<p>anothermom2, as I understand it, that applies only to group coverage, which doesn’t help the millions of people with individual policies, or the 50 million people who don’t currently have insurance at all.</p>
<p>According to my reading of the Department of Labor website, they can exclude preexisting conditions under certain circumstances. They’re allowed to look back six months. At least, that’s the way I read this; please correct me if I’m wrong:</p>
<p>LasMa–for group plans they can only exclude pre-existing conditions if there was a break in coverage, more than 63 days. The above quote is for people new to a plan that did not have continuing coverage. They cannot impose the preexisting clause otherwise. Your old plan will issue a certificate of insurability if you need proof of continuing coverage. In some states this also applies to individual plans under state laws, but not many have this addition.</p>
<p>I spoke to a broker and he confirmed that for now, a plan can refuse to insure us because of pre-existing conditions. In 2014 this will change due to the healthcare law. It is very very frustrating to me, that people who do not care for themselves can switch insurance, but because my DH had one episode of idiopathic atrial fib, we may not be able to switch. </p>
<p>I know people who have not been able to change jobs because a family member had diabetes Type 1 and could not get new coverage.</p>
<p>Anyway, he gave me some plans to look at and it is nice to have a professional who can explain the policies in detail. I live in fear that I will buy something and then get a condition and not be able to see the doctors I want to see.</p>
<p>Am so glad that there will be more options available to all starting in 2014. We were careful not to allow any lapse in S coverage just because we were concerned a out having to fight about his per-existing medical conditions.</p>
<p>It might be cheaper to let your buy insurance through his college. The plan they offer will work well with the nearby medical facilities. The plans colleges offer are usually comprehensive and affordable.</p>
<p>Actually S now has a job where he could get inexpensive (subsidized) medical coverage with his full time job. There was a window after he lost his U coverage and before his job began
N that we had to cover with individual coverage at $300-400/month. Glad he’s back under our family plan until hr turns 26.</p>
<p>I really don’t understand the varying prices from state to state. I have a BC/BS self pay family plan, $10k deductible for under $500/mth. Actually, they have a new program where if deductible is not used it decreases 20%, then another 20% the year after and then another 10%. So, for a healthy family, that $10k ded drops to $5k.</p>
<p>For those in the know, why such drastic costs differences between states?</p>
<p>geeps, one reason is the difference in the authority which different states give to the insurance commissioner or department. In 37 states, the commissioner can deny excessive rate increases. In states where the commissioner doesn’t have that power, rates and rate increases tend to be significantly higher, not surprisingly. For example, this year in New York the commissioner held increases to 10% whereas in California, where the commissioner is powerless, increases are in the mid-20s. In other words, one reason for the disparity is good old fashioned price gouging.</p>
<p>geeps20–there is more to the pricing then just the state–even within a state you will find different rates based on zip code. Age has a lot to do with your rates on individual plans as well. Also, in some states health insurance companies are for-profit enterprises and in other states they are not-for-profit. That greatly affects the rates to as to maintain the not-for-profit standing they have to return at least 95% of their profits back to their “shareholders”–which are the policy holders–which lower rates. Also, some states are just healthier than others so when you are in a larger risk pool like the individual plans (yes, they lump that risk pool together), you pay for the unhealthy people in your plan.</p>
<p>Who are these people who “don’t care for themselves”? Do you think that if you “care for yourself” you are immune from developing health problems? Think again.</p>
<p>FWIW, I would steer clear of the insurance offered by the National Association of the Self-Employed. We had that at one point, and discovered that it didn’t cover chemotherapy (and probably other major things). Not much good if it won’t cover a catastrophic illness. We switched to a plan with a $15K deductible per person, and even that eventually cost us $400 per month.</p>
<p>^^“Who are these people who ‘dont care for themselves?’”</p>
<p>My daughter is an ER nurse and she can tell you who these people are. They are the ones who ignore the doctors instructions, do not take their medicine as directed and basically refuse to help themselves as it pertains to their medical care. They want the hospital (the Drs and Rns)to take care of them. </p>
<p>They are many of the ‘frequent flyers’ at the ER. Ask if they are avoiding sugar sodas (if diabetes is the problem. Ask if they picked up their Rx (sometimes it is even provided free but they still do not even pick it up from the pharmacy). Ask if they went to their dr appt - the one that the hosp made for them at the patient’s request.</p>
<p>There are people out there who run their lives very differently than you or I. It is hard for us to imagine the choices some people make, but my daughter sees this every day at work. And we are subsidizing their choices with our medical insurance costs.</p>
<p>Consolation–the country is full of people that don’t eat right, don’t watch their weight, don’t take medications that they are supposed to, etc, etc, etc. They cost everyone money. No, no one is immune to health issues, however, taking care of yourself does eliminate or greatly decreases your chances if getting many diseases and health issues. You would have to live in a bubble not to understand that.</p>
<p>You would have to live in a bubble not to know that the reason our healthcare distribution system is broken has very little to do with “those people,” even though they do indeed exist.</p>
<p>Probably most people in the US, although unhealthy behavior is only part of the reason (as opposed to the entire reason) for high medical care costs in the US.</p>
<p>Nothing is for certain, but taking better care of yourself does reduce the risk of both health problems, and the various other problems associated with needing medical care in the US (insurance issues, going bankrupt due to medical bills, medical care errors, etc.).</p>
<p>Consolation, I’m sure you didn’t mean any offense, but I am taken aback at what you are saying here.</p>
<p>I’m NOT referring to “these people” (your quotes in a later post, not mine). I am referring to people like my MIL who, when told she had prediabetes, refused to change her diet or lifestyle and is now being treated for resulting complications. Or another close relative who did not follow doctors orders regarding osteoporosis treatment and is now being hospitalized, in great pain, and undergoing many invasive (read expensive) tests, all of which could be avoided.</p>
<p>My original point was that we were being penalized for something idiopathic, when other people are consuming more healthcare costs BECAUSE of certain choices they made, and they are NOT being similarly penalized. Unless they try to change jobs, I suppose.</p>
<p>Yea, asthma (absent smoking or intentionally exposing oneself to lung irritants) is not something one acquires by “choice,” so much as genetically. I suppose of asthmatics didn’t meet, marry and start families, there would be some reduction in asthmatics, but otherwise it is generally NOT seen as something caused or related to lifestyle (ABSENT smoking in the household).</p>
<p>Yes, some health choices CAN cause more expensive medical care, including obesity, Type II diabetes, a huge range of health issues caused by tobacco, alcohol and recreational drugs. Many other health issues are idiopathic and the most diligent and otherwise healthy folks in the world can still have them and require higher medical costs. It is just the way things go sometimes. Blaming folks when no one knows why the medical condition exists and how to improve it is rather pointless and hurtful.</p>