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Message
re: Pre existing conditions
Posted on 5/8/17 at 9:36 am to ApexTiger
Posted on 5/8/17 at 9:36 am to ApexTiger
I know most people don't have to deal with this, so I'm wondering what you'd do if you're in my shoes. And feel free to educate me on the nuances of the currently passed bill and any desired changes regarding pre-existing conditions - in either direction (more or less coverage).
My daughter has not one but two very rare genetic congenital conditions. One is a connective tissue disorder that will cause her migratory problems and chronic pain her entire life. Obviously this will require significant medical intervention across her lifetime.
She also has a very rare immune deficiency. It requires expensive immunoglobulin replacement therapy weekly otherwise her life expectancy is extremely short. Despite that, she's still at risk of frequent infection and will labor through infections longer than typical people. Her doctors are aggressive with her treatment due to these issues.
Because of all of this, we are doing our best to prepare ourselves financially. Luckily I have solid employer insurance. What does concern me is the eventual impacts of my daughter being placed into a high risk pool that will bleed over to my employer insurance plan, and cause not only her doctor visits and intervention costs to shoot up, but the weekly immunoglobulin costs that are already high to be completely unaffordable.
These are issues we obviously cannot avoid and will do our best to prepare for. However we hope she has a long life. Despite our best efforts, her care will be expensive whether her costs go up or stay the same they are now.
What is the board's opinion on situations like this?
My daughter has not one but two very rare genetic congenital conditions. One is a connective tissue disorder that will cause her migratory problems and chronic pain her entire life. Obviously this will require significant medical intervention across her lifetime.
She also has a very rare immune deficiency. It requires expensive immunoglobulin replacement therapy weekly otherwise her life expectancy is extremely short. Despite that, she's still at risk of frequent infection and will labor through infections longer than typical people. Her doctors are aggressive with her treatment due to these issues.
Because of all of this, we are doing our best to prepare ourselves financially. Luckily I have solid employer insurance. What does concern me is the eventual impacts of my daughter being placed into a high risk pool that will bleed over to my employer insurance plan, and cause not only her doctor visits and intervention costs to shoot up, but the weekly immunoglobulin costs that are already high to be completely unaffordable.
These are issues we obviously cannot avoid and will do our best to prepare for. However we hope she has a long life. Despite our best efforts, her care will be expensive whether her costs go up or stay the same they are now.
What is the board's opinion on situations like this?
3
Posted on 5/8/17 at 9:41 am to LSU Wayne
Your daughter will not be exposed to PEC clauses. You have coverage currently so PEC doesn't come into play for her.
The dem machine is scaring you for nothing. Now, BamaSJW or one of the other fear mongering libs may come in here and drop lots of ifs on you but those can be dealt with as they happen.
The dem machine is scaring you for nothing. Now, BamaSJW or one of the other fear mongering libs may come in here and drop lots of ifs on you but those can be dealt with as they happen.
Posted on 5/8/17 at 9:46 am to roadGator
quote:
Your daughter will not be exposed to PEC clauses. You have coverage currently so PEC doesn't come into play for her.
What if he gets laid off or fired and that coverage goes away, then what?
Posted on 5/8/17 at 9:48 am to Lakeboy7
quote:
What if he gets laid off or fired and that coverage goes away, then what?
Jump on the AHCA plan would be my suggestion. Or Cobra for 18 months. Or get another job within 63 days.
You know, like every one else has to do.
Posted on 5/8/17 at 9:53 am to Taxing Authority
quote:No kidding. We may have to write Xi Chin for pre approval to go to the dentist in a decade or so.
ow anyone is comfortable with government (with $20T in debt) in this business is puzzling at best.
Posted on 5/8/17 at 9:53 am to roadGator
quote:
Or get another job within 63 days.
So if there is no gap in coverage the new insurer wont treat those conditions as prexisting?
Posted on 5/8/17 at 9:54 am to Lakeboy7
A gap must be less than 63 days. If so, there is no gap really.
This post was edited on 5/8/17 at 9:55 am
Posted on 5/8/17 at 9:58 am to roadGator
quote:
If so, there is no gap really.
Ok, it just seems it would be tempting to cost save and declare those prexisting.
Posted on 5/8/17 at 10:01 am to Lakeboy7
quote:
it just seems it would be tempting to cost save and declare those prexisting.
Well, if you take more you should have to pay more or the entity funding the care should get more from the group in total.
Claims are claims. They have to be paid.
However, the fear mongering is ridiculous. BamaSJW types are not helping the conversation. The way to attack this is together for once. I doubt either side has the nuts to do that though.
Obstruction 24/7 is the new game by both parties. It's fricking stupid.
Neither side is listening to all the people from all angles.
ETA: Calling for 24M being dropped is ridiculously irresponsible at this point. The Senate has not even started on their version. Fear mongering is dangerous. It can get real people killed and people's property destroyed.
The escalation needs to stop now. Someone is going to pay with their life over this shite eventually. I'm talking about the ratcheting up of the political rhetoric leading to violent protests. We seem to be inching closer and closer to larger violence. That should concern both sides.
Also, thanks for not getting down in the mud.
This post was edited on 5/8/17 at 10:06 am
Posted on 5/8/17 at 10:02 am to WhopperDawg
quote:
And what about a premey born with serious health issues, throw that person on the ice floe with the old folks and bye to them too?
Simple..
Just perform an after birth abortion.
Posted on 5/8/17 at 10:19 am to LSU Wayne
quote:
very rare immune deficiency.
By chance is it CVID?
Eta
If you don't mind me asking
This post was edited on 5/8/17 at 10:29 am
Posted on 5/8/17 at 10:23 am to roadGator
thanks. this helps for better understanding. I still need to watch closely with caution as the senate takes it up next, though obviously. Needless to say there are a lot of folks in the rare disease community that are in full on panic mode. I refuse to go there, I just want to be well educated on the potential implications.
All of this being said, I have no expectations that costs won't go up. I just want to be sure that my daughter's ongoing treatment won't end up in a world where we honestly cannot afford it despite our best efforts to prepare for the worst.
All of this being said, I have no expectations that costs won't go up. I just want to be sure that my daughter's ongoing treatment won't end up in a world where we honestly cannot afford it despite our best efforts to prepare for the worst.
Posted on 5/8/17 at 10:27 am to roadGator
quote:
and drop lots of ifs on you but those can be dealt with as they happen.
If her company folds she is SOL. If she left her job for any reason and had to shop again? She's in deep crap. Company changes carrier? I'm not sure.
Healthcare needs true transparency in cost. Then a discussion can be had about driving down costs. Right now most numbers you are given can be used to wipe arse.
Posted on 5/8/17 at 10:31 am to LSU alum wannabe
quote:
If her company folds she is SOL. If she left her job for any reason and had to shop again? She's in deep crap. Company changes carrier? I'm not sure.
Company folds: Options include COBRA, AHCA, find another job. So, not SOL.
Left her job: Options still include COBRA, AHCA find another job within 63 days. So, not in deep crap.
Company changes carriers: That is just full takeover of all people regardless of health status. No medical underwriting occurs at the individual level.
Feel better? Don't let the dems scare you. They are targeting the ignorant.
Posted on 5/8/17 at 10:34 am to ApexTiger
quote:
Pre existing conditions
Never was an issue before Obama and the democrats ruined healthcare. Now all of the sudden everybody is going to die...just like before Obama and the democrats ruined healthcare.
Posted on 5/8/17 at 10:37 am to AU_Right
quote:
Never was an issue before Obama and the democrats ruined healthcare
That's not exactly true.
For individual policies (non-group based or non-corporate plans) insurance companies could medically underwrite you. If you had an expensive past medical history they could decline you, charge you more or write the policy without covering certain procedures related to your malady for a period of time. It depended on the State.
Most of Americans are on group policies where PEC clauses don't exist.
Posted on 5/8/17 at 10:37 am to AU_Right
Everybody remember having to bring out your dead and load them in to the death carts every day prior to Obamacare?
I 'member...
I 'member...
Posted on 5/8/17 at 10:40 am to AU_Right
Always been an issue--evidently it's one you ignored. Don't tell me it wasn't an issue. I lived it.
Posted on 5/8/17 at 10:41 am to LSU Wayne
quote:
Needless to say there are a lot of folks in the rare disease community that are in full on panic mode.
That's on purpose. The dems are brilliant at this.
We can take up more questions once the house gets through with their version.
Just know that the dems will only hype the ifs and buts and never anything good about the bill.
Also, the Rs know that PEC is a huge political football that they can't fumble. They will have to do something and it will cost us all more. Maybe that's OK. I'm fine with it as long as they hold our largest takers accountable for being compliant with the free care they received and have some requirements to change bad behavior (stop smoking and drinking to excess). They should get help but only if they start caring about themselves. If they don't care, I don't care.
Posted on 5/8/17 at 10:49 am to InTheDetails
quote:
Don't tell me it wasn't an issue. I lived it.
Did you have health insurance when you lived it?
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