help with insurance...please

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

vls
Regular Member


Date Joined May 2005
Total Posts : 166
   Posted 10/22/2008 11:17 AM (GMT -7)   
My insurance company is obviously going under.  Last year it took them over 10 months to pay my hospital bills.  This year they haven't paid anything.  They were dropped by their underwriter and now they are just a "sharing" arrangement.  It says that they will pay if they have the money, but they inform all medical requests for prequalification that they are not a "billable insurance company", so I am told I have to pay up front before I receive any treatment.
 I've searched everywhere for another carrier.  Declined.  I even asked them to exclude the Crohn's, give me a $10,000 deductible, still, no way.  I'm just afraid of getting in an accident and needing multiple surgeries, etc.  We aren't poor so getting assistance is out of the question.  We make a comfortable living, but can't afford $25,000 - $30,000 a year for the state insurance. (my husband has been self employed for 30 yrs.)  I'll be 50 on Sat. and Medicare is quite a ways off for me (my husband just now got on it, so he's the only one with insurance in our family).
I've talked with our CPA, numerous insurance people and no one has any advise.  I've even talked with my GI about it and he said that "sucks" he only pays $18,000 a year for his malpractice insurance.
 
Any ideas would GREATLY be appreciated.

Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 10/22/2008 12:06 PM (GMT -7)   
Ya, vote Democrat! Sorry you're in this predicament, I'm in Canada so I can't really help you. Maybe someone else can chime in.
Dx'ed in 1999. No surgeries.

Current meds: 100 mg 6MP. Just finished prednisone taper. Udo's Choice Probiotics (30 billion).
 
Betaine, digestive enzymes, Candicin (oil of oregano capsules), Beta Sitosterol.


kimberlayn
Regular Member


Date Joined Jul 2007
Total Posts : 239
   Posted 10/22/2008 2:41 PM (GMT -7)   
I know this isn't always an idea that can help everyone, but have you tried getting a part time job at an employer that provides insurance for part time employees? I've recommended Walmart, they have insurance coverage for part time employees working 16 hours a week (i think its 16). Running a register a few nites a week and one day on the weekends might be worth it. Just an idea, I hope you find something, I would be really scared without insurance.
diagnosed w/Crohn's 11/06. 34f with 2 boys, a lovable dog, and a wonderful husband. 150 mg Imuran, bentyl, entocort, vicodin as needed, metoprolol for orthostatic hypotension and heart palpitations. Bowel resection 9/07. Active disease back, darn it 8/08. 11 year old son with IBS-C, on Bentyl.


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 10/22/2008 3:32 PM (GMT -7)   
I was also going to suggest Petco, Lowes, Home Depot, Fedex, and of course voting DEM!!! I would just love to see them do away with pre existing conditions!! Also, I wonder if you would have a breach of contract action against your insurer for failing to uphold their end of the bargain. See if part of them going under they can force all their customers on another company. I'm surprised you can't find anyone to take you if you exclude the crohns. You could go to school take a class or two and get school insurance! There is no rx coverage though.
27 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.


vls
Regular Member


Date Joined May 2005
Total Posts : 166
   Posted 10/22/2008 3:59 PM (GMT -7)   
Over the last four years I've been in a constant flare. I haven't had more than two months at a time where I was actually well enough to do anything. I've told my husband many times "how do people with Crohn's go to work?" Believe me, I've often thought of getting a job just for the insurance and then, wham, it knocks me off my feet again. I want off this rollercoaster! I've learned that I can't make any plans. I went to visit my daughter two hrs away who just strted college. I felt great, we had lunch, shopped, and then out of no where, major accident, right on the steps of her dorm.
Anyway, if I want to have any testing done, I have to pay up front. I was sent to Vanderbilt last June...same thing. Pay up front and have your tests done with your local hospital and send them the results. I quit.
We took this insurance out in the '90's and it was a good deal for self employed people. $1,000. deductible per illness per year then 80/20 til you reach $5,000. From $5,000. to $5 million they would pay 100%. They always paid my bills until last year. They notified everyone about losing the underwriter and alot of members left, leaving only people like me, and now they just can't cover the costs.

about excluding the Crohn's, Blue Cross told me that even then they would not insure me because it could always "come back to haunt them".

FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 10/22/2008 4:03 PM (GMT -7)   
Could your husband make you an "employee?" You could do paperwork from home or something. Then, with 2 employees he would be eligible for group insurance through small business insurance. It would still probably be expensive but cheaper than no insurance. I know a guy self employed installing and running software and his wife is his business partner and they employee a third person too and have group insurance.  Could your husband take on a partner who can bring in his/her own business and also reduce the cost of the group plan by having an extra party?


27 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.


tsitodawg
Veteran Member


Date Joined Sep 2006
Total Posts : 845
   Posted 10/22/2008 11:48 PM (GMT -7)   
I know that you mentioned that you make too much for medicaid or medical assistance, but have you tried for S.S.D.I. ? My wife works, but I because I was unable to work, I was granted S.S.D.I. In qualifying for this, I also qualified for medicare and prescription part D. I already have really good insurance through my wife, so I only took the medicare part A that covers hospital stays, but if I were to lose my other insurance I could purchase full medicare without any penalty. If you have worked long enough to earn enough credits for social security disability, then that is the route that I would go. Also, isn't there a law that once you have been turned down by so many insurance companies and have been without insurance for so long, that a company has to accept you? I will check with my brother-in-law who sells all types of insurance. Hopefully, come November we will not have to worry about any of these pre-existing conditions, high premiums, drug cost, deregulation, or lack of health care for everyone. I know that this is not a place for politics, but I am so glad that our situation is finally being discussed. Regardless of which party or person you choose to vote for, it is really nice to hear that healthcare is finally being put out in the open. I voted early yesterday and urge everyone to continue to write your local senators, reps, and party leaders; in order to keep this discussion alive past the elections. There is no reason that someone like v.sho should every be denied health coverage.

vls
Regular Member


Date Joined May 2005
Total Posts : 166
   Posted 10/23/2008 4:37 AM (GMT -7)   
Thanks so much for the advice. FtizyK23, I always had helped with my husband's business by keeping the books, etc, until I got Crohn's and he finally had to turn it all over to someone in our CPA's office. He subcontracts everything now and has no employees. In the 25 yrs I worked with him, I never took a paycheck. That's why I have no SS benefits. Are people who have not paid into SS allowed to file for benefits anyway? Maybe I should check this out.

tsitodawg
Veteran Member


Date Joined Sep 2006
Total Posts : 845
   Posted 10/23/2008 10:47 PM (GMT -7)   
Before the 25 years that your worked with your husband, did you work any other type of job? Any job that you paid taxes toward, should have given you some social security work credits. Even a high school job gives your credits. If not, it would be of great benefit for you to get at least a part time job, so that when you are ready to retire, you can receive social security.
New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, December 04, 2016 7:29 PM (GMT -7)
There are a total of 2,732,818 posts in 301,057 threads.
View Active Threads


Who's Online
This forum has 151210 registered members. Please welcome our newest member, Margaretcb.
355 Guest(s), 11 Registered Member(s) are currently online.  Details
notsosicklygirl, Psilociraptor, JaSanne, Rikky1, magoo2, BKelly, Buzzlymeyear, Ed Ski, Red_34, Sue*Nash, Sissy63


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2016 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer