibility of addiction. I have had very limited success getting folks covered who are taking serious pain meds.

I know there is more to it than I am mentioning here, but it's not like IFP plans pay much for mental health anyway. If they need to go to rehab, most plans do not provide for much benefit.

I guess, underwriting worries more about accidents deriving from intoxication or kidney failure while using narcotics.

somarco · 09-10-2008, 11:20 AM

Doesn't really matter about psych benefits which, as you have said, pay very little any way.

There are potential physiological issues which can be expensive to treat that are covered under the medical side of the plan.

toc3 · 09-10-2008, 11:25 AM

Pre screen with Aetna and was also rejected. UHC is my last hope.

TXINSURANCE · 09-10-2008, 01:46 PM

Aetna doesn't rider which means for sure decline.