HIPPA and pre-existing conditions

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fisheerman

Senior member
Oct 25, 2006
733
0
0
Originally posted by: 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.

So pointing out another problem should persuade me that I should support UH how?

Nice one!

 

fisheerman

Senior member
Oct 25, 2006
733
0
0
Originally posted by: 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.

Extortion. Are you kidding? You do know that you don't have to have health insurance? at least not yet anyway.



 

fisheerman

Senior member
Oct 25, 2006
733
0
0
Originally posted by: IGBT
can I wait till my house is on fire to buy fire insurance?

Not if you borrowed the money from a bank you can't because they require it!

If you self finance or own your home then yeh you can go without fire insurance.

If it burns down then its on you!
 

shadow9d9

Diamond Member
Jul 6, 2004
8,132
2
0
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 :)

That is the problem. American's health shouldn't be a business where profit rules all.
 

fisheerman

Senior member
Oct 25, 2006
733
0
0
Originally posted by: shadow9d9
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 :)

That is the problem. American's health shouldn't be a business where profit rules all.

So what should it be a government run entity? Been to the DMV lately?

No thanks

 

jonks

Lifer
Feb 7, 2005
13,918
20
81
Originally posted by: fisheerman
Originally posted by: 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.

So pointing out another problem should persuade me that I should support UH how?

Nice one!

Er, the point is your definition of freedom doesn't exist anywhere and never has in any civilized society. Part of the price of living in a civilized society is a sacrifice of unqualified freedom. As to calling mass transit a "problem", do you have any idea what major metropolitan areas would look like if there were no mass transit? You think rush hours are bad now?
 

Special K

Diamond Member
Jun 18, 2000
7,098
0
76
Originally posted by: 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

Would this be different than buying a plan from ehealthinsurance? Are all of those plans going to be individual ones?
 

shira

Diamond Member
Jan 12, 2005
9,500
6
81
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."

This is true as far as it goes. The problem is that HIPAA continuation coverage is typically NOT transportable. For example, if you exhaust your 18 months of COBRA and transition to HIPAA continuation coverage in your state (typically a "pool" type plan with high deductibles, relatively high cost, and lots of limitations), if you then move to another state, you probably can't get immediate coverage, if any at all.

I live in MD, and there's a waiting list for the state pool for non-HIPAA-qualified individuals. And in Virginia, if you aren't HIPAA-qualified, you can't get into the state insurance pool at all. Which means that if you have a pre-existing condition and move to Virginia, you are probably screwed insurance-wise, unless you can get a job with group coverage.

Imagine a situation where Person A, who has a pre-existing condition covered by HIPAA continuation coverage in State X wants to marry Person B, who has a pre-existing condition covered by HIPAA continuation coverage inin State Y. Oops. Guess they can't live together.
 

spidey07

No Lifer
Aug 4, 2000
65,469
5
76
Originally posted by: Special K
Originally posted by: 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

Would this be different than buying a plan from ehealthinsurance? Are all of those plans going to be individual ones?

It depends on your state and the plans. That's why it's always best to talk to a broker.
 

shira

Diamond Member
Jan 12, 2005
9,500
6
81
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.

Not to mention: HIPAA continuation coverage is about as lousy as health insurance can be. The networks are often VERY limited, with many smaller communities lacking any providers at all. The cost is very high for what you get, and the deductibles are typically very high. HIPAA is safety-net coverage, not the coverage most of us would choose if we had any other options.

My sister lives in New Mexico, and she has HIPAA continuation coverage. For almost any specialist visit at all, she will need to travel to Albuquerque because there are no in-network specialists where she lives.
 

Athena

Golden Member
Apr 9, 2001
1,484
0
0
Originally posted by: fisheerman
So what should it be a government run entity? Been to the DMV lately?
Why is it that health care reform opponents so often make this kind of comment as though it has any relevance to the discussion?

Why don't you ask Veterans who have actually used the VA whether they would prefer the care organized as their relatives get it? Or, ask how many 50 somethings who are caring for parents covered by Medicare whether they would prefer that Medicare was dissolved?

And as far as the DMV is concerned, almost all of our transactions with the DMV are online. I did have to appear in person for a matter today so I made an appointment 10 days ago. I had a 12:00 appointment, checked in 15 minutes early and was back in my car at 12:02. What's not to like about that?

 

IGBT

Lifer
Jul 16, 2001
17,974
140
106
Originally posted by: fisheerman
Originally posted by: IGBT
can I wait till my house is on fire to buy fire insurance?

Not if you borrowed the money from a bank you can't because they require it!

If you self finance or own your home then yeh you can go without fire insurance.

If it burns down then its on you!


I want to wait till the house is burning just like the obama wants insurance for pre-existing health problems. my burning house is a pre-existing condition.

 

Athena

Golden Member
Apr 9, 2001
1,484
0
0
Originally posted by: spidey07
That's why it's always best to talk to a broker.
Yep, that's just what everyone needs...another person involved in the process. An insurance broker gets commissions from the insurance company, whose premiums include allowance for his work. IOW, we need more overhead that doesn't contribute anything to actual care.

 

JKing106

Platinum Member
Mar 19, 2009
2,193
0
0
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."

Not all of us have rich mommies who pay our bills, whitey07. COBRA is an absolute scam. No wonder you like it.
 

Descartes

Lifer
Oct 10, 1999
13,968
2
0
No amount of information will wake up the people that want to believe that any reform is evil and the status quo is working. Sadly, the only thing that will wake these people up is when they too face these problems.

And that's the sad reality of insurance. You don't know it until it's largely too late, and too great a population in the US is without the ability to rebound.

I always hate to say, "Well, I know this because...", but honestly, my company has processed over 100 million claims in the past 16 months alone. The amount of things we learned in doing so is both sobering and terrifying, and it's especially so when you have family or friends that have been affected. I could go into specifics, but what's the point? People will believe their ideologies over anything else.

But most people know next to nothing about how the healthcare industry, payors and providers, actually works; hell, half the people in the industry don't even understand it. The amount of processing that occurs before a claim decision even hits the doctor goes through potentially a dozen hands, including different companies. Each one gets a decision on the claim, potentially negotiates a reduced rate, risk analysis, etc. etc.
 

spidey07

No Lifer
Aug 4, 2000
65,469
5
76
Originally posted by: JKing106

Not all of us have rich mommies who pay our bills, whitey07. COBRA is an absolute scam. No wonder you like it.

Ahh, racism. The last resort of a liberal. My mom will have been dead 6 years coming this December after a tremendous amount of care paid for by her health insurance. I've shown how pre-existing conditions are still covered, so that point is dead.
 

JKing106

Platinum Member
Mar 19, 2009
2,193
0
0
Originally posted by: spidey07
Originally posted by: JKing106

Not all of us have rich mommies who pay our bills, whitey07. COBRA is an absolute scam. No wonder you like it.

Ahh, racism. The last resort of a liberal. My mom will have been dead 6 years coming this December after a tremendous amount of care paid for by her health insurance. I've shown how pre-existing conditions are still covered, so that point is dead.

Ah, the "liberal..." card. Last resort of a money worshiping sociopath. Why did your mom have insurance when she made enough to pay out of pocket? She didn't have any savings? I hope she wasn't drawing SS either.
 

DaveJ

Platinum Member
Oct 9, 1999
2,337
1
81
Originally posted by: 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!

You don't seem to understand the concept of "pooled risk". Do you have insurance? If so, then you're already paying for others' care. My last round of medical bills was around 50 grand, and I damn sure didn't pay that much in premiums. Where else do you think the money came from?
 

jonks

Lifer
Feb 7, 2005
13,918
20
81
Originally posted by: spidey07
Originally posted by: JKing106

Not all of us have rich mommies who pay our bills, whitey07. COBRA is an absolute scam. No wonder you like it.

Ahh, racism. The last resort of a liberal. My mom will have been dead 6 years coming this December after a tremendous amount of care paid for by her health insurance. I've shown how pre-existing conditions are still covered, so that point is dead.

Well you should tell the Republicans that because they kinda disagree with you.
 

Special K

Diamond Member
Jun 18, 2000
7,098
0
76
Originally posted by: Descartes
No amount of information will wake up the people that want to believe that any reform is evil and the status quo is working. Sadly, the only thing that will wake these people up is when they too face these problems.

And that's the sad reality of insurance. You don't know it until it's largely too late, and too great a population in the US is without the ability to rebound.

I always hate to say, "Well, I know this because...", but honestly, my company has processed over 100 million claims in the past 16 months alone. The amount of things we learned in doing so is both sobering and terrifying, and it's especially so when you have family or friends that have been affected. I could go into specifics, but what's the point? People will believe their ideologies over anything else.

But most people know next to nothing about how the healthcare industry, payors and providers, actually works; hell, half the people in the industry don't even understand it. The amount of processing that occurs before a claim decision even hits the doctor goes through potentially a dozen hands, including different companies. Each one gets a decision on the claim, potentially negotiates a reduced rate, risk analysis, etc. etc.

Could you elaborate on this? I would be interested to know what your experience was like working with the claims.

 

CitizenKain

Diamond Member
Jul 6, 2000
4,480
14
76
I always love the bootstraps speech from spidey, I'm sure someone who lives off the work of others has valuable information to share on why others are too lazy to afford insurance.