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Possible Insurance Issue For Celiacs Disease?

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Hello all, this is my first post.

A few weeks ago my mother was diagnosed with Celiacs disease. While there is no major weight loss, for as long as I can remember I have had gastrointestinal issues (primarily chronic loose and often floating stool, sorry if this is TMI) and fatigue, which I found out are some of the major symptoms of Celiac. These symptoms seem to worsen when I eat consume wheat products, so I am trying a gluten-free diet for the next month or so to see if anything improves before I actually get tested, if I get tested at all. I am concerned about getting tested due to insurance issues. I am soon be 21 and while I am currently under my parents insurance, that will end when I turn 23 and I will have to get my own insurance through whatever job I have then. Does anyone know that if diagnosed, Celiac would be considered a pre-existing condition, where I could be turned down for insurance coverage? Has anyone here had a similar situation like this or any experience with Celiac disease and insurance issues? Please let me know, and please give me some direction.

Thank you,


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Firstly, if you go gluten-free even for a week or 2 and then get tested they may ALL come back negative (a false negative). You DO NOT want that. So if you want to get tested you MUST keep eating gluten. Do not stop. Or it ruins the tests. They would be useless.

Secondly, I am sure each insurance carrier has different rules about PECs. You might call several of the larger ones and ask it Celiac would be considered a PEC.

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If you are getting insurance through an employer, then it is (almost?) always open to ALL employees - shared risk. It includes healthy and the less healthy. You can't be turned down if it is a group health plan that is offered to all employees.

If you are continuously covered by insurance, you can usually provide proof of coverage (dating back to a certain point depending on the plan) to prove you were insured, and then, its often covered. However, all plans are different - some don't require any proof of coverage/don't ask about pre-existing conditions/past insurance coverage on pre-existing conditions.

See info here - it helps explain better than I can (particularly title 1) http://en.wikipedia.org/wiki/Health_Insura...ountability_Act

The moral of the story is to NOT let your health insurance lapse (see the 63 day rule) - even if it means buying a less than ideal insurance to tide you over in between insurance 1 and insurance through your job. Always keep your paperwork.

If you plan to be tested for Celiac, do it BEFORE you start the diet.

And, welcome to the board.

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If the gluten-free diet works, do it and don't worry about a diagnosis. What difference will it make? My Hubby sells ins and it is a pre existing disease, an autoimmmune disease. Your mom's diagnosed you know that you are having problems. If the diet works continue and pray you never have problems because you started the diet early. You have a long future ahead of you to add insurance worries. No diagnosis no denials. My son just had to get his own insurance, he has crohns disease. What a hassel. He ended up working for the college and has an excellent insurance but it will always be a concern for him.

God bless


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Yes, and ask if celiac is pre-existing, how that impacts coverage for other things? Like blood tests for malabsorption or checking levels of nutrients. Ask if this diagnosis will exclude any other autoimmune condition?

Once you are diagnosed celiac, the current treatment is diet. Sometimes a follow up blood test and or biopsy is done after going gluten-free to make sure things are healing. The malnourishment could possibly be considered due to celiac, but the treatment of supplements is likely not going to be covered anyway. If you get shots of B12 and stuff they might be covered; mine aren't.

If you are following the diet carefully and are not getting well, I would think that the doctor wouldn't say it is due to celiac--he or she would be looking for another cause.

In addition, the doctor can be careful about the diagnosis code if he knows your situation.

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