My husband and I applied for long term care insurance. We did the medical questionnaire and waited for what we thought would be good news from the insurer – we hoped to get their “preferred” rates, since we both have excellent health. The insurer came back and said they’d give my husband “standard” rates (higher than the “preferred” rates) because he had degenerative joint disease and took medication for it last year. There never was such a diagnosis. He had an issue with his wrist – which he determined to be caused by many miles of cycling, leaning down on the handlebars of the bike.
I think the doctor’s office just put the wrong diagnosis. What should we do? Are we stuck with paying higher rates for long term care insurance even though he does not have any joint diseases?
Dear Missed Diagnosis,
You are entering the wild and wooly world of medical coding, where a single missed number can wreak havoc. (Cue the eerie music.)
Your best bet is to contact the doctor’s office and explain what has happened. They may be willing to adjust his diagnosis, especially if his symptoms have resolved and they do not expect more deterioration.
The agent for the long term care insurer should explain to you how to “appeal” the rating decision. The insurer may accept a letter from the doctor’s office, or may provide a form.