Does this make DH "uninsurable"

[ChiliPepr]

I thinK there is a full moon this weekend

Not only a full moon, but a Supermoon!

 

[dgoldenz]

I think the broken back is a bigger issue than the REM sleep disorder, though going against medical advice is sure to lead to a decline if a company orders his medical records. There must be some type of residual issues from the broken back....narcotic pain medication, physical therapy, etc? You may have a few options:

1. Move to a state with a high-risk pool or that offers a guaranteed-acceptance policy, like DC or MD.

2. Check with the BCBS company in the state you are considering a move to and see if they offer guaranteed conversion coverage to someone with a BCBS plan from another state. Some BCBS companies call this an "interplan transfer" and others just call it a conversion. I believe all BCBS companies are required to offer at least one plan, though I could be wrong.

 

[Corporate ORphan]

I think the broken back is a bigger issue than the REM sleep disorder, though going against medical advice is sure to lead to a decline if a company orders his medical records. There must be some type of residual issues from the broken back....narcotic pain medication, physical therapy, etc? You may have a few options:

1. Move to a state with a high-risk pool or that offers a guaranteed-acceptance policy, like DC or MD.

2. Check with the BCBS company in the state you are considering a move to and see if they offer guaranteed conversion coverage to someone with a BCBS plan from another state. Some BCBS companies call this an "interplan transfer" and others just call it a conversion. I believe all BCBS companies are required to offer at least one plan, though I could be wrong.

Thanks for the information. We are currently paying the "very good" rate because before this we had no pre-existing conditions. Anthem BCBS sells insurance in other states. When we were researching insurance companies they said we would not have to go through underwriting again if we moved to another state they sell in but would have to change the policy to what they sell in the state we move into. Would they also change the rate based on his mishap??

His back is healing. We think the bones are healed, its just the muscles now. He is not taking any of the pain meds nor did they recommend physical therapy. THey just sent him home with a script for percocet and said it could take 6 weeks or 6 months. Hard to tell.

 

[dgoldenz]

Thanks for the information. We are currently paying the "very good" rate because before this we had no pre-existing conditions. Anthem BCBS sells insurance in other states. When we were researching insurance companies they said we would not have to go through underwriting again if we moved to another state they sell in but would have to change the policy to what they sell in the state we move into. Would they also change the rate based on his mishap??

His back is healing. We think the bones are healed, its just the muscles now. He is not taking any of the pain meds nor did they recommend physical therapy. THey just sent him home with a script for percocet and said it could take 6 weeks or 6 months. Hard to tell.

Anthem in VA does not accept transfers from other states that Anthem sells in, so this may be state-specific. I'd check with the BCBS company in whatever state(s) you are considering a move to. A guaranteed conversion policy may be charged at the highest rate, again depends on the state/company.

 

[sunnysideup]

I am really naive to this subject since I am still working, but I was under the impression that even with pre-existing conditions, if you have continuous insurance you CAN get it. It's having a gap in insurance that creates the problem.

Have I been misinformed?

 

[toofrugalformycat]

I am really naive to this subject since I am still working, but I was under the impression that even with pre-existing conditions, if you have continuous insurance you CAN get it. It's having a gap in insurance that creates the problem.

Have I been misinformed?

It didn't work that way for me. I was offered insurance all right, but they had riders like "no coverage for any tumor" (and I had never had cancer). What's the point? Many states now have high risk pools, and that's what I used (very high deductible) until I could get coverage through my work/retirement.
I'm sure someone else will chime in on this.

 

[Accidental Retiree]

You will not have as much choice, in our experience. Once COBRA expired, my husband could not get coverage, even through my P/T job, because of his pre-existing condition: T2 diabetes.

He had to get a guaranteed coverage plan.

For guaranteed coverage, each company provided the choice of 2 of their plans. The coverage was less than the COBRA plan he left behind, for more $$$.

Or he could have gone without coverage for 6 months and applied for CA's high risk pool, which costs even more than the guaranteed (HIPAA) plans.

I got my own policy and got a 10% surcharge for a couple of small things.

We weren't planning to retire when we did, and the retiree insurance we thought would be there "went away," but we had prepared. Still it is expensive and often I have felt somewhat held hostage.

Learning about other states' insurance pools has been encouraging.

 

[Old Microbiologist]

Madness

I am a bit shocked when I read these posts about the issues that face the US citizenry. As a military person I never actually had to deal with this issue and being relatively healthy it wasn't a big deal for me. NOw that I am living outside the US I also am not faced with these kinds of issues as I just go and get care. It is cheap and affordable and not an issue. But really I am reading through what is posted and wondering why people aren't completely fed up with the way it is in the US? I mean really, it is madness what health care has become. Here in Hungary if we need something we call our doctor. If it is minor he can come to the house and examine us and write a prescription for whatever we need. If it is major we meet him in the clinic and it is only $20 instead of the home visit which is $30. Major care is still not an issue and very inexpensive. My sister-in-law who visited us has congestive heart failure and entered a major medical crisis. We took her to the ER at our local County Medical Center and she was seen, x-ray'd, lab work, IV drugs etc. and we were out the door in under 3 hours and less than $100. I have many stories similar. Why can't this be the way it is in the US? It doesn't seem unreasonable to me. I have a number of physician friends here (I am a PhD level microbiologist and we socially gravitate to this class) and they are making comfortable incomes. They are not rich by any means nor do they expect that. Here doctors go into the profession through a desire to provide care for those who need it. They are aghast at what they see in the US and can't figure out our US system at all. For them it is also madness and incomprehensible. Medicine is not big business here. Pharmaceuticals are also very inexpensive unless it is a US manufactured product. Everyone in the country pays for health care by buying the national medical insurance (government plan). The cost is low and is roughly $25 a person per month. Amazingly it covers everything including dental, eyeglasses, prescriptions, long term care ... everything. No one even thinks about deductibles or co-pays. No one here even can understand what pre-existing condition means or having your insurance cancelled because of some minor infraction in filling out the forms. It is so bizarre to Europeans they actually can't follow the logic. I wonder how we let this come to pass in the US and why we don't just fix it? I would get out of there as soon as a person can like we did and enjoy life where human values actually have some meaning to the government. It really seems crazy to me to have to put up with any of this like we do in the US.

 

[Buckeye]

I am a bit shocked when I read these posts about the issues that face the US citizenry. As a military person I never actually had to deal with this issue and being relatively healthy it wasn't a big deal for me. NOw that I am living outside the US I also am not faced with these kinds of issues as I just go and get care. It is cheap and affordable and not an issue. But really I am reading through what is posted and wondering why people aren't completely fed up with the way it is in the US? I mean really, it is madness what health care has become. Here in Hungary if we need something we call our doctor. If it is minor he can come to the house and examine us and write a prescription for whatever we need. If it is major we meet him in the clinic and it is only $20 instead of the home visit which is $30. Major care is still not an issue and very inexpensive. My sister-in-law who visited us has congestive heart failure and entered a major medical crisis. We took her to the ER at our local County Medical Center and she was seen, x-ray'd, lab work, IV drugs etc. and we were out the door in under 3 hours and less than $100. I have many stories similar. Why can't this be the way it is in the US? It doesn't seem unreasonable to me. I have a number of physician friends here (I am a PhD level microbiologist and we socially gravitate to this class) and they are making comfortable incomes. They are not rich by any means nor do they expect that. Here doctors go into the profession through a desire to provide care for those who need it. They are aghast at what they see in the US and can't figure out our US system at all. For them it is also madness and incomprehensible. Medicine is not big business here. Pharmaceuticals are also very inexpensive unless it is a US manufactured product. Everyone in the country pays for health care by buying the national medical insurance (government plan). The cost is low and is roughly $25 a person per month. Amazingly it covers everything including dental, eyeglasses, prescriptions, long term care ... everything. No one even thinks about deductibles or co-pays. No one here even can understand what pre-existing condition means or having your insurance cancelled because of some minor infraction in filling out the forms. It is so bizarre to Europeans they actually can't follow the logic. I wonder how we let this come to pass in the US and why we don't just fix it? I would get out of there as soon as a person can like we did and enjoy life where human values actually have some meaning to the government. It really seems crazy to me to have to put up with any of this like we do in the US.

Are you retired from the US military? If you grew up in the US and lived in the US for your military career, were you still completely unaware of how the civilian medical system worked? You seem surprised by the state of US healthcare system and I find that odd.

 

[Old Microbiologist]

Actually, it isn't that odd. I did in fact work in the private sector as a Clinical Laboratory Director but that was in the early 80's and things hadn't gotten this bad yet. HMO's were a "new" thing and there were still a lot of not-for-profit (in fact the majority of health care was from religious institutions) hospitals. Medicine was not yet a business. Blue Cross/Blue Shield were not-for-profits still. Kaiser was the new boy on the block and represented the first foray into profitable medicine as a business.But, yes also my personal medical care has all been through the military which, by the way, is the most socialistic system on Earth. I retired after 28 years in 1999 but still had TRICARE Prime which at $400 a year I can now see isn't so bad after all. After all, this is the same medical care system that Congress and the Executive branch utilize, free of charge. There are some negative's though in the military health care system. You can't sue for malpractice, there are long and frustrating waits for appointments and tests. The care can be bad and somewhat risky but not especially different than anywhere in the US and differs from facility to facility and doctor to doctor. But, having been under that system for over 40 years I was completely unaware of the problems facing most Americans. $12,0000 deductibles? I had no clue. My point is that this such a horrible problem why aren't Americans protesting en masse? Why do we tolerate this shift of health care from reasonable and/or charitable care to a business model? It doesn't have to be that way. Why is socialized medicine perceived as so bad? It is the system our military and Congress use so why not for the rest of the US as well?

 

[dgoldenz]

Hungary has a 27% VAT and a flat income tax of 16%. Nothing in life is free.

 

[Buckeye]

Actually, it isn't that odd. I did in fact work in the private sector as a Clinical Laboratory Director but that was in the early 80's and things hadn't gotten this bad yet. HMO's were a "new" thing and there were still a lot of not-for-profit (in fact the majority of health care was from religious institutions) hospitals. Medicine was not yet a business. Blue Cross/Blue Shield were not-for-profits still. Kaiser was the new boy on the block and represented the first foray into profitable medicine as a business.But, yes also my personal medical care has all been through the military which, by the way, is the most socialistic system on Earth. I retired after 28 years in 1999 but still had TRICARE Prime which at $400 a year I can now see isn't so bad after all. After all, this is the same medical care system that Congress and the Executive branch utilize, free of charge. There are some negative's though in the military health care system. You can't sue for malpractice, there are long and frustrating waits for appointments and tests. The care can be bad and somewhat risky but not especially different than anywhere in the US and differs from facility to facility and doctor to doctor. But, having been under that system for over 40 years I was completely unaware of the problems facing most Americans. $12,0000 deductibles? I had no clue. My point is that this such a horrible problem why aren't Americans protesting en masse? Why do we tolerate this shift of health care from reasonable and/or charitable care to a business model? It doesn't have to be that way. Why is socialized medicine perceived as so bad? It is the system our military and Congress use so why not for the rest of the US as well?

Thanks for the background info.

DGOLDENZ - Thanks for the background info.

 

[Old Microbiologist]

Yes, Hungary has a 27% VAT and a flat rate income tax of 16% (actually that seems pretty fair). I don't pay the income tax as I file in the US and there are international laws against dual taxation. If I work here then yes, I will pay but I believe I can claim it as foreign earned income as well. It hasn't and isn't likely, to have come up for us. But, if you examine the US the tax situation is much worse (at least for the 47% who actually pay income taxes). There is the 15.3% for FICA/Medicare (yes, it is half for employees but it is really taken out of your pay anyway), state income tax (most states), and sales tax which can run as high as 18% in upstate NY. Then there is a huge property tax in most areas it hovers around 1% and in Norther VA, Arlington County it is 1.5%. In Hungary it is essentially zero. I must pay a city property tax of about $200 a year for maintaining the streets etc. There is also no death tax here. Yes, 27% VAT sucks but with the dollar having risen 30% this year we don't feel it and it is built into the prices so you don't see it. Even so most things are the same prices as in Germany where the VAT is 18%. The biggest difference with regard to health care is all doctors, nurses, and ancillary staff are federal employees. Doctors all have a fixed salary because of that which is roughly $1,200 a month. That is considered a relatively high income here where the President earns $75k a year and minimum wage is roughly $400 a month. There is a black economy of "tipping" doctors roughly 1/2 of the fee they would get but it isn't mandatory and nearly all doctors run private offices after hours for cash for those who can afford it or don't want to wait for service. For us it is great and I usually get same day (evening) appointments when I call and no requirement for any referrals or permission for anything. You want something, pay cash and you can have it done the same day for very cheap. It is all a matter of perspective and what you are willing to have your government do with it's tax money. I think health care, education, retirement benefits, etc. are better than a huge military budget. But the people in the US make that choice and we now suffer the consequences of those decisions. As far as I know there is no perfect country to live in. All have some positives and negatives. We chose Hungary more for the climate and lifestyle and relatively low cost of living. The health care turned up as a surprise and I am merely sharing our experience here as an alternative choice. In fact I was a bit shocked how good it is. Like many I assumed former communist countries were is some kind of never ending despair and things would be non-functional. How wrong I was to have assumed that. Yes, there are some crazy bureaucratic nuances to deal with which are holdovers from the communist era. But, these are few and far between and usually a bit comical.

 

[Buckeye]

I think health care, education, retirement benefits, etc. are better than a huge military budget. But the people in the US make that choice and we now suffer the consequences of those decisions.

+1 (from one who also served, 10 years Air Force)