If you’re a woman and you have health insurance or are contemplating getting health insurance, here’s an important question to think about. When you think of the term “pre-existing” condition, what comes to mind?

These days it’s probably diseases like diabetes, as well as health problems such as high cholesterol, excess weight, and the like. Serious health problems, diseases that can seriously impact on your quality of life, can require expensive or ongoing treatment — right? Yes…but that’s not all. And you might be shocked to find out what, for women, constitutes a pre-existing condition.

One Woman’s Unexpected Health Costs

In 2001, Jacqueline Ruess received surgery to remove a suspected ovarian tumor. Thankfully, that tumor wasn’t as dangerous as her doctors had first thought.

However, there was an additional problem in the works. Ruess subsequently found out that the surgery, which with hospital and doctor bills came to more than $15,000, was not covered by her insurance. Worse, she found out that she had never been covered for gynecological problems—and she had never even known!

So what happened here? Did she have a major pre-existing condition such as prior cancer, endometriosis, or polycystic ovary syndrome? A potentially serious health issue of any kind?

Nope. She had one instance of irregular periods—an extremely common (and usually inconsequential) issue which affects up to 30% of women at some point during their reproductive years.

The Health Insurance Company’s Side of the Story

The company that managed her insurance policy claimed that because her doctor had once noted an instance of “dysfunctional uterine bleeding” (a fancy way of saying irregular menstruation), she was ineligible for any gynecological cover.

At the time her doctor made that notation Ruess was under heavy emotional stress (a common cause of irregular periods), and her doctor had also noted that there was nothing medically wrong with her. So when her insurance policy application asked about abnormal menstruation she didn’t note down that single instance, simply because her doctor had said there was no underlying medical issue.

Now, there is no doubt that this is standard insurance company practice, and if you hold back on pre-existing condition information, and you’re found out, you will lose your cover — no matter how inconsequential you think that information is.

This specific instance might be a case of insurance companies gone wild, but the message is still the same basic cautionary tale: don’t hold back any information.

Unfortunately for women like Jacqueline Ruess, it’s sometimes too late to remedy the situation. In a final ironic kicker, the insurance company claimed she owed them several hundred dollars because her premiums would have been higher had she noted the information in her application.

photo credit: CJ Sorg