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My husband finally has good health insurance
Old 01-02-2014, 08:02 PM   #1
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My husband finally has good health insurance

When my husband was in his 20s he developed psoriasis. My husband is now 62 and his psoriasis is controlled by medication and he is otherwise very healthy. Because of the psoriasis all the insurance companies in our state (North Carolina) determined that he was uninsurable. He could not get private health insurance at any price. As a consequence he had to work at jobs he did not want or need just to keep health insurance. A few years ago North Carolina started a high risk pool which enabled him to get insurance but at a VERY high premium, a high deductible and with a life time cap of $1,000,000 (that amount of insurance is not adequate in my opinion--what if he were in serious car accident? We were always concerned that he was not adequately insured)

But now today he has real health insurance through Blue Cross of North Carolina. A good policy, with a large network, fairly low deductible and NO LIFETIME CAP. All this for only $550 per month.

It gives us great piece of mind to know that my husband now has good health insurance. We can really enjoy our retirement now.

I wonder how many other people out there will be able to take early retirement knowing they can get insurance?

Jo Ann
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Old 01-02-2014, 08:11 PM   #2
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Congrats!
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Old 01-02-2014, 08:12 PM   #3
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Congratulations! It's great when good things happen to good people.
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Old 01-02-2014, 08:55 PM   #4
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Excellent news! I can hear the relief in your post. What a great thing to have this burden lifted so you can concentrate on what's important - having fun!!
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Old 01-02-2014, 08:57 PM   #5
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It gives us great piece of mind to know that my husband now has good health insurance. We can really enjoy our retirement now.
Good news indeed. Hope this makes your retirement all the better.
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Old 01-02-2014, 09:09 PM   #6
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Congratulations! We weren't able to commit to retirement until that Supreme Court ruling ourselves. I used my new card to go to my regular doctor today!
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Old 01-02-2014, 10:28 PM   #7
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The ACA has been great for us as well. We had home businesses that covered our annual expenses for many years, but DH kept a regular job in large part for affordable group health insurance coverage.

One of the kids went to the doctor today with his new ACA policy insurance card.
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Old 01-02-2014, 11:11 PM   #8
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Always glad to hear good news like this. It is certainly a benefit to many.
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Old 01-03-2014, 07:25 AM   #9
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One of the most positive effects of the ACA, in my opinion, is that a few features are so popular that it will be impossible to repeal them. The no pre-existing conditions feature in particular will have to be incorporated in any changes going forward regardless of who is in office. Costs may go up (or down) but you will not be dropped as long as you can foot the bill.
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Old 01-03-2014, 07:53 AM   #10
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I presume this was a direct result of the ACA. if so a great example of why it was needed.
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Old 01-03-2014, 10:29 AM   #11
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Long live ACA. Congrats!
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Old 01-03-2014, 10:45 AM   #12
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OP here. Yes this was a direct result of the ACA. Without it, my husband would not have gotten good insurance until age 65 when he qualified for Medicare.

No one who has not been able to buy health insurance (at any cost) can understand what we have gone through. We are very grateful for the Affordable Care Act.

Jo Ann
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Old 01-03-2014, 10:55 AM   #13
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High risk pools were an attempt to make insurance available to the "uninsurable" but they have lumped people with marginally high blood pressure in with cancer survivors. Your husband has an issue that I don't think (in my ignorance) is that much of a drain on an inusrance company but they use this condition as an excuse to force him into paying the high risk pool rates. I would have been pushed into the Texas high risk pool at a monthly cost of approximately $600/mo. It would have been a $7500 deductible plan. You didn't say what your deductible is but it doesn't sound like you are saving much on the old high risk premium. You do get the unlimited lifetime coverage.

The ACA attempts to address issues with the prior insurance plans. The biggies were the lifetime maximum and preexisting conditions. These are "resolved" with the ACA but insurance companies need to have the the currently healthy individuals that previously weren't covered to buy coverage. If they don't, these ACA plans will quickly resemble the old high risk plans with premiums raised to cover the unlimited liabilities. There is nothing in the current law keeping an individual from paying the "fine" until their cancer is discovered.

The law counts on the healthy to pay for the sick and the young to pay for the old. If those young and healthy individuals don't buy their insurance we'll prossibly see some dramatic rate increases. I do think that these initial plans are priced to pretty well protect the insurance companies since the difference I would pay in a plan is not much different than what I'd pay for a high risk plan.

I'm waiting for the "I can't afford the high deductible" news stories in a couple of months.
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Old 01-03-2014, 10:59 AM   #14
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OP here, we were glad to have the high risk pool, better than nothing, but it was not a long term solution.

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My husband finally has good health insurance
Old 01-03-2014, 11:00 AM   #15
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My husband finally has good health insurance

Amazing that psoriasis would make someone uninsurable forever. DH has a pretty common issue with a mitral valve prolapse that gets checked every so often and so far no issues, but imagine how far he would get on an individual health insurance application pre-ACA.
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Old 01-03-2014, 01:57 PM   #16
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OP here, not only did psoriasis make my husband uninsurable for health insurance, he was also turn down for disability insurance, life insurance and long term care insurance. At one time I got a copy of the list of conditions that would make you uninsurable for Blue Cross of North Carolina and it was over 200 conditions. It would be my guess that most people over 55 would be uninsurable by Blue Cross. I was lucky to get insurance from them at age 50 before I got high blood pressure that would have made me uninsurable prior to ACA.

Jo Ann
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Old 01-03-2014, 02:20 PM   #17
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I agree that the ACA was long overdue and greatly needed. I have never understood why the US had to be at the "bottom of the barrel" of industrialized countries in providing health equity to hard-working folks. I am very relieved for the OP and her husband!
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Old 01-03-2014, 02:24 PM   #18
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Originally Posted by golftrek View Post
OP here, not only did psoriasis make my husband uninsurable for health insurance, he was also turn down for disability insurance, life insurance and long term care insurance. At one time I got a copy of the list of conditions that would make you uninsurable for Blue Cross of North Carolina and it was over 200 conditions. It would be my guess that most people over 55 would be uninsurable by Blue Cross. I was lucky to get insurance from them at age 50 before I got high blood pressure that would have made me uninsurable prior to ACA.

Jo Ann
You wouldn't have been uninsurable as much as being exiled to the high risk pool. I think the insurance companies wanted as many people as possible in the high risk pool to help cover the costs of the cancer patients. I agree with the point about most people over 55 having something on the list. I don't know anyone over 50 that qualified for insurance other than the Texas high risk pool.

In plans available to me in Texas, I'm not seeing dramatic savings versus the now defunct Texas high risk plan. I'm pretty sure insurance companies priced their product with the expectation that individual policies would be closer to the old high risk pools.
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Old 01-03-2014, 02:33 PM   #19
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High risk pools were an attempt to make insurance available to the "uninsurable" but they have lumped people with marginally high blood pressure in with cancer survivors. Your husband has an issue that I don't think (in my ignorance) is that much of a drain on an inusrance company but they use this condition as an excuse to force him into paying the high risk pool rates. I would have been pushed into the Texas high risk pool at a monthly cost of approximately $600/mo. It would have been a $7500 deductible plan. You didn't say what your deductible is but it doesn't sound like you are saving much on the old high risk premium. You do get the unlimited lifetime coverage.
Yes, the ACA eliminates lifetime caps. Depending on your state, savings over the cost of the high risk pool may be considerable. Not all states established HRPs.

Quote:
Originally Posted by 2B View Post
The ACA attempts to address issues with the prior insurance plans. The biggies were the lifetime maximum and preexisting conditions. These are "resolved" with the ACA but insurance companies need to have the the currently healthy individuals that previously weren't covered to buy coverage. If they don't, these ACA plans will quickly resemble the old high risk plans with premiums raised to cover the unlimited liabilities. There is nothing in the current law keeping an individual from paying the "fine" until their cancer is discovered.
That's why there is an open enrollment period every year. This year it's extra long, next year and in subsequent years it will run from October until December. That's why there is a fine/tax to make free-riders kick in at least some small portion to cover their potential costs. Medicare part A and part D also raise premiums for people who do not sign up immediately. That may be something that needs to be added to the ACA.

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The law counts on the healthy to pay for the sick and the young to pay for the old. If those young and healthy individuals don't buy their insurance we'll prossibly see some dramatic rate increases. I do think that these initial plans are priced to pretty well protect the insurance companies since the difference I would pay in a plan is not much different than what I'd pay for a high risk plan.
That's how insurance works. When I was a young engineer, I was part of my company's pool. The old guys with COPD and pocket protectors paid the same premium as I paid even though I used to hoof it to work, 3 miles each way. Now, I'm old and starting to use some of the system. The ACA turns the individual market into one big group, like an employer's group.

In all likelihood, everyone who is young and healthy today, will have medical needs sometime in the future and will also, hopefully, get old. You know all those old people whingeing about their insurance plans covering maternity care and contraception? (my plan covers prostate cancer and I'm quite certain I'll never need that).

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I'm waiting for the "I can't afford the high deductible" news stories in a couple of months.
After working as a physician for twenty years, I've heard that complaint for oh, about, uh, twenty years. Next year, when premiums rise, I'm sure that there will be people loudly blaming it on the ACA. Presumably the ACA also caused all the premium rises over the past decades, too.

My BIL was born with two flaps in his aortic valve instead of the usual three. He's completely healthy, however, statistically the two flap valves occasionally need to be replaced. He doesn't need a valve replacement at this time and may never need one, however he was also uninsurable. Now he has insurance which he is paying for himself.
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Old 01-03-2014, 02:42 PM   #20
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I am truly happy for you. At the same time, it makes me upset that you had to deal with such absurdity.
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