This morning I went to my new primary care physician for the first time. I am at an age where I am still pretty healthy but I am almost at the point where I can be legitimately accused of being middle aged. Given what I do for both a living and for fun, I know the actuarial tables indicate that I will need to spend increasing time with my PCP in the next decade than I have in the previous decade.
As part of the intake process, I had to complete a form of my medical history and relevant history of family members. Duke Primary Care made it easy to do that online so I did that pre-visit as I drank my morning coffee. And then I came to a question of “Anything else relevant….”
I have a high probability of a genetic pre-disposition of certain types of GI tract cancers running in my family. A younger siblings had a screening colonoscopy this year. They found and snipped several polyps.
I’m entering an age band where if I have that genetic variant, I am likely to be at significantly increased risk. I might have it, I might not. I should get a genetic test to confirm whether or not I really need bi-annual colonoscopies at this point in my life.
If I have that gene, it is one hell of a pre-existing condition. I’m fairly confident that I’ll be in the employer sponsored insurance world regulated by ERISA throughout the time that I am at an increased risk. But I am not sure.
I thought for a second, and then wrote it down the pre-existing condition. I’m betting that I don’t have to worry about coverage for that condition in case I actually do have it. But this is the second time in five years where I have had a PCP visit on the same day there was a risk of losing guaranteed issued insurance (NFIB v. Burwell SCOTUS day). Each time, I had to weigh whether or not I needed to be fully open to my doctor or hope that a pre-ex condition would not be a life time anchor against me.
At the end of the visit, the doc wanted me back next week for some labs and we scheduled a colonoscopy for sometime this fall.