Skippy Posted March 31, 2011 Share Posted March 31, 2011 (edited) My sister and her family got a real shock yesterday when she was at the doctor and told that she would need to wear a heart monitor. Well that was not the shock. The shock was when the doctors office ran her insurance to make sure everything was okay. Then they told her that she was not covered as of March 1, 2011. She came home and called her insurance only to be told that her Cobra ran it's 18 months and they dropped her on March 1, 2011. She asks why and how, etc. and the guy said preexisting about five times and said there is nothing that she can do. She said he was very rude and hung up on her. She called every major healthcare provider in Pittsburgh and no one will pick her up for any sort of reasonable coverage. This really sucks for her and she is so down and out over it that I am really worried about her. Life has not been real easy on her health wise in the past five years or so and she suffers some of the same major back and neck problems that I do. It just breaks my heart to see her in this position. Edited March 31, 2011 by Skippy Quote Link to comment Share on other sites More sharing options...
Ursa Majoris Posted March 31, 2011 Share Posted March 31, 2011 This is exactly why we needed health care reform, however imperfect the final result was. All my best to her. Quote Link to comment Share on other sites More sharing options...
Skippy Posted March 31, 2011 Author Share Posted March 31, 2011 This is exactly why we needed health care reform, however imperfect the final result was. All my best to her. I know I have my head up my ass as of late but I thought there was language to get rid of the preexisting crap. Has that not been implemented? Quote Link to comment Share on other sites More sharing options...
Ursa Majoris Posted March 31, 2011 Share Posted March 31, 2011 I know I have my head up my ass as of late but I thought there was language to get rid of the preexisting crap. Has that not been implemented? Pretty sure it's pending. Might have been implemented for children. Quote Link to comment Share on other sites More sharing options...
rocknrobn26 Posted March 31, 2011 Share Posted March 31, 2011 Why didn't they notify her? That sucks! My best to her! Quote Link to comment Share on other sites More sharing options...
Clubfoothead Posted March 31, 2011 Share Posted March 31, 2011 That sucks. Best of luck to her. Quote Link to comment Share on other sites More sharing options...
gbpfan1231 Posted March 31, 2011 Share Posted March 31, 2011 This is exactly why we needed health care reform, however imperfect the final result was. All my best to her. Agree. Love or hate Obamacare this crap should not happen to people!! Quote Link to comment Share on other sites More sharing options...
Chargerz Posted March 31, 2011 Share Posted March 31, 2011 Why didn't they notify her? That sucks! My best to her! That does suck!!! I'm sorry she has to go through this. They SHOULD have let her know ahead of time. Getting rid of exclusions based on pre-existing conditions is supposed to be one of the first steps implemented with Obamacare. I just don't know when that is to occur. Quote Link to comment Share on other sites More sharing options...
Double Agent Posted March 31, 2011 Share Posted March 31, 2011 Terrible this happened...but the preexisting conditions language in the Obama bill should only apply if there has been continuous coverage. Otherwise uninsured people will get sick then go buy insurance to coverage cancer, operations, etc. None of us will be able to afford healthcare if that happens. Just like you can't buy homeowners insurance a day after your house burns down...you can't expect a health insurance company to cover preexisting conditions when the person was uninsured when applying. Quote Link to comment Share on other sites More sharing options...
Double Agent Posted March 31, 2011 Share Posted March 31, 2011 Agreed. But shouldn't there be a reasonable window of no coverage? I mean, if his wife's coverage was terminated recently, shouldn't she be covered anyways? The reasonable window is the 18 months she had to find alternate coverage. I'm not trying to be unsympathetic. Just stating the way it works. The reasonable window in the P&C business is 30 days. You miss a payment and your policy doesn't actually cancel for a month. On day 31 you have an accident...no coverage. Some may say it was only a day past the cancellation date. But actually the person had 30 days. Not saying the system isn't broke. It is. But there has to be limits on preexisting conditions. If not, we are all screwed. Quote Link to comment Share on other sites More sharing options...
Clubfoothead Posted March 31, 2011 Share Posted March 31, 2011 Terrible this happened...but the preexisting conditions language in the Obama bill should only apply if there has been continuous coverage. Otherwise uninsured people will get sick then go buy insurance to coverage cancer, operations, etc. None of us will be able to afford healthcare if that happens. Just like you can't buy homeowners insurance a day after your house burns down...you can't expect a health insurance company to cover preexisting conditions when the person was uninsured when applying. I think most people are uninsured because they can't afford it, not because they are looking to game some loophole. That's absurd. In some people's case, health insurance is pretty close to a life or death matter. I pay $1,400ish a month for BCBS. I can't imagine what the Cobra would be if I got laid off, but it would certainly be less than trying to get a new policy on my own while unemployed. If I get laid off, to keep my youngest alive, my first step, before even looking for another job and figuring out how long the savings will last, would have to be the government teat so that she remains covered because if she has any gaps in coverage, I am not screwed, she is. Quote Link to comment Share on other sites More sharing options...
Double Agent Posted March 31, 2011 Share Posted March 31, 2011 I think most people are uninsured because they can't afford it, not because they are looking to game some loophole. That's absurd. You completely missed my point. Quote Link to comment Share on other sites More sharing options...
Ursa Majoris Posted March 31, 2011 Share Posted March 31, 2011 You completely missed my point. I don't think he missed the point at all. What you said does make sense, clearly, but what Club said was right. Health insurance is riotously expensive for the individual and is the main reason there are so many uninsured people. Quote Link to comment Share on other sites More sharing options...
Double Agent Posted March 31, 2011 Share Posted March 31, 2011 I don't think he missed the point at all. What you said does make sense, clearly, but what Club said was right. Health insurance is riotously expensive for the individual and is the main reason there are so many uninsured people. I never said people were looking for a loophole. Obviously the reason people don't have any kind of insurance is cost. Doesn't change the end result though. But FYI...individual insurance is almost always cheaper than COBRA. But typically the coverage isn't as good. And I hope everyone realizes that I'm not defending Healthcare companies. Can't stand them. But I also don't want my premiums to skyrocket more than they already have. And covering preexisting conditions from currently uninsured applicants will most certainly do that. On to Skippy's sister...not sure what a heart monitor is. Is that a pacemaker or just a device on the outside of her body? Point is if she is really ill and needs surgery, I'd find whatever job I could with benefits and get that surgery. Preexisting conditions on group plans are covered. They could make her wait up to 6 months for surgery though (if required). Quote Link to comment Share on other sites More sharing options...
wiegie Posted March 31, 2011 Share Posted March 31, 2011 Terrible this happened...but the preexisting conditions language in the Obama bill should only apply if there has been continuous coverage. Otherwise uninsured people will get sick then go buy insurance to coverage cancer, operations, etc. None of us will be able to afford healthcare if that happens. Just like you can't buy homeowners insurance a day after your house burns down...you can't expect a health insurance company to cover preexisting conditions when the person was uninsured when applying. That is why they put the individual mandate in. You can't cover pre-existing conditions without requiring everybody to buy insurance. Quote Link to comment Share on other sites More sharing options...
Skippy Posted March 31, 2011 Author Share Posted March 31, 2011 Terrible this happened...but the preexisting conditions language in the Obama bill should only apply if there has been continuous coverage. Otherwise uninsured people will get sick then go buy insurance to coverage cancer, operations, etc. None of us will be able to afford healthcare if that happens. Just like you can't buy homeowners insurance a day after your house burns down...you can't expect a health insurance company to cover preexisting conditions when the person was uninsured when applying. Yes but how does this work; she had and paid 1643.00 a month for the family cobra. Her intent was always to keep the policy and it was told to her way back when they went on cobra that so long as she paid the bills, they would be covered. Now she understands why they dumped her as her monthly meds alone are almost 800.00. She also see's a specialist that I am sure costs a boatload. Her husband who went into business of his own when his 23 year job ended also suffers from a major back injury that he receives constant treatment for. That injury happened at his old work but they went tits up very shortly after his injury and he has been tied up in court ever since. That is not looking real good so now it is looking like he is crap out of luck. Also here in PA she was told that as long as she had proof of coverage within the last 90 days that she should not have trouble picking up insurance. However, even with said letter no one will touch her and to be very honest if I was an insurance company I would not want her either. I just don't understand how the first company could just drop her like that. Quote Link to comment Share on other sites More sharing options...
Double Agent Posted March 31, 2011 Share Posted March 31, 2011 They lied to her when they said she'd have coverage as long as she pays the premium. COBRA is for 18 months. In some cases you can get it extended to 36 months. But I think that usually involves divorce. Have your brother in law check into purchasing a group policy for his business. You only need 2 for a group. So if he has one employee that wants to participate it could be done. Other than that I really don't know. Health insurance is not my specialty. Most states (if not all) have a health care pool for high risk applicants. Not sure on the preexisting conditions coverage on these though. Quote Link to comment Share on other sites More sharing options...
lennykravitz2004 Posted March 31, 2011 Share Posted March 31, 2011 This kind of thing happens all the time. Not saying good, bad, indifferent, just that people aren't aware of their coverage and plan rules. Yes, a lot of it is in fine print. Even knowing this, how many of us take the time to know what we really have in our plans? Much of it assumption. A gal I work with just found out she's not getting paid for the first 30 days when she takes maternity leave, and then only 60% for a period of time after that. She was stunned. Until we need it, we have no idea what we have, how long we have it, or any of that "fine print". Me included. Until health insurance and healthcare are not profit driven industries like selling bubblegum, this is the way things will continue to be for us. Even after reading this crummy story about Skippy's sister, how many of us are going to pull out our plan docs and see what we really have? I really do wish your sister and your family the best Skippy. GL. It's a tough lot to be dealt. Quote Link to comment Share on other sites More sharing options...
Skippy Posted April 1, 2011 Author Share Posted April 1, 2011 Have your brother in law check into purchasing a group policy for his business. You only need 2 for a group. So if he has one employee that wants to participate it could be done. That is a great idea. He has one employee and his wife does bookwork. I wonder if push came to shove if they could get insurance based on her being the second in his group? Probably not but still a great idea that I will pass on to her. Quote Link to comment Share on other sites More sharing options...
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