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Grex > Health > #23: Insurance denial - pre-existing condition | |
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mcpoz
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Insurance denial - pre-existing condition
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Apr 24 23:19 UTC 1996 |
There was an article on NPR that I listened to today. It was about a woman
NPR reporter who left and went to a smaller company. At NPR she had full
medical coverage. During her stint with NPR she was diagnosed as having
cancer. It was 100% curable and it was medically taken care of.
When she went to the new job, she filled out the questionnaire and told about
the prior cancer. (She knew they shared medical info and if she lied she
would be in trouble). As a result, she was denied coverage for a
"Pre-existing" condition. There was no appeal process. It took her a year
to find her own coverage.
This article was part of a program discussing legislative proposals to prevent
people from experiencing such scary experiences.
There was one quote by the women (can't remember her name) which was
memorable: "You are only one illness away from poverty."
I guess I don't have any specific point other than to share this. Any
comments?
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| 14 responses total. |
rickyb
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response 1 of 14:
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Apr 25 19:59 UTC 1996 |
Denial for pre-existing conditions does not mean you are denied all coverage,
only coverage for _that condition_. I didn't hear the interview you refer
to, but I'd think the reported could have had full coverage with the exception
that if she had a recurrance of the cancer her insurance would not pay for
any related services.
If she was not to be granted _any_ coverage due to a pre-existing condition
I'm not sure if that is legal even by yesterdays standards. OTOH, if she was
talking about life insurance, as opposed to health insurance, well...
As I understand the recent legislative initiatives, companies will be
prevented from denying insurance (medical/health care insurance) on the
grounds of any pre-existing conditions, however, they will be able to set much
higher premium fees for such coverage. This could essentially be the same
as denying coverage since they could just out-price themselves and the
employer or individual would not be able to afford it. I'm not sure how this
will pan out. It's good to be able to be assured insurance is available, but
at what cost? Will the insurance industry be able to police itself and avoid
raping the already injured person suffering with some condition? will the
congress be able to restrict the insurance companies if they embark on such
a tact, once the congress has _mandated_ that they (insurance companies) are
obligated to provide insurance?
There's more back-room issues going on here than meets the eye on first
glance.
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mcpoz
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response 2 of 14:
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Apr 25 23:04 UTC 1996 |
The report definitely was about health insurance, but as you say, it could
have been coverage for that particular condition. I may have missed that
point.
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otter
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response 3 of 14:
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Aug 19 13:33 UTC 1996 |
Unless it is a condition that will affect the patient's general health. Three
of my technicians are diabetic, only one is insulin-dependent. That tech has
been completely denied health coverage by the company's carrier. Period.
Forever. Amen.
My pre-existing asthma will be covered only if I can go for a year without
being treated for it in any way, shape or form.
I would like to see our health care situation change, but have heard no
reasonable, workable suggestions as yet.
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eeyore
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response 4 of 14:
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Aug 21 23:37 UTC 1996 |
mine says that it will cover if it's been three months....i like that. :)
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rickyb
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response 5 of 14:
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Aug 28 22:44 UTC 1996 |
I think the Kennedy/Kestenbaum Bill signed into law last week will prevent
these denials for pre-existing conditions. Not sure when it becomes
effective, or if it will allow huge premium charges to effectively prevent
you from getting coverage, but it's a start.
Keep your ears open.
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otter
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response 6 of 14:
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Sep 5 02:10 UTC 1996 |
How would one go about finding out the text of the bill (now law) and when
it goes into effect? I suppose it would be on the 'net somewhere, but have
no idea where to start searching.
The insulin-dep technician mentioned above has been bugging me about when to
re-apply, and I told him I'd try to get some info, just because I like him.
8^}
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rickyb
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response 7 of 14:
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Sep 9 15:10 UTC 1996 |
Try www.fedworld.gov. There are also links from there to many government
sites. Might also want to check into www.ama.org, or Thomas (US House of
Reps). Even write a letter to president@whitehouse.gov.
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scg
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response 8 of 14:
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Nov 9 06:21 UTC 1997 |
This item hasn't had a response in over a year, but I just stumbled across
it. When my employer switched health insurance companies a month or so ago,
MCare (the new HMO) said that anybody who came into the program along with
the group, rather than just applying for coverage when it's needed, would be
covered for everything, preexisting or not. Selectcare also sent me a
certificate showing that I had been insured up to the end of the Selectcare
policy, along with a letter saying that if I went to some other insurance
company within some number of days after the Selectcare policy ended and
showed them the certificate, they can't deny insurance based on pre-existing
conditions.
Since I don't have any pre-existing conditions, and my employer pays the
health insurance bill, I have no idea whether they still directly affect rates
or not.
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rcurl
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response 9 of 14:
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Oct 7 00:18 UTC 2005 |
I'm using this item for a different health insurance question.
Our daughter, who has been a dependent until now and under our health
insurance, is now employed and has hit the barrier for further converage.
We can invoke COBRA and continue her coverage for up to 36 months, but the
monthly fee looks like it will be ca. $350.
Others have discussed obtaining private insurance at what I thought was
a lower monthly fee, but I can't find the posts. Does anyone have information
in that regard?
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mary
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response 10 of 14:
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Oct 7 01:04 UTC 2005 |
Blue Cross Blue Shield offers a policy for young adults that's about
$45 a month. It's mostly for catastrophic illness as it carries a
high deductible ($2500 a year, if I remember correctly). You can
only have this policy through age thirty. The application is dead
easy and takes about three weeks from application to being covered.
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rcurl
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response 11 of 14:
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Oct 10 17:06 UTC 2005 |
Mary, can you tell me where to find all the fine details of that?
What's covered and by how much, and what options for choice of doctors,
and copays, and all that stuff. (We are looking at other plans, but it
seems extremely difficult to find all the specifics in any of them.)
Do you know anything about the Amerigroup health care plans? They (like
BC/BS) have a web site with general overviews of benefits, but the details
are missing.
[This search (re)convinces me that we need National Health Insurance to
cut through this jungle of ill-defined requirements and benefits.]
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mary
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response 12 of 14:
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Oct 11 00:38 UTC 2005 |
Blue Cross Blue Shield's web site is short on coverage details
but I did find a link for the monthly quote for the young adult
policy. It's:
http://tinyurl.com/dvujy
I called them on their toll free number and they sent out a
brochure which included plan details and an application.
I don't know anything about Amerigroup, sorry.
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mary
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response 13 of 14:
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Oct 11 00:40 UTC 2005 |
Ack. Bad link. Try this:
http://tinyurl.com/ae7yu
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keesan
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response 14 of 14:
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Oct 24 20:46 UTC 2005 |
American Community Mutual has good ratings and has paid promptly for all my
treatment (including one time when it was billed wrong and after I explained
and the doctor refused to bill correctly they paid anyway). You can get a
cheaper policy if you want a higher deductible (I have $5000 plus 30% of the
next $10,000, and pay only about $1500/year at age 55, and younger people
would pay much less). I have to go to doctors on the list for PPOM, which
includes all of U of M and some private doctors here, and other providers in
other parts of Michigan. Mutual means no stockholders which keeps the rates
lower, and they are honest and friendly. No physical exam required.
One of the nice things is that they have negotiated a large discount with U
of M so that even before I meet the deductible I only pay 55% of the doctor's
bill (and somewhat more for lab tests but not 100%). And my policy also pays
for 80% of $400/year (after the discount) of general physical exams, cancer
screenings and lab tests included. I don't need to pay a deductible on this.
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