<p>I’m in need of serious advice and don’t know where else to turn. Any help will be appreciated. I’ve always had my health insurance through my husband. I have worked but only part time and never with benefits. I am 58 years old. My husband will be 66 in July.</p>
<p>In 2009 I got cancer. My husband was still working at the time and we were adequately covered, or so I though. Since then he retired on disability although he is now old enough to be on full retirement, collecting social security, his pension and retirement accounts. We continued to have health coverage through his previous employer by paying premiums of about $900 a month which we thought was great.</p>
<p>Since 2009 I have had various other health issues due to the cancer. Although I’m in pretty good health now, you know how that goes.</p>
<p>Today we received in the mail a statement from the insurance company saying that we have reached the lifetime maximum benefit allowed by our plan. I’m in pretty much of a panic right now since I have seven years before I’m even eligible for medicare. </p>
<p>I have so many questions, but want to calm down and think before I figure out what to do. Can we get insurance anywhere else? Where should we look? </p>
<p>We own our house outright and I still work part time, but there’s no way that would cover us if something happened to bring the cancer back or if I get something else. I guess I could look for a job with benefits, but would anyone even hire me under this condition.</p>
<p>I think this issue was addressed by the Affordable Care Act. If your bills that exceeded the original “lifetime cap” were from procedures after the act was passed (2010) I think you may be covered - or at least partially. I would suggest you contact your State Insurance Commissioner to clarify your rights. Here is a link explaining the Affordable Care Act and the phasing out of lifetime and annual limits.</p>
<p>It is going to vary from state to state, but both of the states I’ve shopped in have a “high risk” exchange where you can buy insurance if you have been turned down or used up your benefits with private insurance.</p>
<p>I have used an insurance advocate in the past when I’ve had questions about my bill ( mine were less serious than yours, but my point is that I’m talking about someone I have actually used) and I have referred him to others who have had problems with their medical insurance companies refusing coverage. </p>
<p>If you are interested in his name/contact info, PM me and I’ll forward it to you. I don’t know if he can help you or not, but I do know that he is really good at what he does and will be able to give you good advice.</p>
<p>Note, however, there is political uncertainty about the PPACA.</p>
<p>In the worst (for you) case, you would need to find some way of getting into an insured group (usually an employer or a union) to get medical insurance.</p>
<p>Thank you. All of this is very helpful. I can’t imagine what we’re going to do. If I have a reoccurence, it could potentially cost hundreds of thousands of dollars which we just cannot afford. I thought we were doing everything right.</p>
<p>I tried to answer all the PMs that I got about a referral for the advocate I mentioned in post #4. Some bounced. If you did not get a response from me tonight, then you mailbox is full and I can not reply to your PM until you clean out your inbox. Or PM me with your email address and I’ll reply that way. </p>
<p>I tried to post his contact info here, but I see that my post was deleted, so I evidently violated a CC rule.</p>
<p>Some colleges offer school sponsored “group” health insurance plans to their enrolled students. I have seen comprehensive college plans that charge the same flat premium regardless of the students age or gender…a 58 y.o. female student with preexisting would be charged the same as an 18 y.o. boy student. Preexisting conditions are covered and the annual premium could be as low as $1500. This certainly might not be for you, but it might be something to investigate if you would be willing and able to enroll in a nearby college that made coverage available to you at your age and with your health history. I know this is a quirky insurance plan for you, but it is out there and available at some colleges. Good luck.</p>
Doesn’t it concern anybody else that there are that many people just on this site that are in need of this information?</p>
<p>This made me go look into our coverge and what I found really scared me. </p>
<p>Lizard: that is a wonderful suggestion except that wouldn’t the tuition you have to pay for a non necessary degree in your 50’s outweigh any savings in health care costs? Not only that, but you’d have to stay enrolled until you reached at least 65 for medicare eligibility.</p>
<p>I’m just trying to make an “outside the box” suggestion. It wouldn’t work for everyone, but it’s a possibility for someone who can’t get coverage elsewhere. A 72 y.o. woman graduated from my college with a doctorate degree in nursing last month!</p>
<p>lizard, that is a brilliant suggestion. I wonder how many people are enrolled in courses “just for the health insurance” the way many people take on a crappy job “just for the benefits?” At the same time it is a sad comment on our system that a person would even have to consider that option.</p>
<p>Can’t get a job, desperately need health insurance? Run for office!</p>
<p>Not necessarily. The OP’s cancer history basically makes her unable to get any individual medical insurance policy (this will change in 2014 if the PPACA remains in place, which is not certain politically, and does not solve the problem for the current time frame anyway). So she will have to self-insure, which could be extremely expensive if something expensive (like cancer recurrence) happens.</p>
<p>Local non-flagship state universities may be worth considering for this purpose, due to the lower in-state tuition, relatively easy admission standards (including more lenient policies on seeking second bachelor’s degrees, if applicable), and greater likelihood of allowing part time enrollment (if desired). The group student health insurance plans are often not that expensive (since most students, even non-traditional ones who are more common at local non-flagship state universities, are relatively young and healthy), but may not be very extensive (due to the relatively young and healthy student demographic not needing or wanting to pay for deluxe features like generous prescription drug benefits).</p>
<p>Community colleges would be an even less expensive way, except that it does not appear from a sample check that those in Michigan have any sort of group medical insurance plan available for students.</p>
<p>One big question I have is should we continue to pay the premiums if we can no longer be covered? The next premium is due July 1 so I guess that is one big question that should be answered. Also, my husband is worried that if we were to be taken to the hospital with no insurance, how would we be treated? This is not just a random question. I’ve been hospitalized six times so far this year.</p>
<p>You should be able to get an answer to that question from your current insurance provider. Call the number on your card or if you are not satisfied with that answer, call the person I referred you to. He should know for certain.</p>
<p>Please call your state insurance commissioner’s office. I would not stop paying premiums – if you do, you may not have the right to restart even if they gave you incorrect information.</p>