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Posted 8/19/2005 3:30 PM (GMT -8)
Hello everyone,

There were a few posts in one of the topics in this forum about health insurance... Some mentioned that they don't have any... wow, I can only imagine how difficult that must be if you are dealing with medical issues!

My boyfriend (soon to be fiance tongue ) is suffering from pericarditis, and was in the hospital (and the ICU for almost a week in the beginning of May).  Thank god, he is recovering well and fingers are crossed that this is the last we see of the devil's death grip (that is what they call it!).

We have discussed, though, that he will never be able to give up his health insurance because it would probably be very difficult to get coverage after all this.  That makes me worried, like what happens if his insurance carrier goes under? (It is no Blue Shield or Blue Cross or anything big like that).  In addition, through my work, I get good coverage, and could add family members... But then what happens if I stop working?  Then he is left in the dust...

I'm wondering if anybody here has dealt with similar issues... and what creative solutions you have devised in order to deal with it....?

Thanks,

Maya

Posted 8/19/2005 5:04 PM (GMT -8)
Maya, I'm one of the "46 million" and growing (and I'm sure I wasn't even counted) who don't have health insurance. I often say that not having it is my biggest health risk.
I've investigated things recently and here's what I've found. My heart disease would have a minimum 2 year exclusion, even after that the coverage could be limited, and my insurance premiums in the meantime would be over $1000 a month. That could be extended or raised at any time. Because I need medical care now, including my heart, I have found that my best (only) option is to go through the teaching hospital, however I have been trying to get a referral approved to see a cardio since January, apparently without regard for my history of rheumatic heart disease with 3 damaged valves and now symptomatic. This is why I have decided to go see a cardio at Cleveland Clinic. Before it occurred to me to do that, I found that in my area NO cardio will see me at all without health insurance. CC was the one exception to this, so even though it's about 2 hours away, that's where I'm going.
I have a friend who had a heart attack 5 years ago with no recurrences of any kind. She is a cardio nurse at a local hospital. First, they tried to terminate her insurance (unsuccessfully) and then they raised her rate to $880 a month and still climbing. During all that time she has still been employed at the same hospital - which she feels she can't leave because if she changed employers, the new insuror would throw in a 2 year exclusion and raise her rate even more.
I believe that if you have insurance and lose your job, there is something called Cobra, which is a transitional policy that you pay for individually until you obtain other insurance. However, if you miss a payment (remember, you're not working!) you are immediately cancelled. If this happens, then you are right where I am, though mine is for different reasons.
From my experience, I would urge everyone who is now insured to do everything possible to keep your insurance. I believe that my prognosis and treatment options are extremely limited compared to what they would be if I had insurance.
In emergencies, ER's do have to treat you (insured or not) - only until you are stable. During the last decade 14% of all ER's in the US have closed down - for cost cutting measures. See where all this is going?
If you have health insurance - do your best to hang on to it! There are no good ways around this problem.
Posted 8/19/2005 5:15 PM (GMT -8)

Maya

please check with your local insurance commissioner where you live . Different states have different rules  too , their is Blue Cross Blue Shield then Humana and you didnot say how old you and your boyfriend is . Their is AARP over the age of 50 medicare and medicaid too but it all boils down to the state you live in. Your state guidelines and wait period too.  And you need to consider how much extra would it be to add him to your policy with his health riskes which could be taken as high risk thus  they take more out of your paycheck. but please talk with the person in charge of your insurance at work and also talk to yuor boyfriend too.

Heidi

Posted 8/21/2005 7:04 AM (GMT -8)
>>>My boyfriend (soon to be fiance tongue )<<<

 

  Does he know this? :-) ..Just teasing....I know my company offers you the option of taking over paying for your health insurance if you leave the company

Posted 8/21/2005 1:20 PM (GMT -8)
Hi Maya!  Unless it has changed recently, it is a law that in group insurance a pre existing condition has to be covered if you switch jobs that uses a different insurance company.  This is for HMO's or PPO's.  However, you have to have been covered previously for at least a year (I'm pretty sure that is the required time) with no more than a 30 day lapse in coverage.  And they can charge a higher premium do to an existing problem and some employers may frown on this.  And as Famulus mentioned, if you lose your job COBRA is available if the company you worked for meets the requirements and you pay the premium.  In Arizona one of the requirements is a company must have 30 or more employees but that may just be a state ruling.  COBRA is only available up to 18 months.  Health insurance is definately a BIG problem for so many...myself included.  I agree, if you have insurance now try to keep it if at all possible!
Posted 8/21/2005 2:59 PM (GMT -8)
Thanks Pat, Oona, Sara and Heidi - that was some very good info!!  I think Pat and someone else mentioned the COBRA plan - one of my sisters had to go that route a while back...so I searched for a link and came up with this one -hope it helps!

Hugs, Teri tongue

http://www.dol.gov/dol/topic/health-plans/cobra.htm

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