NEWLY UPDATED! (SEE BELOW)
!!! WARNING – ONCOMING RANT !!!
This is something I believe more and more each day. When the Clinton administration was looking into this, I really didn’t have much of an opinion about it. I thought it was “pie-in-the-sky” thinking and wouldn’t be worked out. It also didn’t really affect me because I hardly ever needed to use it. But now it’s a daily topic with Marcia.
Unfortunately we are dealing with a situation that has me very upset and unsure what to do. Our insurance provider, through my employer, is having issues covering Marcia because they see her as pre-existing condition. And because we let our cruddy Cobra insurance coverage lapse for three months in spring/summer of 2007, before I hired into Lehigh Cement, we seem to be stuck in this position. (We didn’t really let it lapse because we wanted to, we just couldn’t afford to pay it, which is ironic because we couldn’t afford it due to the costs it wasn’t covering.) Then we went through the time where Marcia couldn’t get insurance because of these reasons. Why is it that people that need health insurance the most can’t get it? GREED! And now we have companies going to Washington and asking the government to give them money because they did a bad job of running their business and expect them to bail them out! BULLSH_T!! Let them go BANKRUPT! Because that is what’s going to happen to us if Marcia won’t be covered! (Alright, we won’t go bankrupt, but we won’t be able to get ahead, and we are already facing an up hill climb.) But some of the billions of dollars that are being put into these companies could be used to fix the health care system. Now that is something I wouldn’t mind paying a bit higher in taxes for, if I knew that we would have some choices, and wouldn’t have to worry about pre-existing conditions.
Before someone comes ridiculing me for speaking out this way, or not seemingly knowing the ins-and-outs of this situation and government in general, I do understand that there are limitations to what can be done. But it is obvious that the profit-making priority line of thinking when it comes to health care and insurance needs to be re-adjusted to making sure people get the help they need at an affordable cost. Why should someone go bankrupt just because they had bad luck or got sick at no fault of their own?
As for us, we are currently looking into options, but they don’t look good. Pennsylvania doesn’t have a high risk pool to get into. And other options I have seen don’t cover enough. Of course we could always move to Canada. Hopefully though our insurance provider will come to the decision to cover these things.
UPDATE
The insurance company has just informed the HR department at my employer that the “pre-existing condition” has been waived, and all past claims in questions will be covered.
Great news for us, as you can imagine. However, the Health Care system still needs to be overhauled.
December 10th, 2008 at 3:40 am
It’s been my position for a long time – but emphasized when I got a foot infection in 1979, waited for the insurance to kick in and then spent six days in the infirmary (really, I could have DIED) – that I decided that health care is a right, not a privilege.
But in these economic times – here’s $700 billion for you, banking system; $15 billion for you, auto companies; a bunch of billions for you, war in Iraq, it’s clear that we can afford universal health care. We’ve just lacked the political will.
Clearly, it’s cheaper to treat diseases and illnesses and injuries in the early stages than to wait until one is forced to rush to the ER to get treated.
Damn, Scott, from that intro, I thought you were going to say something controversial.
December 12th, 2008 at 8:38 am
I can’t believe they think Marcia has a pre-existing condition. It’s just a good excuse so they don’t have to cover anything. It’s amazing the loop holes they find. I feel so bad for you/her. I can’t imagine how frustating it is. You have every right to be angry.
Speaking of which, has her doc ever tried her on Diamox? It’s a water pill. Many folks who have what I have are not diagnosed properly, if at all, because it’s a rare thing. They didn’t even test me in the hospital, they just gave it to me to see what would happen and low and behold, it was/is my magic pill. Maybe she could talk to her doc about it… ? The generic form costs me 8.00 to fill for 50 pills (I don’t believe it even gets submitted to insurance because it’s so cheap). I asked my neuro at my last appt if Diamox could work on migrane patients and he said that some people who suffer with migraines it does work for them as well as for people with what I now have (all thanks to most likely the rubella vaccine I received…or so it’s thought)
I received a bill for 33K for my hospital stay in Michigan. There were insurance issues and once they worked the kinks out, insurance would only cover 9K of it, so the rest was written off. So, if I was someone with no insurance I would have been stuck with 33K. What kind of crap is that! If you don’t have insurance, your stuck with whatever prices they throw at you. It just shows how inflated health care prices are.
You both have overcome many obstacles, you will overcome this one as well. Try to keep your faith.
December 12th, 2008 at 8:52 am
Things are starting to look better. I hadn’t posted an update because I don’t know exactly yet. But it appears that the insurance is going to cover most of the costs for the first few months. After that, they again will cover her fully. But again, we are still awaiting word.
What is rather frustrating with that is getting nowhere with the insurance company. Anytime I called them, they seemed as if those claims had no chance in hell of being covered, and my fate was in the hands of those investigating, and it didn’t look good. But then I talked to someone in HR at work about possibly switching plans and if it would help this “pre-existing condition” ordeal. They then, in a matter of minutes, explained to me where things should stand, and that it should be worked out very soon.
As for that hospital in Michigan, Marcia has an appointment there on December 30th while we are out there visiting family. Hopefully things will work out there, too.
December 12th, 2008 at 9:17 am
I’m glad that things are looking up for the insurance stuff. That alone would drive me insane! That’s great about MHNI. What doctor(s) is Marcia seeing when she is there?
December 12th, 2008 at 10:39 am
Not sure who she is seeing. She just made the appointment this morning and we hadn’t talked much about it.
I also updated the post. The “pre-existing condition” has been waived. We are good to go.
December 12th, 2008 at 12:52 pm
AWESOME!!!! That’s wonderful news! What a relief, I am sure. Let me know who she is seeing, I can tell you what experiences I had with each of the doctors (some are better then others). And most likely they will have her see one of the shrinks. There is one that is a little light in his loofers (if you know what I mean). I’ve got a funny story about him. I’ve got lots of info if you/she needs it, just let me know. I also made life long friends from there who can share their experiences if you/her want to make contact with them. What I can say is that she won’t feel alone. Literally as you sit in the waiting room you will see so many others that have the same issues. It provides a bit of comfort because migraines/head pain are a hidden illness. People don’t realize how many people are truely suffering on a daily basis. I know what it did to my life.
Just try to be opened minded with what they say. It’s scary, I know. A friend of mine had gone there along time ago, but once they said she needed to be hospitalized, she panicked (she has bad anxiety) and never went back, after talking to me and my success she conceded that she should go back and once again they wanted to admit her. Well, after 7 days, they found treatment program. She’s got her life back now. The pain is managed, the first time in over 7 years. And her anxiety has lessened, which is an added bonus. As you can tell, I am so hopeful they can help Marcia. It was a good place for me, and I hope for her as well. Keep us posted.
December 19th, 2008 at 7:27 am
I’m lucky to live in a country where the health is covered free for everybody with our taxes.
But the right party has found that is a HUGE bussiness and slowly where they can they are lowering investmens in the health system to let the private companies get into it.
The people is so used to have free health care that are not taking taht in account, let’s see what happens in a few years.
For me health care and basic education should be FREE for everybody.