<p>Let me get this straight. You continue to pay your premiums, but you can’t collect anymore on the benefits side. </p>
<p>Hospitals are required to deal with emergencies that come through the door. That is, the emergency itself. If there’s a chronic condition that caused the emergency, they don’t have to treat it (and, without insurance, usually won’t.) They’ll stabilize your condition and send you home. And then send you a big, fat bill, and threaten to take your house.</p>
<p>Politicians cannot seem to figure out whether they really want an individualized self-pay system (probably much less practical now than in the past, due to very high costs), or a pooled insurance system (whether single payer or community rating with an individual mandate to ensure that the pool includes the healthy as well as the sick).</p>
<p>The current mismash of single payer (Medicare), small insurance pools (employer groups with varying levels of cost and coverage), individualized self-pay (doable for the wealthy, sometimes chosen by the poor and healthy who are willing to take risks, sometimes forced upon others like the OP), and individualized insurance (only available to the currently healthy) is not exactly what anyone would consider an ideal system. To top it off, it costs way more than in any other rich country, without providing better outcomes on average (yes, wealthy people can pay for the best, but most people’s health care decisions are rationed by private or government insurance companies).</p>
<p>Lifetime limits are no longer allowed. The ban on lifetime dollar limits for most covered benefits applies to every health plan whether you buy coverage for yourself or your family, or you receive coverage through your employer. The ban on limits was effective for you on the date you renewed your policy, on or after September 23, 2010. Are they denying a charge from prior to that renewal date?</p>
<p>Here is a good Michigan website discussing insurance: [MDCH</a> - Help Finding Health Care](<a href=“http://www.michigan.gov/mdch/0,1607,7-132-2943_52115---,00.html]MDCH”>Help Finding Health Care). You can contact the state or file a grievance against the insurance company if they were doing something that was not on the up-and-up. Or you can see if there is anything that will help you now.</p>
<p>Did you drop your insurance? If you did, and if you did it only because you thought you no longer had any coverage … contact the insurance office at the State. Maybe you can get your insurance reinstated if you were intentionally misled. It may be that your insurance company was allowed to put a limit on your care, but to be honest, my understanding is that this practice is no longer allowed.</p>
<p>What about the company your husband retired from? They can help. I work for a group insurance broker/consultant, and one of my clients has retiree health care. I help them resolve issues all the time.</p>
<p>Thanks Kelsmom. That’s what I thoughht too but according to the insurance company I meet the exception and am subject to the lifetime limiits. I will try contacting the State. I will pay our premium for this month so it gives me another month to sort this out. Our insurance right now IS through the company that my husband retired from. He has not met his lifetime limits and has Medicare so he’s allright. Thankfully since the SCOTUS affirmed Obama care, I can hope that in 2014 I regain coverage. All I have to do is stay healthy until then.</p>
<p>Ford, this is awful that you have to go through this. You are one of the people who played by the rules of our American health care system, as twisted as they are, and through no fault of your own, got dropped. You should not be in fear of being sick for the last 1 1/2 years…</p>
<p>Another wonderful thing about the ACA is that establishes consumer protections. If your insurance company lies to you about being an exception to the no-cap rule, or if they illegally terminate you, then it’s no longer going to be you vs. a corporate behemoth.</p>
<p>The ACA is being rolled out very slowly. I don’t know if the lifetime-cap rule is already in place, but it’s worth checking. Because if it is, you’re good.</p>