When there is an underlying disease or other conditions are present at the time of the patients office visit This is termed?

Can I be denied health insurance if I have a pre-existing condition?

If you are enrolled in a plan since 2010, then your insurer can’t legally deny you coverage or charge you higher premiums because you have a pre-existing condition.

The Affordable Care Act, passed in 2010, made it illegal for insurers to deny you coverage or charge high rates for pre-existing conditions. Additionally, if your health changes and you develop a chronic medical condition while enrolled in a health plan, your insurance carrier cannot raise your rates because of that medical condition. However, annual premium increases may apply to your plan for other reasons.

If, however, you are enrolled in a plan that started before 2010, you have a “grandfathered plan”. These plans can cancel your coverage or can charge you higher rates due to a pre-existing condition.

If you are exploring coverage options, it’s important to be aware of any potential changes to health care law that could impact how pre-existing conditions are covered.

Is pregnancy considered a pre-existing condition?

If you get pregnant before enrolling in a health plan, you cannot be denied coverage or charged more due to pregnancy. Coverage for pregnancy and delivery begins from the day you enroll in a plan.

Is there health insurance for pre-existing conditions?

Choosing a health plan is no longer based on the concept of a pre-existing condition. A health insurer cannot deny you coverage or raise rates for plans if you have a medical condition at the time of enrollment. However, there may be health plans that are a better fit for you than others if you have a chronic, or pre-existing, medical condition.

For example, if you need regular medical care, surgeries, or treatments, then a plan with a little higher monthly premium and lower deductible may provide you with the coverage you need and help you manage more predictable costs.

Could my health plan have a pre-existing condition waiting period?

No. There are no waiting periods for medical plans, including for pre-existing conditions.

When choosing a health plan, consider your medical needs. If you have a chronic or ongoing medical condition that requires more frequent care, those needs could affect the type of plan you choose, but you cannot be denied coverage or charged more due to a pre-existing condition.

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CDC's new COVID-19 by County community level recommendations do not apply in health care settings, such as hospitals and nursing homes. Instead, health care settings should continue to use CDC's COVID Data Tracker community transmission rates and continue to follow CDC and MDH's infection prevention and control recommendations for health care settings.

Updated 7/22/20

Based on currently available information and clinical expertise, older adults and people of any age with serious underlying medical conditions appear to be at higher risk for severe illness with COVID-19. In a recent report of 7,162 laboratory-confirmed cases of COVID-19 in the U.S., one or more underlying health conditions or risk factors were present in 38% overall and in 78% of those requiring ICU admission.(1) Among 1,482 patients hospitalized with COVID-19, the most commonly reported conditions were hypertension (49.7%), obesity (48.3%), chronic lung disease (34.6%), diabetes (28.3%), and cardiovascular disease (27.8%).(2) Refer to CDC: People with Certain Medical Conditions for more information on underlying conditions and the risk of severe illness from COVID-19.

On this page:
High-risk conditions
Other medical conditions that may increase the risk of severe illness
Pregnancy
Clinical recommendations for health care providers
References

High-risk conditions

In general, the risk for severe illness from COVID-19 increases as you get older. People in their 50s are at higher risk than people in their 40s, and people in their 60s are at higher risk than people in their 50s. Eight out of 10 deaths from COVID-19 in the U.S. have been reported in adults aged 85 years and older; see CDC: Older Adults. In addition, people of any age with certain underlying health conditions are at increased risk of severe illness. These may include but are not limited to:

  • Chronic kidney disease
  • Chronic obstructive pulmonary disease (COPD)
  • Serious heart conditions such as congestive heart failure, congenital heart disease, cardiomyopathy, coronary artery disease, and pulmonary hypertension
  • Type 2 diabetes
  • Immunocompromising conditions such as a solid organ transplant.
  • Obesity, in particular a body mass index >30
  • Hemoglobin disorders such as sickle cell disease
  • Children who are medically complex (e.g., who have neurologic, genetic, or metabolic disorders or congenital heart disease) are at higher risk for severe illness from COVID-19 than other children

Other medical conditions that may increase the risk of severe illness

  • Asthma (moderate to severe) and other chronic lung diseases such as cystic fibrosis or pulmonary fibrosis
  • Cerebrovascular disease (affects blood vessels and blood supply to the brain)
  • Hypertension
  • Immunocompromising conditions such as cancer treatments, bone marrow transplantation, immune deficiencies, HIV or AIDS (particularly if poorly controlled), use of high dose chronic steroids or other immune suppressing medications
  • Neurological conditions such as dementia
  • Liver disease
  • Smoking
  • Thalassemia (a blood disorder)
  • Type 1 diabetes

Pregnancy

Pregnant women may be at higher risk for severe illness from COVID-19. A CDC MMWR report suggested that pregnant women are at higher risk for hospitalization due to COVID-19 and to require ICU admission and mechanical ventilation.(3) The risk of death appeared to be the same for pregnant women and non-pregnant women. Pregnant women should be counseled about the possible risk for severe illness from COVID-19 and measures to prevent infection such as limiting interaction with others. Additional data are needed to further understand the risk to pregnant women from COVID-19. Pregnant health care workers should reach out to their supervisors and occupational health departments to discuss measures to limit their exposure to suspected or confirmed COVID-19 patients during higher risk procedures such as those that are aerosol generating; see Aerosol-Generating Procedures and Patients with Suspected or Confirmed COVID-19 (PDF). For additional information on COVID-19 and pregnancy, please see the American College of Obstetricians and Gynecologists Advisory at ACOG: Clinical Guidance; Novel Coronavirus 2019 (COVID-19).

Clinical recommendations for health care providers

Based on data from other viral respiratory infections such as influenza, COVID-19 may cause exacerbations of chronic lung disease such as moderate or severe asthma or COPD and may lead to severe illness. In patients with underlying cardiovascular disease, COVID-19 infection may be associated with myocardial injury and impairment of cardiac function.(4) It is important to note that not all patients may present with typical symptoms of fever and cough and thus COVID-19 may not be suspected initially in patients presenting with exacerbations of chronic cardiac or pulmonary disease.

  • Consider COVID-19 testing in the following situations even if typical symptoms (fever, cough) are absent:
    • Acute decompensated heart failure.
    • Acute exacerbations of COPD, CF, or IPF.
    • Asthma exacerbations.
    • Illness in immunocompromised patients, even if mild.
    • Illness in patients aged ≥ 65 years and especially those ≥ 85 years.
    • Illness in patients living in congregate care settings such as long-term care, correctional facilities, and shelters for people experiencing homelessness.
  • Specific medication issues:
      • For patients with asthma or COPD, steroids should be used per standard clinical guidelines both in the management of chronic stable disease and for acute exacerbations.(5)
      • To date, there is no evidence that angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB) are associated with improved or adverse outcomes in COVID-19 and should be continued in patients for whom they are currently prescribed for conditions where they are known to be beneficial.(6,7)
    • Patients with underlying high-risk conditions should be advised to seek medical care quickly if they develop symptoms of illness and should practice social distancing.
  • Every effort should be made to optimize medical therapy for patients with poorly controlled chronic diseases (such as diabetes, HIV).
  • Patients who smoke should be strongly encouraged to quit. Visit Quitting Commercial Tobacco to learn more about free resources to help Minnesotans quit smoking, chewing, and vaping.
  • For clinical questions regarding patients with suspected or confirmed COVID-19, CDC's COVID-19 Clinical Call Center is available 24 hours at 770-488-7100.

References

  1. MMWR: Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020
  2. MMWR: Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 – COVID-NET, 14 States, March 1–30, 2020
  3. MMWR: Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status – United States, January 22–June 7, 2020
  4. Guo T et al. Cardiovascular Implications of Fatal Outcomes of Patients with Coronavirus Disease 2019 (COVID-19). JAMA Cardiology, March 27, 2020 doi:10.1001/jamacardio.2020.1017
  5. ACAAI Statement of COVID-19 and Asthma, Allergy and Immune Deficiency Patients - 3-12-20
  6. HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19
  7. Fosbøl E et al. Association of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use With COVID-19 Diagnosis and Mortality. JAMA 2020;324(2):168-177. Doi:10.1001/jama.2020.11301

What are the six documentation components of a patient's history?

Mod 2 Wkbk Chap 4 Medical Documentation.

Who renders a service to a patient?

The Rendering Provider is the person or company (laboratory or other facility) who rendered the care. In the case where a substitute provider (locum tenens) was used, enter that provider's information here. The Rendering Provider is the individual who provided the care.

Which of the following is the correct definition for the term symptom?

Listen to pronunciation. (SIMP-tum) A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests.

How should an entry in a patient's electronic medical record be corrected?

Proper Error Correction Procedure.
Draw line through entry (thin pen line). Make sure that the inaccurate information is still legible..
Initial and date the entry..
State the reason for the error (i.e. in the margin or above the note if room)..
Document the correct information..