Uncategorized

HEALTH PLANS/POLICY: And it’s a right, and a left, and another right–I’m not sure he can take any more…

You’d think the LA Times’s Lisa Girion would have had the human decency to stop beating up the health insurance industry. It’s getting close to the time when the referee should step in to save the insurers from further punishment. But oh no, it’s haymakers landing on the chin time after time.

This time she uncovers another little nuance about why the individual insurance market is such a disaster—entire classifications of occupations are automatically disqualified. Good article, go read it.

I’m reminded of two things. One, back in 1991 Mary Ann O’Sullivan then (I think) of Health Access gave a speech in which she described exactly the same thing. She quoted one insurer denying used car salesmen insurance because “you just can’t trust those people!”

Two, I paraglide, and on the paragliding list in a discussion about how to make sure that your health insurance covered paragliding we got a beautifully naive question from a recent immigrant from (I think) Hungary where the national paragliding association groups together and buys health insurance for its members. He suggested that the US national association did the same thing as the Hungarians! Some of us on the list suggested that this might not be the best way to go about finding affordable insurance.

0107_health_brand_250x250

Livongo’s Post Ad Banner 728*90

Categories: Uncategorized

Tagged as: ,

20
Leave a Reply

20 Comment threads
0 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
8 Comment authors
Tom QuigleyAbbyJohn FembupPeterSBD Recent comment authors
newest oldest most voted
Tim
Guest
Tim

That may well be true. I’ve seen them even create “evidence” of non-payment of premium ( even though the cashed the checks ), in order to cancel a group they no longer wanted.
If SBD is not guilty and can prove it, he should be federeally eligible and guarantee issue. If nothing else, he can form a small group on his own by hiring his spouse or a business partner.

Peter
Guest
Peter

Tim, SBD has only been ACCUSED of fraud, not tried and convicted. And the accusation is from an insurance company, not something I would take as truth by any stretch. As usual insurance companies get to be judge and jury while it’s the insured’s responsibility to pay legal fees to bring light to the issue. Why don’t we require insurance companies to prove before conviction and cancellation? Insurance companies are your friend :>)

Tim
Guest
Tim

<<<>>>
If nothing else, you could form your own business entity, and have a group of two people on the plan. Small groups are guaranteed issue.
Then again, if you have comitted fraud, that may be an exception.

Tim
Guest
Tim

http://www.usc.edu/schools/college/crcc/private/docs/health/calif_options.pdf
Read the matrix pertaining to PREXSISTING CONDITIONS and the Caifornia risk pool.
You would have been guaranteed issue, because you would have been FEDERALLY ELIGIBLE… but you committed fraud. Like I said, you made your own mess.
It clearly states under GUARANTEE ISSUE that if you committed fraund, you are SOL, SBD.

Tim
Guest
Tim

What exactly is “fraud” in this case? If for any reason you would be Federally Eligible… I don’t think the waiting list applies. Just like Ohio has HIPAA plans with open enrollment and maximum numbers for any given carrier ( that they must take ), if you are federally eligible, that is bypassed.
If you are guilty of fraud, however, you have created your own mess. What is it that you have alledgedly done to be found guilty of fraud?

SBD
Guest
SBD

Tim, please point me to a Health Insurance I can apply for and be accepted in the State of California. It is my understanding that in order to qualify for Medical or Medicare, I must be disabled for two years prior to be accepted. The requirements for California’s MRMIP insurance also make me ineligable because my previous insurance company canceled my policy and accused me of fraud. I have filed a lawsuit because of this, but their letter is what I must supply to MRMIP for enrollment. This is from the MRMIB quailification requirements. You have been involuntarily terminated from… Read more »

Tim
Guest
Tim

I don’t know if I won anything or not, I’m just trying to show that there are other options. Although California’s particular state plan is rather shoddy in terms of lifetime an annual caps in comparison to other state plans, you’d be hard pressed to spend it all on medications and surgeries without being qualified for Medicaid or Medicare. No one is being told there is no insurance avaiable for them “no matter the cost”. If you can get individual, good for you. If you can’t, don’t fret… you are just going to have to pay more. If anyone should… Read more »

Tom Quigley
Guest

Tim wins this one. SBD is the loser better luck next time

Peter
Guest
Peter

“Also a fair question to ask your doctor.” John, not the ice breaker question you want to start a doc visit with when establishing a relationship :>). But here is my recent approach to a new doc I visited for a lingering stomack problem last week. It’s been 15 or more years since I needed a GP visit. I had been trying to self fix a constant upset/sour stomack. I did not owe this doc anything and was prepared to walk if he didn’t meet expectations. After I explained my symtoms I said that I don’t condone or believe in… Read more »

Abby
Guest
Abby

I can never leave Massachusetts. I need my community rating.

Tim
Guest
Tim

But you CAN get helath insurance. Just like care insurance ( I know how much you love that comparison 8^) ) there are options for the otherwise “unsinsurable”. Yes, it costs more, just like high risk auto. But, unlike high risk auto, the plans are pretty nice. I’d even venture to say that the plans are better than many group plans out there and many individual plans. Take a look at this: http://www.diabetes.org/advocacy-and-legalresources/insurance/california.jsp There IS health insurance for the higher risk people. The argument that they won’t take them “no matter what they are willing to pay” doesn’t stand. Here… Read more »

SBD
Guest
SBD

Tim, the difference is that if you can’t get auto insurance, you can take the bus or walk. If you can’t get Health Insurance, you go Bankrupt and/or Die.
SBD

Tim
Guest
Tim

SBD, You missed one thing. Your DUI driver will NOT be insured by many carriers. Only certain carriers will even LOOK at them, and those that do will make them pay dearly for it. It’s called HIGH RISK INSURANCE. Call around to numerous carriers this afternoon, tell them you have a DUI, and ask if they can insure you. Better yet, tell them you’ve gone without insurance for three months and want back in the game. Good luck. Same thing applies for certain health conditions and occupations. There are medications, conditions, health history, occupation, etc. that certain carriers will cross… Read more »

John Fembup
Guest
John Fembup

“Does anybody believe that it’s about healthcare and not profits?”
Fair point.
Also a fair question to ask your doctor.

Peter
Guest
Peter

SBD has it nailed. That’s one reason why these mandated health insurance plans will fail, they rely on the same insurance/health delivery system that got us here. They assume more premium payers in essentially the same “free market” system will somehow control costs. It sounds like Bush’s Iraq policy – “stay the course”. Does anybody believe that insurance companies consider patients when they write policies? Does anybody believe that it’s about healthcare and not profits?