HIPPA and pre-existing conditions

[TruePaige]

Originally posted by: CitizenKain
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.

:laugh::thumbsup:

 

[Patranus]

I find it funny that Democrats tout the line "pay their fair share" but then when it comes to something where something cost more, that group of people somehow doesn't have to pay "their fair share"

 

[jonks]

Originally posted by: Patranus
I find it funny that Democrats tout the line "pay their fair share" but then when it comes to something where something cost more, that group of people somehow doesn't have to pay "their fair share"

I find it funny that you can utter with a straight face "COBRA is very affordable" when a google search for that phrase has exactly one hit: YOU saying it on here.
http://www.google.com/search?h...dable%22&aq=f&oq=&aqi=

And yet "COBRA is very expensive" yields over 156,000 hits.
http://www.google.com/search?h...nsive%22&aq=f&oq=&aqi=

Granted, I don't know how many of those are about snakes.

ED: Ok, I added "-snake" and it's down to 136,000. Hm, but how many of those posts are from people who got bit by a snake but couldn't go to a doctor because "Cobra is very expensive"? Oh, you get the idea.

 

[Patranus]

Originally posted by: jonks

Originally posted by: Patranus
I find it funny that Democrats tout the line "pay their fair share" but then when it comes to something where something cost more, that group of people somehow doesn't have to pay "their fair share"

I find it funny that you can utter with a straight face "COBRA is very affordable" when a google search for that phrase has exactly one hit: YOU saying it on here.

And yet "COBRA is very expensive" yields over 156,000 hits. Granted, I don't know how many of those are about snakes.

ED: Ok, I added "-snake" and it's down to 136,000. Hm, but how many of those posts are from people who got bit by a snake but couldn't go to a doctor because "Cobra is very expensive"? Oh, you get the idea.

Something that is affordable can also be expensive. It just depends on your priorities.

Now answer the question, if your health care cost more money, why shouldn't your pay your "fair share"?

 

[MooseNSquirrel]

Originally posted by: fisheerman

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

Now that made me laugh.

The DMV is the very model of efficiency compared to private health insurance.

Go ahead, ask a doctor.

I don't understand how anyone can support a system of insurance where what you are insuring against is guaranteed to happen.

See that's the thing. With other insurance your gambling bad things won't happen. With health insurance you KNOW people will make claims, so why even call it insurance?

Imagine if we ran national defense or the transportation infrastructure this way...some public funding some private, it would be a disaster. No rational person gets upset about paying for a highway in another state they will never drive on.

Health care should be infrastructure in this country, if only to allow us to compete better with those countries that have UH.

EDIT: damn mouse buttons

 

[jonks]

Originally posted by: Patranus
Something that is affordable can also be expensive.

Quoted for eternity.

Originally posted by: Patranus
Now answer the question, if your health care cost more money, why shouldn't your pay your "fair share"?

I don't know what you are asking. Liberals are willing to pay more for UH.
http://www.cbsnews.com/htdocs/...ontentMain;contentBody

Are you willing to pay higher taxes so that all americans have health insurance?
Dems - Yes - 73%, No - 23%
Reps - Yes 29%, No - 66%

 

[Patranus]

Originally posted by: jonks

Originally posted by: Patranus
Something that is affordable can also be expensive.

Quoted for eternity.

Originally posted by: Patranus
Now answer the question, if your health care cost more money, why shouldn't your pay your "fair share"?

I don't know what you are asking. Liberals are willing to pay more for UH.
http://www.cbsnews.com/htdocs/...ontentMain;contentBody

Are you willing to pay higher taxes so that all americans have health insurance?
Dems - Yes - 73%, No - 23%
Reps - Yes 29%, No - 66%

Are you that dense?
First of all, 45% of the country doesn't even pay taxes.
Secondly, that poll doesn't say 'how much more' in taxes.
I can continue.....but UHC is neither here nor there.....

Answer my question.

 

[jonks]

Originally posted by: Patranus

Originally posted by: jonks

Originally posted by: Patranus
Something that is affordable can also be expensive.

Quoted for eternity.

Originally posted by: Patranus
Now answer the question, if your health care cost more money, why shouldn't your pay your "fair share"?

I don't know what you are asking. Liberals are willing to pay more for UH.
http://www.cbsnews.com/htdocs/...ontentMain;contentBody

Are you willing to pay higher taxes so that all americans have health insurance?
Dems - Yes - 73%, No - 23%
Reps - Yes 29%, No - 66%

Are you that dense?
First of all, 45% of the country doesn't even pay taxes.
Secondly, that poll doesn't say 'how much more' in taxes.
I can continue.....but UHC is neither here nor there.....

Answer my question.

1. I did.
2. I asked you to further clarify above. See where I said "I don't know what you are asking"? Well when someone says that to you, asking them the same question isn't likely to get you anywhere. Who isn't willing to pay their fair share?
3. You know what? Forget it. I just realized I'm conversing with someone who thinks that expensive and affordable aren't opposites.

 

[Patranus]

Originally posted by: jonks
1. I did.
2. I asked you to further clarify above. See where I said "I don't know what you are asking"? Well when someone says that to you, asking them the same question isn't likely to get you anywhere. Who isn't willing to pay their fair share?
3. You know what? Forget it. I just realized I'm conversing with someone who thinks that expensive and affordable aren't opposites.

So if people are willing to pay their "fair share", why does the government need to pass this cost shifting scheme that is being purposed in congress and pushed by Obama?

 

[JKing106]

Originally posted by: Patranus

Originally posted by: jonks
1. I did.
2. I asked you to further clarify above. See where I said "I don't know what you are asking"? Well when someone says that to you, asking them the same question isn't likely to get you anywhere. Who isn't willing to pay their fair share?
3. You know what? Forget it. I just realized I'm conversing with someone who thinks that expensive and affordable aren't opposites.

So if people are willing to pay their "fair share", why does the government need to pass this cost shifting scheme that is being purposed in congress and pushed by Obama?

So if people are willing to pay their "fair share," why are you opposed to those who have more money than they can ever spend paying more taxes to help people who can't afford medical care at all?

 

[TruePaige]

Originally posted by: JKing106

Originally posted by: Patranus

Originally posted by: jonks
1. I did.
2. I asked you to further clarify above. See where I said "I don't know what you are asking"? Well when someone says that to you, asking them the same question isn't likely to get you anywhere. Who isn't willing to pay their fair share?
3. You know what? Forget it. I just realized I'm conversing with someone who thinks that expensive and affordable aren't opposites.

So if people are willing to pay their "fair share", why does the government need to pass this cost shifting scheme that is being purposed in congress and pushed by Obama?

So if people are willing to pay their "fair share," why are you opposed to who have more money than they can ever spend pay more taxes to help people who can't afford medical care at all?

Because, much like Spidey, if you pay your "fair share" your whole life and still have to die it is better than if they had to pay an ounce more in taxes.

Duh! Right? I mean, what American would want to pay for universal health care.

In America we just pay for the elderly.

And the disabled.

And the super poor in some states, though that is mostly less than 21..otherwise you need to pump out babies and be on welfare..

And the uh..children..

Everyone else though, they can just fuck off and die.

 

[ahurtt]

Originally posted by: MooseNSquirrel

Originally posted by: fisheerman

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

Now that made me laugh.

The DMV is the very model of efficiency compared to private health insurance.

Go ahead, ask a doctor.

I don't understand how anyone can support a system of insurance where what you are insuring against is guaranteed to happen.

See that's the thing. With other insurance your gambling bad things won't happen. With health insurance you KNOW people will make claims, so why even call it insurance?

Imagine if we ran national defense or the transportation infrastructure this way...some public funding some private, it would be a disaster. No rational person gets upset about paying for a highway in another state they will never drive on.

Health care should be infrastructure in this country, if only to allow us to compete better with those countries that have UH.

EDIT: damn mouse buttons

This basically is my feeling as well. Normal insurance like renters, homeowners, auto, life, etc. . .is like gambling. They insurance company is gambling but they don't like to lose. Be prepared to move mountains to get them to pay up on their obligations when they do lose. Course you miss one premium payment BAM. . .CANCELLED. But you can't gamble with your health. It's like you say. . .you are almost guaranteed that people will make claims and when they (the insurer) argue over the semantics of fine print and contracts and "pre-existing conditions" and the like it's people LIVES they are are talking about. Not material posessions like cars, boats, houses, etc. . .If there is anything you cannot afford to lose it's your health because that basically spells the beginning of the end for you if you can't get care. But insurance companies treat it no different than if they were insuring material goods that can just be replaced. There is just a conceptual mismatch here.

 

[Carmen813]

New study Harvard medical school put out, when controlling for numerous other factors (SES, gender, age, education level) lack of health insurance increases your chance of dying 40%, and about 45,000 American deaths annually can be attributed to lacking insurance.

 

[spidey07]

Originally posted by: Carmen813
New study Harvard medical school put out, when controlling for numerous other factors (SES, gender, age, education level) lack of health insurance increases your chance of dying 40%, and about 45,000 American deaths annually can be attributed to lacking insurance.

And what the hell does that have to do with the subject at hand that the point of "but, but,but, the pre-existing conditions" have to do with anything? Stick to the point.

Make up your mind people. Is it a lack of health insurance due to pre-existing condtions (the rally cry that I have completely destroyed).

Or is the cost of health care?

Or is it those 13 million that genuinely have no access?

Or is it 50 million?

Just what are you trying to solve here? Because I have totally destroyed the "but, but, but I lost my job and can't get health insurance due to pre-existing conditions!". Destroyed by legislation executed by Clinton, enhanced by Bush, extended by BB.

Triple points me.

 

[Carmen813]

Originally posted by: spidey07

Originally posted by: Carmen813
New study Harvard medical school put out, when controlling for numerous other factors (SES, gender, age, education level) lack of health insurance increases your chance of dying 40%, and about 45,000 American deaths annually can be attributed to lacking insurance.

And what the hell does that have to do with the subject at hand that the point of "but, but,but, the pre-existing conditions" have to do with anything? Stick to the point.

Make up your mind people. Is it a lack of health insurance due to pre-existing condtions (the rally cry that I have completely destroyed).

Or is the cost of health care?

Or is it those 13 million that genuinely have no access?

Or is it 50 million?

Just what are you trying to solve here? Because I have totally destroyed the "but, but, but I lost my job and can't get health insurance due to pre-existing conditions!". Destroyed by legislation executed by Clinton, enhanced by Bush, extended by BB.

Triple points me.

Perhaps in your little reality you've destroyed pre-existing conditions, but for the millions of Americans who have pre-existing conditions (like me), you've done...well...jack and shit. Honestly, do you think you are the first person to think of this solution? Stop patting yourself on the back.

As others have pointed out, Cobra premiums are insane (especially once this stimulus assistance runs out). I know, because I tried to pay them for just my wife for a couple months when she transitioning offer her parents insurance when we got married. If you have a single minute with a lapse in coverage, you are totally fucked, and I definitely think insurance companies are looking for that minute.

I mean this in the nicest way possible, but you are utterly clueless when it comes to the problems people with pre-existing conditions have when it comes to insurance. Again, no disrespect, but you really need to put yourself in someone else's shoes for a minute. Try that evil "empathy" thing conservatives railed against a few months ago.

As for the study, I thought it was an interesting and would share it. If you want to award yourself points, knock yourself out, I'm just not sure you can redeem them anywhere.

 

[shira]

Originally posted by: heyheybooboo
Summary: Insurers can't deny you for pre-existing conditions

Assuming, of course, you can afford their huge premium and riders.

Insurers can deny you coverage, period, because of pre-existing conditions.

 

[spidey07]

Originally posted by: Carmen813


Perhaps in your little reality you've destroyed pre-existing conditions, but for the millions of Americans who have pre-existing conditions (like me), you've done...well...jack and shit. Honestly, do you think you are the first person to think of this solution? Stop patting yourself on the back.

As others have pointed out, Cobra premiums are insane (especially once this stimulus assistance runs out). I know, because I tried to pay them for just my wife for a couple months when she transitioning offer her parents insurance when we got married. If you have a single minute with a lapse in coverage, you are totally fucked, and I definitely think insurance companies are looking for that minute.

I mean this in the nicest way possible, but you are utterly clueless when it comes to the problems people with pre-existing conditions have when it comes to insurance. Again, no disrespect, but you really need to put yourself in someone else's shoes for a minute. Try that evil "empathy" thing conservatives railed against a few months ago.

As for the study, I thought it was an interesting and would share it. If you want to award yourself points, knock yourself out, I'm just not sure you can redeem them anywhere.

1st off, lapsing coverage is bad, but you have 62 days (minor correction needed, the OP has the laws) before it counts.

You've explained your point nicely with personal experience and I respect your post in kind. But nothing is/was preventing you from getting a new job with group insurance benefits to take care of your wife. That's the whole point - work, provide, get benefits, take care of yourself and your wife.

Believe it or not I have a whole lot of empathy, but I pulled my ass out of it without assistance and maybe that's why I am what I am. If one wants to work, there is work for you.

Real life is pretty damn difficult.

 

[spidey07]

Originally posted by: shira

Originally posted by: heyheybooboo
Summary: Insurers can't deny you for pre-existing conditions

Assuming, of course, you can afford their huge premium and riders.

Insurers can deny you coverage, period, because of pre-existing conditions.

Not according to federal HIPPA laws.

 

[Patranus]

Originally posted by: spidey07
Believe it or not I have a whole lot of empathy, but I pulled my ass out of it without assistance and maybe that's why I am what I am. If one wants to work, there is work for you.

Real life is pretty damn difficult.

Word.

 

[ebaycj]

Originally posted by: Athena

Originally posted by: ebaycj
However, When I did switch from United Healthcare to BCBS a few years back, I had to fax BCBS a copy of my "exit letter" from United Healthcare before BCBS would waive pre-existing.

You said that you converted from COBRA BCBS to an individual policy. Can we assume then, that the exit letter was to get full coverage at your new employer?

One of the many gotchas with HIPAA is that it only protects people who weren't paying for their own coverage in the first place. "Creditable" insurance means:

• A group health plan
• Medicare
• Medicaid
• A military-sponsored health care program such as TriCare
• Health plans offered by the Indian Health Service
• A state high-risk health insurance pool
• The federal Employees Health Benefit Program
• A public health plan established or maintained by a state or local government
• A health benefit plan provided for Peace Corps members

In other words, if you work for one of the 60% of small businesses that do not offer coverage and pay or self-employed and take responsibility for your family's well being by participating in the individual health insurance market, you are basically penalized if/when you go to work for a company with better benefits.

Nope, both were group policies. Group BCBS (COBRA coverage from my old job) -> Group BCBS (new job).

And yes, the exit letter scenario was also a group (UnitedHealthcare) -> group (BCBS) transfer.

 

[OrByte]

Originally posted by: 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.

:laugh:

 

[OrByte]

Originally posted by: 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.

actually, the fact is irregardless of what you THINK you may have solved...there are millions of Americans without coverage, plugging up our emergency rooms all across the country...adding to an overburdened health system.

Fact is, thousands of people die because they didn't seek medical treatment every year, because they couldnt afford it.

but, maybe you are ok with that....or maybe...they deserve to die because they had "options" in the system but "chose" poorly...

you are awful.

 

[ebaycj]

Originally posted by: 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.?

This really depends. Most insurance companies will accept single coverage (not group policy) as "counting" in this case. There are probably a handful of states with laws that cover this scenario as well. In truth, I can't say for certain.

However, I'm sure if push came to shove, and insuring you would cost them $20k/month (cancer meds, chemo, etc..), that they would be happy to flag that as "pre existing" even if that's not the case.

 

[OrByte]

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 pay for it anyway...everytime someone seeks medical treatment thru an emergency room and skips out on the bill.

gotta love it!

 

[jonks]

Originally posted by: spidey07
If one wants to work, there is work for you.

smack yourself, hard. Unemployment doesn't oscillate based on people's varying degrees of laziness. People don't decide to lapse their coverage and allow their families to go without health insurance when jobs are readily available. seriously, what planet do you live on.

Originally posted by: Patranus
Word.

schmuck, there's a word.