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Lindakimy

(19 posts)
Sun Dec 11, 2011, 10:26 PM Dec 2011

Just found out I am "uninsurable"

It wasn't much of a surprise. I've had Crohn's disease since childhood. It tends to freak people out. But I've worked very productively for over 20 years (and that is after staying home raising my children when they were little). I have a great attendance record; I am on time and ready to work. And I do a pretty good job, if I do say so. I have learned to deal with some pain and inconvenience but my life is more or less normal. I don't think I am any more handicapped than someone with seasonal allergies, if that much.

Recently I found a new job - WOW! AT MY AGE! IN THIS ECONOMY! - to replace the one that had been cut 20% 3 years ago and was threatening to cut again. I had group insurance at that job but it had a $10,000 deductible and cost me $380 a month. Because of problems with my doctor and the insurance company nothing had been paid for over 2 years, not even office visits. Besides that, the job was driving me insane. It was filthy, noisy, unhealthy, lacking any hope of pay raise or appreciation. And the boss had a habit of going off now and then and screaming at me for no particular reason besides his own stress relief. I had been there almost 8 years and knew the next 8 would be the same. Monday mornings I went to work wishing I could just take a beating instead. That is no way to live.

So when the new job came along with new challenges and possibilities I decided I should go for it. So far it has been good. It is a stretch but that is o.k. Finally I can feel competent and worthwhile in my job. People who know me comment on how much better I look and what a positive move this has been.

Insurance, though, means finding a private insurance policy and my employer will cover half of the premium after my probation period. So. After hunting and looking and applying, it turns out that I am uninsurable because of the Crohn's disease. I have been referred to a risk group in my state or a federal option.

Does anyone have information or recommendations about what would be best?

I am waiting for 2014 and then for Medicare. If I can make it until then, fine. But there are a few years still to get through. I'd appreciate any insight or advice.

Thanks in advance!

52 replies = new reply since forum marked as read
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Just found out I am "uninsurable" (Original Post) Lindakimy Dec 2011 OP
I commiserate with you and rage at the 'system' CurtEastPoint Dec 2011 #1
Best of luck, great you're out of old job and doing nicely in new job. elleng Dec 2011 #2
Skip the insurance. izquierdista Dec 2011 #3
It's one hell of a risk to take Warpy Dec 2011 #5
The other thing to point out is that the current health care system truedelphi Dec 2011 #21
I would have to agree Seedersandleechers Dec 2011 #6
I had to stop taking pain meds because my doctor decided that I needed to see him every 3 weeks MedicalAdmin Dec 2011 #11
That is so not right. Seedersandleechers Dec 2011 #13
Those are great ideas. MedicalAdmin Dec 2011 #16
Our household has been in the same situation truedelphi Dec 2011 #23
That is just so not right. Warpy Dec 2011 #25
Good ideas, but I can't afford the appointment for the referral and then the referral appointment... MedicalAdmin Dec 2011 #27
+1 freshwest Apr 2012 #44
same here--cancer survivor at 39 zazen Dec 2011 #4
Glad you survived! Lindakimy Dec 2011 #10
That is great advice. And one other thing - for the duration of your time truedelphi Dec 2011 #24
Best of luck to you Irishonly Dec 2011 #7
Have you checked out the federal pre-existing condition pool? Vinca Dec 2011 #8
Checking it out now Lindakimy Dec 2011 #9
I just checked out the federal program in my state... MedicalAdmin Dec 2011 #12
I am so sorry Irishonly Dec 2011 #14
Chronic health and insurance Bully Taw Dec 2011 #15
I am glad that your son is getting good care. MedicalAdmin Dec 2011 #18
When your son is no longer able to be on your insurance, some fifteen years from now, truedelphi Dec 2011 #22
Working in admin in a private clinic as I do (and as a former drone for BCBS)... MedicalAdmin Dec 2011 #28
I had heard that information mentioned and didn't truedelphi Dec 2011 #30
you are correct. unapatriciated Jun 2012 #46
I'm going with "what is dumber than a sack of hammers, for $200 Alex?" n/t MedicalAdmin Dec 2011 #17
LOL Thank You! Irishonly Dec 2011 #19
Anytime and it was my pleasure. MedicalAdmin Dec 2011 #20
Yet our health costs in this country are significantly higher truedelphi Dec 2011 #31
I heard the crap regarding wait time - Canada vs US. unapatriciated Jun 2012 #47
I was thinking about the federal pool, too tpsbmam Dec 2011 #26
IT's good that you can afford that. MedicalAdmin Dec 2011 #29
OMG, that's the story of my life! tpsbmam Dec 2011 #32
Good luck and merry Christmas. MedicalAdmin Dec 2011 #33
Update on uninsurable Lindakimy Feb 2012 #34
Please . . . check the federal pool. Vinca Feb 2012 #35
Information? Lindakimy Mar 2012 #36
Here you go. Good luck. Vinca Mar 2012 #37
Where to start Lindakimy Mar 2012 #38
I just clicked on South Carolina at the link and you're in luck because the feds control it. Vinca Mar 2012 #40
New hook in the fish Lindakimy Mar 2012 #41
That's a big flaw in the law. My neighbors were in the same boat. Vinca Mar 2012 #42
That is exactly what I need - anon223 Oct 2012 #50
Here's what happened when I applied - Vinca Oct 2012 #51
PICIP (Pre-Existing Condition Plan Preybrother Mar 2012 #39
Holding pattern Lindakimy Apr 2012 #43
Spring for the high risk insurance and pray that Obamacare survives the SCOTUS. McCamy Taylor Apr 2012 #45
I am in heart failure. My insurance company dogday Sep 2012 #48
Just saw this and KNOW you can relate. Check it out. Proof that PCIP WORKS! SJohnson5677 Oct 2012 #49
That's great Lindakimy Nov 2012 #52

CurtEastPoint

(18,650 posts)
1. I commiserate with you and rage at the 'system'
Sun Dec 11, 2011, 10:34 PM
Dec 2011

This is what happens when $$$ reign almighty in health care.

I, too, am looking forward to changes w/2014. Best wishes to you!

elleng

(130,974 posts)
2. Best of luck, great you're out of old job and doing nicely in new job.
Sun Dec 11, 2011, 10:38 PM
Dec 2011

No info about insurance, sorry, but

 

izquierdista

(11,689 posts)
3. Skip the insurance.
Sun Dec 11, 2011, 10:39 PM
Dec 2011

Even if you could get it, it's betting against the house; they will make sure you pay them more than they have to pay out for you. Start looking now for clinics outside the country that you can visit if and when you need to. Also have your travel options figured out so that you can get there in fairly short order.

Warpy

(111,276 posts)
5. It's one hell of a risk to take
Sun Dec 11, 2011, 10:58 PM
Dec 2011

but I've been uninsurable since 1987 and if I added it all up, medical expenses against lower wages and then money out of my pocket for premiums and copays, I'd be thousands and thousands of dollars ahead of the game, that money saved for when I became too sick to work (which I eventually did). All my medical expenses were out of pocket. They didn't stretch to preventive care, so I feel like a collection of marginal parts silently wearing out, but I did manage to take care of the illness that disqualified me from insurance.

One hopes the high risk pool will eventually spell some relief, but knowing the industry from the inside out the way I do, I am not optimistic. They will continue to try to hit us with unaffordable premiums and if forced to take us, will delay and deny all the care they possibly can.

truedelphi

(32,324 posts)
21. The other thing to point out is that the current health care system
Fri Dec 16, 2011, 05:03 PM
Dec 2011

Is so rigged for profit that even if you have top of the line insurance, and think you'll be okay, it all depends on where you live as to how well you will do after a needed procedure.

For instance, if you live in the San Francisco Bay Area, and your doctor practices at UCSF, a "teaching hospital," you will probably have a great experience. On many levels. And although this institution faithfully fulfills the "diversity" requirement resulting from anti-discrimination legislation, it doesn't do this on the backs of the patients.

People who work at the hospital speak English. For the most part, fluently.

Contrast that with Marin General Hospital, where the nursing aides will simply scream at the patients "No compren' Ingles" when the patients ask for water or even more critical needs to be met. And since there are very few nurses, this is a huge and even life threatening problem.

Additionally, hospitals that are geared for profit, like Kaiser and Sutter franchises, do not mind skimping on equipment, even to the point that "sterile" bandages are so old they are no longer sterile. Many nurses are "Traveling" nurses, meaning they do not work for the hospital, but work for a nursing agency. As a result, the first few days on a ward, they don't have any idea where most things are. Good luck to patients needing a crash cart, digitalis, or a shot to stop anaphylactic shock.

When Big Insurers approve an $ 89K by pass heart surgery, they should care that the post op care is excellent as well. But they don't. So if the bandages for that surgery are poor quality, if the nursing staff is inattentive and non-existent, all this means is that a person gets to undergo a tremendously upsetting ordeal, where they may "fly through" the super-expensive surgery, but then die of an infection due to inadequate post op care.







Seedersandleechers

(3,044 posts)
6. I would have to agree
Sun Dec 11, 2011, 11:00 PM
Dec 2011

With what you were paying for monthly fees you could stash away in a savings account. Flights to Europe can be bought for $400 round trip if need be. I hear Spain has really good medical facilities and at a reasonable price. I know it really sucks that it has come to this but here's hoping you will make it until 2014. I'm 58 without insurance (not working) so I pay cash for a doctor's visit to get refills on my meds. It costs me $200 every 6 months for just a 10 minute visit. I'm lucky because I only require muscle relaxers and pain meds. Best of luck to you.

MedicalAdmin

(4,143 posts)
11. I had to stop taking pain meds because my doctor decided that I needed to see him every 3 weeks
Tue Dec 13, 2011, 08:32 PM
Dec 2011

at !00 a pop to get a new script. And he wouldn't issue refills. Then the meds went from $6 to $200. ...

So I go without. I too can't get coverage. And I have 20 years to go before medicare. I won't make it. So why pay those bastards a fucking dime?

Seedersandleechers

(3,044 posts)
13. That is so not right.
Tue Dec 13, 2011, 09:03 PM
Dec 2011

The doctor I see is on staff at the local "charity hospital" and I get discounted pain meds if I use their pharmacy. It's a walgreens but I'm only charged $14 for a prescription that would cost $120 at any other walgreens. I really don't know how it works but it's an outpatient hospital pharmacy that has been "outsourced". Do you have any intercity charity type hospital you could go to as an outpatient? These hospitals run on grants, donations and state/federal funding. It is also a teaching hospital with a medical and nursing school which also cuts the costs greatly. Another thing - when I get my doctors bill I call the account manager and tell them I don't have a job. They discount it 30% everytime.

MedicalAdmin

(4,143 posts)
16. Those are great ideas.
Thu Dec 15, 2011, 02:04 PM
Dec 2011

I'll look into them but I've already asked about discounted or limited income programs. So far, nada. Couldn't hurt to make a few phone calls again I suppose.

As for the drugs, I have found a non addicting south pacific narcotic that is not (at this time - author crosses fingers and prays) too expensive and seems to take the edge off when I need it.

Thanks for your feedback. I wasn't in a good place when I wrote it.

truedelphi

(32,324 posts)
23. Our household has been in the same situation
Fri Dec 16, 2011, 05:24 PM
Dec 2011

And we managed to find a clinic run by a Native American Tribal group that does sliding scale appointments. So we are no longer paying $ 154 for an office visit, but only $ 45. And the new doctor doesn't require that we see him every time the pain meds run out, but every third time.

After we found this group, we were mentioning this inability to pay full rate to someone who runs one of the local hospitals. And she said that often hospital administration teams know of "free" or cheaper clinics for people to use.

I had never thought of simply calling the hospital to ask them to help with information about our situation. But it makes sense: If local people have a clinic to go to, they are less likely to be showing up at the hospital emergency room.



Warpy

(111,276 posts)
25. That is just so not right.
Fri Dec 16, 2011, 05:55 PM
Dec 2011

I get my Ultram six months per scrip and I've found out that's not unusual any more, a lot of chronic pain patients are getting big refills. Most of the medical profession seems to have been alerted to the fact that we don't try to get high, we just want to function.

Ask for a referral to a pain service. Untreated pain is fatal, patients isolating themselves, getting depressed, and finally ending it all.

You deserve better than that.

MedicalAdmin

(4,143 posts)
27. Good ideas, but I can't afford the appointment for the referral and then the referral appointment...
Sun Dec 18, 2011, 02:48 PM
Dec 2011

would just add to the stress.

I get what you are saying and will keep it on my plate for consumption at a later time. At least it'll allow me to start of budget and save up...

zazen

(2,978 posts)
4. same here--cancer survivor at 39
Sun Dec 11, 2011, 10:55 PM
Dec 2011

Well, I went back for my PhD and have great student health insurance ($800/year, free labs at student health, reasonable co-pays elsewhere) until the "health exchange" is up and running (or I get remarried to a state employee!). Is a doctoral program something you can do? I also needed to borrow the money just to pay the bills, and a doctoral program made me eligible for low-interest loans. Pathetic, isn't it? But being a grad student reopened doors so that I was no longer "unemployed." People perceive me as younger and more up to date. I have great part-time work that I can leverage into something better. It was a good jumpstart.

Maybe a part-time or online program at a public university would give you an affordable option?

Lindakimy

(19 posts)
10. Glad you survived!
Mon Dec 12, 2011, 08:15 PM
Dec 2011

I'm glad you have found a way around your problems but do be careful of debt. I hope your education will help you greatly in the future. However, at 61 (very close to 62) I think it may take more than a doctoral program to make me seem younger. I already have a degree, the job I have now requires more than 40 hours per week and, frankly, I just don't have the stamina to add night classes to this mix.

My choice is between no insurance or some sort of government risk pool provision. My question is whether the state or federal version is superior. I lean toward the federal because I have very little faith in my state (SC). I am not terrified by the prospect of no insurance because, in spite of my stigma (Crohns) I am among the "healthiest" people my age that I know. I am active, normal weight, take only one little BP pill a day (and I think that is because of my last job!), have a great attendance record, and outstanding professional reputation. Almost everybody I know who is my age takes at least 3 or 4 different prescription medications daily. I figure I can get by for a few years until I qualify for Medicare. I don't want to but I can.

truedelphi

(32,324 posts)
24. That is great advice. And one other thing - for the duration of your time
Fri Dec 16, 2011, 05:26 PM
Dec 2011

As a full time student, you don't have to repay the student loans (At least, that is how it used to be.)

Irishonly

(3,344 posts)
7. Best of luck to you
Sun Dec 11, 2011, 11:21 PM
Dec 2011

I don't have any information about the insurance. I am not even sure where to tell you to look. Isn't there a federal program for people with pre-existing conditions? I read a post about it and for the life of me I cannot find it. Maybe your representative could give you some guidance.

Vinca

(50,278 posts)
8. Have you checked out the federal pre-existing condition pool?
Mon Dec 12, 2011, 08:58 AM
Dec 2011

There's no reason an employer couldn't give you a check to cover half the premium every month and the coverage sounds better than what you previously had. I've been on it for nearly a year and I've been pretty satisfied with it (although I'm still a single-payer advocate).

Lindakimy

(19 posts)
9. Checking it out now
Mon Dec 12, 2011, 08:03 PM
Dec 2011

I, too, am a single payer advocate. I lived in Europe for years and enjoyed universal care and traveled extensively in the 70s in countries that were "behind the curtain". The two are not the same. The people who are afraid of "socialism" when one speaks of government responsibility for its citizens apparently don't get it.

It seems that there are two options for me at this point - a state program (and I don't really trust my state) and a federal one that resulted from the Health Care Law. I am hoping that I will be able to find some coverage for this bridge period because I don't want to twist in the wind and I don't want to stiff some hospital that is obliged to treat me. Somebody has to pay the bill if there is one. I probably won't be able to do it if something bad happens. I feel that figuring out some provision is the responsible thing to do.

To your comment: my employer will do just that - pay half of whatever insurance is found. They are not yet aware of my uninsurable status but I don't think it will matter. They assured me that they would be willing to pay more for my policy because of my age before I took the job. Thanks for your comment.

MedicalAdmin

(4,143 posts)
12. I just checked out the federal program in my state...
Tue Dec 13, 2011, 08:38 PM
Dec 2011

I still can't afford it which is not surprising. Even the cheapest option has huge deductibles and only pays about 60% of any treatment.

It might as well be millions....

Irishonly

(3,344 posts)
14. I am so sorry
Tue Dec 13, 2011, 09:10 PM
Dec 2011

I am the lone liberal cousin in my family. One of my right winger cousins love the care she and her family recieved in Belgium but is totally against single payer. I still can't figure out that one.

 

Bully Taw

(194 posts)
15. Chronic health and insurance
Wed Dec 14, 2011, 11:38 PM
Dec 2011

I am a parent of an 11 yr old with Cystic Fibrosis, and I am very happy with the care he gets through my insurance (which I pay dearly for). His health is very, very good for an 11 yr old with this condition. I have attended various support groups and talked with people that have come from a single payer system. Their overall feeling is that a single payer system isn't nearly as effective for chronic illness as care is slow, and any experimental treatment is very hard to qualify for. i am sure that a single payer system would get more people with chronic conditions covered and treated, but being a bit selfish, I am very happy that the current system in the U.S. has given my son the very best care. what will happen when he can no longer be covered under my insurance? I don't know. but the care he is getting now has at least made that a problem I am happy to be facing. I am sure I will feel differently when he joins the ranks of the uninsurable, though.

MedicalAdmin

(4,143 posts)
18. I am glad that your son is getting good care.
Thu Dec 15, 2011, 02:10 PM
Dec 2011

Keep in mind that many in single payer nations (many of my relative fall into this category) either don't know or don't care to purchase supplemental insurance, or explore other options. But they are there.

I get what you are saying about the problems tho'. No system is perfect. I hope that before your son is bumped from your coverage that something is in place for him. He deserves it and so do you.

truedelphi

(32,324 posts)
22. When your son is no longer able to be on your insurance, some fifteen years from now,
Fri Dec 16, 2011, 05:16 PM
Dec 2011

Many of us think that by then perhaps the whole system will be changed.

And since the whole system needs to be reformed, the care for chronic illness could be overhauled as well. There is no reason why care for chronic illness should be slow. nor is there any reason for treatments that worked to be "labeled as experimental" just to keep most patients away from them. Those elements could be reformed as well.

MedicalAdmin

(4,143 posts)
28. Working in admin in a private clinic as I do (and as a former drone for BCBS)...
Sun Dec 18, 2011, 02:52 PM
Dec 2011

... I have seen the term "experimental" applied to FDA approved treatments that have been in use for 40 years without any know adverse reactions or controversy vis a vis new research.

In short, if an insurance company uses the term "experimental" they know it works and they still just don't want to pay for it.

truedelphi

(32,324 posts)
30. I had heard that information mentioned and didn't
Mon Dec 19, 2011, 04:42 PM
Dec 2011

Know if it was an urban myth or reality. Sad to hear it is a reality.

But thanks for the information.

unapatriciated

(5,390 posts)
46. you are correct.
Sat Jun 30, 2012, 07:07 PM
Jun 2012

I'm glad that the poster above has had a positive experience with her insurance carrier. I on the other hand did not. My son was diagnosed with Dermatomyositis in January of 1991. It took six months after he started having symptoms (rash, fatigue and muscle weakness) before my hmo doc would do the blood work I had requested in month one. After he was diagnosed it was a constant fight (ten years) with Blue Cross California Care regarding denials and delays. They deemed the use of Chemo and Chemo drugs to be "experimental" in regards to Dermatomyositis and denied coverage. On going Physical Therapy is very important yet they would only cover 90 days per year. I would fight and prove that it was not experimental and PT was a covered expense, only to have to do it all over again on a yearly basis. This left wide gaps in insurance payments for meds and medical care that I had to pay for. After year three I finally had to sell my home to cover medical cost my insurance company denied. The worst part is my son was left disabled in part by the delay in diagnoses and proper care.



btw my premium was over $600 a month.

MedicalAdmin

(4,143 posts)
17. I'm going with "what is dumber than a sack of hammers, for $200 Alex?" n/t
Thu Dec 15, 2011, 02:07 PM
Dec 2011

I don't get it either.

The new england journal of medicine published a study comparing ER and specialist wait times in the US, Canada and selected industrialized countries from each world region. The US was NOT at the top of the list. Nowhere near it.

Irishonly

(3,344 posts)
19. LOL Thank You!
Thu Dec 15, 2011, 03:06 PM
Dec 2011

Usually I feel sad when I think about my family as they do not like me much because of my stand on many issues. I read your answer and laughed and laughed. Makes sense to me.

MedicalAdmin

(4,143 posts)
20. Anytime and it was my pleasure.
Thu Dec 15, 2011, 04:53 PM
Dec 2011

One of the few times I don't notice the pain is when I am laughing so I try to see the humor in every moment. It's a better way to live.

Good luck with your family. It can get frustrating, but I have found that humor goes a long way to convincing people and bringing them together than exasperated disgust.

Most times when I visit my family it is hard not to act like this when I see how badly they have fucked up their lives while voting for the very things that are fucking them up.

truedelphi

(32,324 posts)
31. Yet our health costs in this country are significantly higher
Mon Dec 19, 2011, 04:43 PM
Dec 2011

Per person than anywhere else in the world.

unapatriciated

(5,390 posts)
47. I heard the crap regarding wait time - Canada vs US.
Sat Jun 30, 2012, 07:27 PM
Jun 2012

Our wait time for proper test and a specialist was six months with devastating results.
This child had a shorter wait time with a better outcome.

&feature=my_favorites&list=FLV2-91clsM7Y0MA_z-NchCw

I corresponded with the mother in the above vid for a while in 2009, During the health care debates and she just couldn't believe the misinformation some people spouted.

edited to add: Sam in the vid and my son have Dermatomyositis.

tpsbmam

(3,927 posts)
26. I was thinking about the federal pool, too
Fri Dec 16, 2011, 09:03 PM
Dec 2011

That's what I recently joined. It's no panacea, though! The deductible is HUGE, BUT the plan I joined pays at 100% once the deductible is met. Well, 100% for "in-network," but there's lots of that around here. I joined when I was diagnosed with what we thought was ovarian cancer. I'd been going without up until then -- and NC didn't get the federal plan until a year ago. Up 'til then, it was just the NC high-risk plan, which was awful. I'd been getting by using freebie care through "Project Access" here (a wonderful program) and going to the local community health clinic for general care. Even with insurance, I've stuck with community health -- I love my primary there (a very talented nurse practitioner) and the drugs are WAY cheaper than regular pharmacies. I have 10 prescriptions/month that would cost about $300/month elsewhere. They cost me about $85/month at community health. Since my deductible is so high, I'm much better off just paying cash for most of my meds and handling it that way. I really have the insurance for catastrophes, as the probable ovarian cancer was. It literally took about 2 weeks to be approved for it AFTER the diagnosis of probable ovarian cancer. (I got lucky....the large tumor turned out to be "low-malignant" with no spread.)

So, I'm rambling at this point (REALLY tired).....that would be my advice. I have MASSIVE medical bills at this point -- I really don't advocate going the no insurance route. Even if one has catastrophic, it's something that prevents losing everything one has to medical bills! The monthly cost of the insurance is higher than I'm comfortable with, but everyone I know who has private insurance says my fees are WAY lower than they pay.

It all sucks -- I'm also a single-payer advocate. The medical costs in this country are shameful, and most of it's due to lobbyists, private corporations & their political puppets!

MedicalAdmin

(4,143 posts)
29. IT's good that you can afford that.
Sun Dec 18, 2011, 02:59 PM
Dec 2011

In fact it is great, even with all of the problems you have outlined.

I participate in an online forum for those with chronic pain and related problems. And there is a subgroup for those who are either getting worse or who just don't have any resources. We share ideas and resources and support.

And the general consensus among those of us who don't have insurance is that we can't afford care and, as such, we would prefer not to know if things are getting worse. The logic is thus; we can't afford the tests, and if we could afford the tests, we can't afford the care that would be proscribed from the diagnosis that the tests support, thus, why get the tests in the first place. Ignorance, while it lasts, is bliss.

Those who aren't in this situation don't get it.

tpsbmam

(3,927 posts)
32. OMG, that's the story of my life!
Sat Dec 24, 2011, 02:06 PM
Dec 2011

Even with insurance. This is the first time I've had insurance in 10 years! And the deductible is so high, nothing is getting done on a "testing" basis unless there's a crisis. I've never had a colonoscopy -- my rich sister who's 2 years older than I am has had 3! Since I've met the deductible this year, I tried to schedule one. Nope -- the only practice I could find is out of network (small-ish city here....sometimes the choices are limited) and insurance would only cover half the cost. Forget it -- can't afford it.

Even with the insurance I'm sticking with community health for my primary care. I have a nurse practitioner there who I really like and we work well together, so I don't want to give that up -- that's worth it's weight in gold! Moreover, it has a 340B pharmacy -- it's federally supported and regulated. My meds there cost less than half what they'd cost in a regular pharmacy. Since the deductible is so high, until it's met I won't be able to afford my meds. I now usually pay $85/month for 10 regular prescriptions. In a regular drugstore, I'd pay over $300! So I'm still paying cash at community health for my meds.

Believe me, I did the ignorance is bliss thing for MANY years!

I'm not sure how long I'll be able to keep up the insurance. I'd eschewed it before due to cost and the only reason I got it was for what we all thought was ovarian cancer (turned out to be "low-malignant" with no spread....yippee!). It covered the surgery and the tests, etc. I live off of my savings & IRA. I was screwed out of Medicare, etc by a preposterous fucking loophole, so I don't get any of that. I live VERY frugally as a result -- I barely have enough to last me through the years into old age. BARELY. When we thought I had OvCa, it obviously made sense to start using more of the money since my lifespan would clearly be shortened. That's not the case now. I'm keeping it for now -- my lifespan is definitely shorter than what we'd originally planned for. But I'll have to see -- I have an excellent financial planner who helped me with all of this and she's on the cuff about it. We'll see!

Lindakimy

(19 posts)
34. Update on uninsurable
Sat Feb 11, 2012, 12:46 PM
Feb 2012

Well, I finally found some information online about my state's insurance for those of us who are "uninsurable". News is not good. The info I found was dated 2010 so it may be out of date - why do I think that means it will be even more expensive? The price for policies, depending on my age, deductible, etc. range from about $1,200 to $1,900....A MONTH! How much do they think I make? I simply cannot pay everything I make for insurance that may or may not pay if the time comes. Oh, and by the way, they say the coverage can be cancelled at any time by state legislative action (oh, I really want to depend on that group) and the price of premiums can change at any time. And - wait for it - any condition for which I have been considered uninsurable will not be covered!

I really think cons should be more subtle than this. It's bad enough to be mistreated and robbed but do they have to insult my intelligence, too?

Obviously I will remain uninsured. I hope I make it to Medicare and that it is still there if I do.

Why is it not logically clear to all those who think our current - or, even better, our pre- health care law - system is superior to single payer that when those who have had some ongoing healthcare problem cannot get insurance they will either be condemned to illness/death or will end up taking charity from the system? Somebody has to pay for that. Either doctors and hospitals have to take it on and then raise their rates or government agencies absorb it costing tax payers and limiting other tax supported efforts. Why is it so hard for so many people to see that it would be far better to even out the "risk" over the whole population and get healthcare out of the "market".

And don't get me started on Romney being happy that he can fire his insurance company. I can't. They have already fired me.

Vinca

(50,278 posts)
35. Please . . . check the federal pool.
Sun Feb 12, 2012, 06:57 PM
Feb 2012

My state pool was about $1,200 and it didn't cover my condition. The federal pool did and was half the cost. Still not cheap, but that's about all we've got to work with for the time being.

Lindakimy

(19 posts)
36. Information?
Sat Mar 3, 2012, 12:00 AM
Mar 2012

Is there a link or something to direct me to that pool? I'd like to look into this but haven't found it. Thanks for the advice.

Vinca

(50,278 posts)
37. Here you go. Good luck.
Sat Mar 3, 2012, 08:59 AM
Mar 2012
https://www.pcip.gov/StatePlans.html

Don't feel discouraged if your state administers the federal program. That's what my state does and it seems to have more to do with where the payments go than anything else. Somewhere on the site I also got the name of a local insurance agent who helped me get all the paperwork together and sent it in. The whole procedure took about 2 weeks from start to finish.

Lindakimy

(19 posts)
38. Where to start
Fri Mar 16, 2012, 10:08 PM
Mar 2012

So would you suggest that I just address myself to the state program? I'll freely tell ya. I live in South Carolina. The dark side. Should I find a local insurance agent? I have a friend who works at Blue Cross. She yelled at me when I told her my sad story. She said, "YOU ARE NOT UNINSURABLE. YOU JUST CAN'T AFFORD INSURANCE!" Well, yeah... that would be my problem. Same. Same.

I just need a starting point. I am pretty sure that my employers will be willing to pay half of whatever I find that will work so long as it doesn't cost the $1900 a month I read about in our state plan. Get real. There has to be an upper end. They are very nice and willing to help - more than usual. I'd like to find the most efficient plan for them and for me. Neither of us needs to pay more than necessary.

I don't really care who administers it as long as they don't charge me more than I can possibly pay. $1900 is more than I make. There is no way I'm going to work 41 hours a week and also dip into savings just to pay insurance.

Vinca

(50,278 posts)
40. I just clicked on South Carolina at the link and you're in luck because the feds control it.
Sat Mar 17, 2012, 05:28 PM
Mar 2012

(I live in NH and it's administered by the state and a little more expensive.) The premiums don't look too terrible for the basic plan, which is what I have. Still a stretch, of course, but better than nothing. It seems you can apply online for the federal program at the PCIP site. Once they get the application, it's a fairly speedy process. Good luck.


https://www.pcip.gov/StatePlans.html

Lindakimy

(19 posts)
41. New hook in the fish
Sat Mar 24, 2012, 10:13 PM
Mar 2012

I finally went to the fed website and found a reasonable (well, $500-$600 a month but my present employer would pay half beginning in May) insurance option but now...after 24 hours of thinking all would be well...I realize that I can't even apply.

My husband, who is 73 and had been retired for 5 years, went back to work about the time I changed jobs because my last job had been downsized so far that it was beginning to eat into our savings. And he was probably starting to feel a little guilty about staying home or carousing with his buddies while I slaved - ha! He is now working full time in IT at Blue Cross/Blue Shield - not FOR them, of course, but for a temp service they hire. He now has access to "health insurance". And when he started there, before we found out about this government possibility, he signed us up. He doesn't need it - he has Medicare and the VA. But he signed us up so I would have some insurance. Now I do. It's cheap, I'll say that for it. But it has a limit of $2000 total on what it will pay in a year - doctor, hospital..everything. That is what? Fifteen minutes in the hospital? Yeh, about that.

And now, because I HAVE insurance - as lousy and inadequate as it is - I don't qualify for the PCIP insurance. I'm afraid to even ask if I can just quit that and do the six months uninsured and then qualify. If I have any possibility of insurance (which I do, even though it is crap) does that mean I'm shut out? I fear it does.

Well, I'll still be watching the Supreme Court case. Wonder if the big guys will take the very hope away from us. It won't surprise me if they do.

Vinca

(50,278 posts)
42. That's a big flaw in the law. My neighbors were in the same boat.
Sun Mar 25, 2012, 07:37 AM
Mar 2012

They are older with pre-existing conditions and their private insurance premium (they're self-employed) went to $3,500 a month. Who can afford that? In your case, since your existing coverage is a lousy $2,000.00 total, I'd drop it and wait the 6 months. Worst case scenario, you go in the hole $2,000.

anon223

(15 posts)
50. That is exactly what I need -
Tue Oct 30, 2012, 04:16 PM
Oct 2012

Can you tell me where you saw the link to the friendly insurance agent? I need to get the letter from one refusing coverage (or refusing to cover my pre-existing condition) so I can get a PCIP. I live in a state where it's administered by the Feds (VA). Also, I have a limited time frame to get this done... I'd appreciate any help.

Thanks!

Vinca

(50,278 posts)
51. Here's what happened when I applied -
Wed Oct 31, 2012, 12:52 PM
Oct 2012

there was a list of insurance agents in my state on the federal site. I called one of them and he insisted I had to send him $1,200 to apply to BC/BS to be turned down. Since I had already gotten my hands on the federal application form, I knew that wasn't necessary. I had gotten a note from my doctor that I would benefit from continuing physical therapy for my arthritis and that was all that was needed since the very last "pre-existing condition" was a need for continuing medical care of any kind. I pointed that out to the insurance agent and he agreed to send in my application with my doctor's note and a check for the first month's premium. I got in, no problem. I had been in excrutiating pain 24/7 so it was like a miracle happened. My first appointment was with an orthopedic surgeon who told me one of my hips was just about the worst he'd ever seen. I was immediately sent for all the testing and pre-op sessions necessary for a hip replacement. A month later I had it done and my life is a million percent better. I hope you get into the federal pool because it's pretty decent insurance. There are still deductibles and co-pays, but it sure beats having to go without medical care because you can't afford it.

 

Preybrother

(4 posts)
39. PICIP (Pre-Existing Condition Plan
Sat Mar 17, 2012, 02:52 PM
Mar 2012

My 30 year old niece has RA. High Risk State Fund Insurance and private insurance companies were far too high with limited coverage. I accidentally stumbled across the PICIP Federal Plan under the new National Healthcare Law. It has very good coverage and affordably priced. All you need is a copy of an insurance company rejection letter not more than six months old. This national plan is necessary for people with pre-existing conditions but I'm afraid the "baby might be throw out with the bath water" if the Supreme Court rules against the law or Republicans defund it next year. The plan is funded with $6 Billion and should be good up to 2014. Just this week, I read a Rassmussen poll that said Democrats had lost 21% of registered voters and this really concerns me. Reluctantly, I also watched a the AZ Cold Case Posse video concerning new evidence beyond the President's birth certifcate that could hurt him in November. Hopefully, the Democrat Party leaders are taking these allegations seriously. We need and must keep this PICIP Federally funded insurance program to help people with pre-existing conditions!

Lindakimy

(19 posts)
43. Holding pattern
Thu Apr 5, 2012, 11:26 PM
Apr 2012

Well, it was a bit discouraging to listen to reports about the Supreme Court arguments. But I am not going to turn on the gas quite yet. I don't really have insurance now (too small to count) and if I really don't have insurance at all because of the Court's decision I haven't lost that much, right?

Maybe it won't go away and I will be able to get the government plan. Or not. I'll wait to see.

At first I was really upset that the Court seemed so negative about the health care law. Now I'm thinking...well, maybe this will give us a chance to just go ahead and do the single payer thing we should have done before. Come on, people. That is what we need. Maybe this will shake people up and make them think a bit before electing reactionaries. Maybe it will backfire on the right. It could. Maybe. O.K. I'm grasping. But what can ya do?

In the meantime I have my UTI...since last May. Several rounds of antibiotics. Can't get rid of it. Doctor said he would only do "expensive" tests for cancer now. I can't afford that and he said that too. He didn't even offer to order the tests...just said, "You can't afford it." Kinda makes me feel like I am too poor to live.

I am getting a little tired of the symptoms though. It shouldn't be like this, should it?

McCamy Taylor

(19,240 posts)
45. Spring for the high risk insurance and pray that Obamacare survives the SCOTUS.
Wed Apr 18, 2012, 07:15 PM
Apr 2012

If your employer will pay half of your $1000 a month premiums (for insurance with a $5000 deductible) consider yourself lucky.

Sadly, people with mild diabetes, high blood pressure, asthma once a year and even acne can also find themselves "uninsurable". It is the no man's land where people who work without group insurance end up once they turn 40.

dogday

(24,008 posts)
48. I am in heart failure. My insurance company
Wed Sep 12, 2012, 09:05 PM
Sep 2012

will not cover my nitro-glycerin tablets. Go figure

Like you I am also un-insurable it has not been easy getting insurance...

Lindakimy

(19 posts)
52. That's great
Fri Nov 2, 2012, 10:47 PM
Nov 2012

I am glad that there are employers out there who understand that workers need healthcare. Thank you for your efforts in this area.

I have really nice employers who are willing to pay half of what private insurance will cost me. But I don't qualify for private insurance because I have a pre-existing condition - Crohns Disease. And they also want to tack on a bunch of other stuff I have been tested for but didn't have.

It basically annoys me that I am being shut out for something that is not my fault. I can't help having this disease. I don't take medicine for it. I don't go to doctors for it. I haven't been to a doctor in many months. I am going to go back or call or whatever because I really want my prescriptions renewed. I take a blood pressure pill and Prozac. That really works. It has been a huge help. I don't think it will help me as far as insurance goes, but screw that.

I don't think I can get PCIP because my husband is working and his employer offers a really piddly insurance plan. They pay about $250 per year for major med. Still. I think the PCIP says that if you are qualified for ANY insurance - however lame - you can't get PCIP. Am I right about that or not?

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