HIPPA and pre-existing conditions

[Pens1566]

Wonder if spidey will come back in here with some new version of his "let them eat cake" defense again?

 

[Pens1566]

dp

 

[shadow9d9]

We had no stop in coverage, and that didn't stop every insurer in Florida from refusing to cover my wife.

Moron.

 

[Pens1566]

Now that I think about it spidey might be onto something. He of his vast expertise in the healthcare/insurance field bestowed upon him by his numerous friends and family tied to the industry, has found the needle in the haystack solution that has been overlooked by everyone trying to solve this problem.


Nah, nvm. He's an idiot.

 

[Moonbeam]

Americans are being murdered every day by the will of those making money out of health care and the politicians they bribe with campaign donations.

 

[spidey07]

Originally posted by: Common Courtesy

When you are layed off, your salary is no more than 50% of your original income.
You still have your household expenses which are not cut - now CORBA comes in withan extra $300-500/month. That is at least 1 weeks unemployment check.

Right. And that is what savings is for. One needs to be responsible for their expenses, including health insurance even if that means COBRA if the unexpected happens. And nothing is stopping you from getting onto a nother group plan so you don't have a lapse in coverage to where it would make you eligible for pre-existing condition clauses. I've already posted links to group plans that are HIPPA compliant outside of COBRA. This isn't as difficult as most seem to be making it out to be.

So far the only complaint from getting hit with pre-existing clauses is "I can't afford it". No, you CHOOSE to not afford it. It's all a matter of personal responsibility - oh and you can absolutely decrease your monthly expenses - cut the cable, cut the cell phone, sell the car, buy a beater, start eating cheaper foods that are still good for you, modify energy usage, etc.

 

[Special K]

Originally posted by: ebaycj

Originally posted by: Special K

Originally posted by: ebaycj

Originally posted by: spidey07
Doing some research on COBRA and why it's so important to never let your insurance lapse reveled something interesting about pre-existing conditions - insurance companies cannot deny claims based on pre-existing conditions if you've had continuous coverage for 12 months.

Makes sense. It's to not penalize you for switching jobs or policies or if you get laid off there are means to keep continuous coverage. At the same time prevent people from waiting until the get sick or diagnosed before they get health insurance. The HIP in HIPPA is "health insurance portability"

http://www.insure.com/articles...thinsurance/HIPAA.html

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more, a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."

Only valid for group health care plans. FAIL.

So if I opt to buy an individual policy from an insurance company such as BCBS instead of taking COBRA coverage (or buy the individual policy after the ARRA subsidy runs out), does that count as a group plan for the purposes of pre-existing conditions or not?

Since it's called an individual plan I would assume not, but then again I figure they have to pool you in with some other group of people, right? Isn't that how they spread the risk around, at least in theory?

Also is anything that I see a doctor for considered a "pre-existing condition", no matter how trivial?

This just happened to me. I was told over the phone by BCBS's CSR that EVERYTHING would be flagged pre-existing for the first year. Headache, flagged. Fever, flagged. Food poisoning, flagged. You get the point.

That is, until i told her i had previous (continuous) coverage through BCBS in the form of my COBRA. Then she switched to "nothing will be flagged as pre-existing".

OK, but my question concerns what happens after you switch from the individual plan back to another group plan such as your new employer's plan. In that case, will anything you received treatment for while on the individual plan be counted as a pre-existing condition under the new group plan, even if there was no gap in coverage?

Here's the scenario I meant:

1. get on former employer's COBRA plan for awhile
2. instead of continuing the COBRA, pick up an individual policy
3. use individual policy until you get a new employer and their health plan

Assume there are no gaps in coverage between 2 and 3. Are you saying anything I receive treatment for by the plan in step 2. will be considered a pre-existing condition by the plan in step 3.?

 

[spidey07]

Special K - see here, it depends on the state. Also you don't have to get an individual policy, you could jump on a group one and that would be covered under HIPPA. This is why it's normally best to talk to a broker/agent who knows the best course of action.

http://www.statehealthfacts.or...able.jsp?cat=7&ind=356

 

[Ausm]

Originally posted by: spidey07

Originally posted by: Common Courtesy

When you are layed off, your salary is no more than 50% of your original income.
You still have your household expenses which are not cut - now CORBA comes in withan extra $300-500/month. That is at least 1 weeks unemployment check.

Right. And that is what savings is for. One needs to be responsible for their expenses, including health insurance even if that means COBRA if the unexpected happens.

I agree with you that people should have a savings and it is irresponsible not to have an emergency savings. I think many people realized this with the recent near total collapse of our economic system. So much so the blogs I read from many leading economists complain people aren't spending enough to help bring us out of this recession. I think the fear of losing everything has made people much more frugal.

People take their health for granted, I know I did before I was diagnosed with Diabetes which was my wakeup call.

 

[Pulsar]

Originally posted by: Ausm

Originally posted by: spidey07

Originally posted by: Common Courtesy

When you are layed off, your salary is no more than 50% of your original income.
You still have your household expenses which are not cut - now CORBA comes in withan extra $300-500/month. That is at least 1 weeks unemployment check.

Right. And that is what savings is for. One needs to be responsible for their expenses, including health insurance even if that means COBRA if the unexpected happens.

I agree with you that people should have a savings and it is irresponsible not to have an emergency savings. I think many people realized this with the recent near total collapse of our economic system. So much so the blogs I read from many leading economists complain people aren't spending enough to help bring us out of this recession. I think the fear of losing everything has made people much more frugal.

People take their health for granted, I know I did before I was diagnosed with Diabetes which was my wakeup call.

The only problem with spidey's logic regarding his 'just get a job' line of reasoning is this:

There are many people in this country who don't make the wages he earns. He seems incapable of understanding that yes, indeed, many people's pay checks are taken up completely simply to pay for housing, transportation, and food. The idea of a medical coverage payment would make these people laugh.

Picture a single mom trying to support 3 kids. Yes, she made some bad decisions. Or perhaps her husband was run over by Obama's limo. But either way, her situation is what it is. How do you propose this person, with a minimal skillset, generate enough money for housing, transportation, food, clothing, heat, electricity, AND a $700 per month medical insurance payment? What about dental and optical? Car insurance?

That is the crux of the disagreement between right and left. The far-left believes no one should fall through the cracks. The far-right believes people who fall through the cracks do so because of a lack of motivation. Neither side is right, and neither side is interested in intelligent discourse to actually fix the problem. They are merely pandering to their economic base (corporations and wealthy investors).

 

[Athena]

Originally posted by: Special K
[OK, but my question concerns what happens after you switch from the individual plan back to another group plan such as your new employer's plan. In that case, will anything you received treatment for while on the individual plan be counted as a pre-existing condition under the new group plan, even if there was no gap in coverage?

Here's the scenario I meant:

1. get on former employer's COBRA plan for awhile
2. instead of continuing the COBRA, pick up an individual policy
3. use individual policy until you get a new employer and their health plan

Assume there are no gaps in coverage between 2 and 3. Are you saying anything I receive treatment for by the plan in step 2. will be considered a pre-existing condition by the plan in step 3.?

Individual coverage does not qualify as "creditable" insurance under HIPAA.

 

[Ausm]

Originally posted by: Pulsar

Originally posted by: Ausm

Originally posted by: spidey07

Originally posted by: Common Courtesy

When you are layed off, your salary is no more than 50% of your original income.
You still have your household expenses which are not cut - now CORBA comes in withan extra $300-500/month. That is at least 1 weeks unemployment check.

Right. And that is what savings is for. One needs to be responsible for their expenses, including health insurance even if that means COBRA if the unexpected happens.

I agree with you that people should have a savings and it is irresponsible not to have an emergency savings. I think many people realized this with the recent near total collapse of our economic system. So much so the blogs I read from many leading economists complain people aren't spending enough to help bring us out of this recession. I think the fear of losing everything has made people much more frugal.

People take their health for granted, I know I did before I was diagnosed with Diabetes which was my wakeup call.

The only problem with spidey's logic regarding his 'just get a job' line of reasoning is this:

There are many people in this country who don't make the wages he earns. He seems incapable of understanding that yes, indeed, many people's pay checks are taken up completely simply to pay for housing, transportation, and food. The idea of a medical coverage payment would make these people laugh.

Picture a single mom trying to support 3 kids. Yes, she made some bad decisions. Or perhaps her husband was run over by Obama's limo. But either way, her situation is what it is. How do you propose this person, with a minimal skillset, generate enough money for housing, transportation, food, clothing, heat, electricity, AND a $700 per month medical insurance payment? What about dental and optical? Car insurance?

That is the crux of the disagreement between right and left. The far-left believes no one should fall through the cracks. The far-right believes people who fall through the cracks do so because of a lack of motivation. Neither side is right, and neither side is interested in intelligent discourse to actually fix the problem. They are merely pandering to their economic base (corporations and wealthy investors).

I agree with your logic totally on this issue. I was just pointing out that I do believe Spidey is partially correct that people should be saving if they have the means to but I do agree this is always not feasible for many reason as you stated above.

 

[Carmen813]

Originally posted by: spidey07

Originally posted by: Common Courtesy

When you are layed off, your salary is no more than 50% of your original income.
You still have your household expenses which are not cut - now CORBA comes in withan extra $300-500/month. That is at least 1 weeks unemployment check.

Right. And that is what savings is for. One needs to be responsible for their expenses, including health insurance even if that means COBRA if the unexpected happens. And nothing is stopping you from getting onto a nother group plan so you don't have a lapse in coverage to where it would make you eligible for pre-existing condition clauses. I've already posted links to group plans that are HIPPA compliant outside of COBRA. This isn't as difficult as most seem to be making it out to be.

So far the only complaint from getting hit with pre-existing clauses is "I can't afford it". No, you CHOOSE to not afford it. It's all a matter of personal responsibility - oh and you can absolutely decrease your monthly expenses - cut the cable, cut the cell phone, sell the car, buy a beater, start eating cheaper foods that are still good for you, modify energy usage, etc.

What world exactly do you live in? Seriously. I mean, is everyone in your world rich? Even if my wife and I cut out all discretionary spending there is no way we could afford $700 a month. That's near 50% our monthly income (and she works full-time). That's more than the cost of a mortgage where I live.

It's a choice not to afford it. Hahahahahaahahaha.... what a crock of shit. You don't have a clue. Try working while getting chemotherapy pumped through your veins. Hell, try taking a shower. Even better, try working AFTER you finish treatment.

 

[jonks]

Originally posted by: spidey07

Originally posted by: TruePaige
The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

You're just mad because I completely destroyed pre-existing conditions as a point. Already covered, signed into law by Clinton. COBRA costs subsidized and signed into law with ARRA by Obama. The point is dead.

Er, unless your preexisting condition prevented you from getting the initial coverage you mean? dumbass.

And you keep pointing to ARRA. It's a temporary measure using funds from the stimulus, it doesn't subsidize COBRA indefinitely, though that may at some point change. Regardless, claiming this obviates pre-existing conditions as an issue is idiotic.

Oh, and all those folks who first benefitted from the ARRA subsidy? Your 9 months is almost up! What do you mean you haven't found a job yet? Bum!

http://www.earthtimes.org/arti...ending-in,980154.shtml

"For the average laid-off worker, this means a monthly payment jump from $374 to $1,068 for health insurance."

 

[spidey07]

Jonks, they don't have to stay on corbra, they can go to another group plan and still not get hit with the prexisting stuff as they will have had no lapse in coverage. Some states you can get an individual HIPPA compliant plan. You guys keep thinking people are forced into this, there are plenty of options available to them.

As far as the single mother or other low income families - there are child insurance programs in most states along with state medical programs for them so they will be taken care of.

 

[jonks]

Originally posted by: spidey07
Jonks, they don't have to stay on corbra, they can go to another group plan and still not get hit with the prexisting stuff as they will have had no lapse in coverage. Some states you can get an individual HIPPA compliant plan. You guys keep thinking people are forced into this, there are plenty of options available to them.

As far as the single mother or other low income families - there are child insurance programs in most states along with state medical programs for them so they will be taken care of.

There are lots of affordable options for the unemployed? that's amazing. you should tell everyone.

 

[Pens1566]

Originally posted by: jonks

Originally posted by: spidey07
Jonks, they don't have to stay on corbra, they can go to another group plan and still not get hit with the prexisting stuff as they will have had no lapse in coverage. Some states you can get an individual HIPPA compliant plan. You guys keep thinking people are forced into this, there are plenty of options available to them.

As far as the single mother or other low income families - there are child insurance programs in most states along with state medical programs for them so they will be taken care of.

There are lots of affordable options for the unemployed? that's amazing. you should tell everyone.

Maybe he has solved this whole giant national issue all by himself?


Nah, still a moron.

 

[Athena]

Originally posted by: spidey07
Jonks, they don't have to stay on corbra, they can go to another group plan and still not get hit with the prexisting stuff as they will have had no lapse in coverage. Some states you can get an individual HIPPA compliant plan. You guys keep thinking people are forced into this, there are plenty of options available to them.

Newsflash: the issue is not how to game the system and get covered by HIPAA, the goal is to get access to treatment in a manner that will not bankrupt an individual, his family, or government at any level. Just shopping around for an insurance plan doesn't provide security for anyone.

And for the record, HIPAA doesn't guarantee affordable coverage for pre-existing conditions; it just prohibits denial.

As far as the single mother or other low income families - there are child insurance programs in most states along with state medical programs for them so they will be taken care of.

Do you read any news that doesn't conform with what you want to believe? People are being dropped from Medicaid rolls all across the country and programs for the working poor have been frozen for over a year.

 

[spidey07]

Originally posted by: jonks

Originally posted by: spidey07
Jonks, they don't have to stay on corbra, they can go to another group plan and still not get hit with the prexisting stuff as they will have had no lapse in coverage. Some states you can get an individual HIPPA compliant plan. You guys keep thinking people are forced into this, there are plenty of options available to them.

As far as the single mother or other low income families - there are child insurance programs in most states along with state medical programs for them so they will be taken care of.

There are lots of affordable options for the unemployed? that's amazing. you should tell everyone.

Oh absolutely there are. I've explained the options in this very thread already.

 

[spidey07]

Originally posted by: Athena

Originally posted by: spidey07
Jonks, they don't have to stay on corbra, they can go to another group plan and still not get hit with the prexisting stuff as they will have had no lapse in coverage. Some states you can get an individual HIPPA compliant plan. You guys keep thinking people are forced into this, there are plenty of options available to them.

You just don't get it: the issue is not how to game the system and get covered by HIPAA, the goal is to get access to treatment in a manner that will not bankrupt an individual, his family, or government at any level. Just shopping around for an insurance plan doesn't provide security for anyone.

And for the record, HIPAA doesn't guarantee affordable coverage for pre-existing conditions; it just prohibits denial.

As far as the single mother or other low income families - there are child insurance programs in most states along with state medical programs for them so they will be taken care of.

Do you read any news that doesn't conform with what you want to believe? People are being dropped from Medicaid rolls all across the country and programs for the working poor have been frozen for over a year.

Sigh, this just gets old that you folks simply refuse to believe facts after I provide them time and time and time again.

 

[fisheerman]

Originally posted by: JEDIYoda

Originally posted by: spidey07

Originally posted by: TruePaige

Originally posted by: spidey07

Originally posted by: TruePaige
The almighty status quo that Spidey loves...telling us why it is okay to make you pay exorbitant rates for fear of being excluded from insurance plans.

You're just mad because I completely destroyed pre-existing conditions as a point. Already covered, signed into law by Clinton. COBRA costs subsidized and signed into law with ARRA by Obama. The point is dead.

Um..no you didn't.

COBRA and group plans immediately after is not a choice for everyone.

Hell most people couldn't ever HOPE to afford their COBRA.

You just can't live with yourself for being a murderer.

You hate everyone who isn't you, what was that quote of yours about gays and atheists?

Nonsense. They are absolutely a choice, they just choose not to do the work or pay for their insurance. -- thats BS!!!


This looks appealing for anybody that truly thinks they have no choice or somehow prevented from getting health insurance. Never used it, but it's what google gives for the guaranteed-issue clause.
http://www.guaranteed-issue-health-insurance.com/

Your a blooming idiot Spidey!!
I had some of the best health insurance in the world....
I worked for a hospital and I paid nothing practically to have my family covered.
I left my place of employment and the premiums for COBRA alone were over $700 a month just for me......there is no way i could afford to cover myself and my famliy......

So when you lost your job who should pay for your continued health coverage? Me? Everyone else? Someone else? Your past employer? The evil Rich People? All of the above?

Someone has to pay, that is a fact. Please understand that I may or may not want to share your financial hardship problems. It is my choice! All UH is trying to do is take out the my choice part.

Freedom.................gotta love it!

 

[ahurtt]

If you do need insurance and have what is deemed to be a "pre-existing" condition and you cannot be denied coverage because of it, then the insurer will take that pre-existing condition into account and figure out some other trumped up reason to use to deny you. They're crooks and swindlers, the lot of 'em. And not just health care providers but the whole insurance industry is a racket in general.

 

[fisheerman]

Originally posted by: ahurtt
If you do need insurance and have what is deemed to be a "pre-existing" condition and you cannot be denied coverage because of it, then the insurer will take that pre-existing condition into account and figure out some other trumped up reason to use to deny you. They're crooks and swindlers, the lot of 'em. And not just health care providers but the whole insurance industry is a racket in general.

Actually it isn't a racket it is a business. They are in it to make a profit while providing a service that people want. You can very easily self insure and go it alone.

Odds are you will come out ahead if you invest well and don't have any major health setbacks

 

[jonks]

Originally posted by: fisheerman
So when you lost your job who should pay for your continued health coverage? Me? Everyone else? Someone else? Your past employer? The evil Rich People? All of the above?

Someone has to pay, that is a fact. Please understand that I may or may not want to share your financial hardship problems. It is my choice! All UH is trying to do is take out the my choice part.

Freedom.................gotta love it!

You don't get to opt out of paying taxes to support mass transit. All UH is trying to do is make sure people don't die of preventable maladies.

Your definition of freedom borders on anarchy. If you can't do whatever you want whenever you want with any of your money then you aren't free. No, sorry.

 

[Ausm]

Originally posted by: fisheerman

Originally posted by: ahurtt
If you do need insurance and have what is deemed to be a "pre-existing" condition and you cannot be denied coverage because of it, then the insurer will take that pre-existing condition into account and figure out some other trumped up reason to use to deny you. They're crooks and swindlers, the lot of 'em. And not just health care providers but the whole insurance industry is a racket in general.

Actually it isn't a racket it is a business. They are in it to make a profit while providing a service that people want. You can very easily self insure and go it alone.

Odds are you will come out ahead if you invest well and don't have any major health setbacks

I classify it as legal extortion due to the Anti-trust law they enjoy.