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Message
Posted on 5/3/17 at 1:35 pm to Eurocat
Now break out your underwriting manual and tell me what percentage of those are actually uninsurable?
Posted on 5/3/17 at 1:36 pm to roadGator
in employer insurance (that's large group and small group) large group like mine is self insured, small group is underwritten meaning it's insurance, self insurance means your employer is merely paying your claims. when you are hired you have a thirty day waiting period that's typically done to facilitate the payroll deduction aspect of your premiums (in small group) or your employee contribution in large group at that time all pre existing conditions are covered, they can not be excluded. if for some reason you were to cancel your coverage and let it lapse for more than 90 days, then pre-existing conditions can be uncovered for up to 18 months for adults (16 or over) and six months for minors. you can skip coverage but you are allowed a chance to enroll during the next open enrollment period but if you haven't maintained some form of valid coverage since the past open enrollment period the 90 day lapse rule applies.
in other words you have coverage through your wife's plan you decide you want it through your employer instead, you got no problems, you just didn't want the coverage cause it's expensive and you didn't plan on getting sick then that condition will be excluded doesn't mean they won't take you it's simply means claims related to that specific pre-existing condition will not be paid.
in other words you have coverage through your wife's plan you decide you want it through your employer instead, you got no problems, you just didn't want the coverage cause it's expensive and you didn't plan on getting sick then that condition will be excluded doesn't mean they won't take you it's simply means claims related to that specific pre-existing condition will not be paid.
Posted on 5/3/17 at 1:37 pm to tedmarkuson
Um, I've been in the health insurance industry since 1996.
Also, I served a brief time in underwriting. Not everyone with a PEC was denied coverage. It depends on what it was and actually what the market was doing at the time.
Also, I served a brief time in underwriting. Not everyone with a PEC was denied coverage. It depends on what it was and actually what the market was doing at the time.
This post was edited on 5/3/17 at 1:38 pm
Posted on 5/3/17 at 1:38 pm to Eurocat
quote:
84% of people between 55 and 64 have a pre-existing condition.
No. Pre-existing means existing before they think "Oh, I need health insurance now."
5% of those 84% have no health insurance.
Posted on 5/3/17 at 1:41 pm to tedmarkuson
quote:
large group like mine is self insured
Ahh.. you are bringing up 25 year old memories of calling up blue cross every single morning, finding out what claims were paid and making a bank transfer to cover those claims at the physicians group I worked for then. Fun times.
Posted on 5/3/17 at 1:41 pm to Eurocat
quote:
ACA TO MAKE PEOPLE GET INSURANCE
It didn't exactly do that.
Posted on 5/3/17 at 1:42 pm to Zach
40 hours a week at minimum wage is about 15k before tax.
Under the current plans, having a condition like Asthma could cost $4k a year. Asthma.
What do you do if you're on minimum wage and have Asthma? Or a more expensive condition?
Under the current plans, having a condition like Asthma could cost $4k a year. Asthma.
What do you do if you're on minimum wage and have Asthma? Or a more expensive condition?
Posted on 5/3/17 at 1:42 pm to SSpaniel
You had to transfer daily? Holy hell.
Posted on 5/3/17 at 1:45 pm to Eurocat
quote:
it was a GOOD thing for the ACA TO MAKE PEOPLE GET INSURANCE AND NOT WAIT UNTIL THEY GOT SICK!
That's unconstitutional. You cannot MAKE people buy a service. If you read the friggin' news you would know that the Sup Court 'out' on the issue was 'It's a Tax' and the federal govt has the power to tax. They do not have the power to make you buy a product.
And.. a TON of people refused to get covered even though the ACA 'MADE THEM.' How did that happen? Why aren't those people in prison for breaking the law?
Posted on 5/3/17 at 1:45 pm to roadGator
quote:
You had to transfer daily? Holy hell
Yep. Every day. Low man on the totem pole gets that job.
This post was edited on 5/3/17 at 1:46 pm
Posted on 5/3/17 at 1:46 pm to SSpaniel
I feel for you for having to get on the phone with a BCBS employee every day. Damn.
Posted on 5/3/17 at 1:46 pm to roadGator
quote:
Not everyone with a PEC was denied coverage. It depends on what it was and actually what the market was doing at the time.
if for some reason you were to cancel your coverage and let it lapse for more than 90 days, then pre-existing conditions can be uncovered for up to 18 months for adults (16 or over) and six months for minors.
it's can be not will be.
Posted on 5/3/17 at 1:50 pm to tedmarkuson
Sure, but not all PECs always led to a denial of coverage or subjected to a waiting period.
This post was edited on 5/3/17 at 2:00 pm
Posted on 5/3/17 at 1:59 pm to SSpaniel
quote:
If you want those coverages, you should certainly be able to buy a plan that includes them.
But you should also be able to buy a lower cost plan that doesn't include them. For instance, if you are a 65 year old woman... just maybe you don't need maternity coverage. But you get it. Or if you are man. You probably don't need maternity coverage then, either.
Exactly.
One advantage to the old system was you had the choice between insurance and comprehensive health care. If you chose insurance it was cheaper and rightfully so.
Patients who chose insurance were typically healthy people who never used the system. They paid in every month and covered other people, unless a catastrophic event happened. The other possibility was they had a chronic condition and bought a catastrophic plan so the premium savings could be used for their meds.
With the ACA, they have to play four certain "essential" benefits they can't use, but it's perfectly OK for the mandatory plan to leave them on the hook for thousands of dollars if their needs aren't on the politically preferred list of services. That's why you still see charitable fundraisers for medical bills.
Posted on 5/3/17 at 2:07 pm to mahdragonz
quote:He is definitely not the person to deliver this message. His doctor shopping for opioids and his obesity makes him the worst type of patient.
I'd rather pay for a kid with cancer than mg rates going up due to his co-morbidities from obesity and drug addiction.
Posted on 5/3/17 at 2:16 pm to cornhat
quote:
He is definitely not the person to deliver this message. His doctor shopping for opioids and his obesity makes him the worst type of patient.
Rush does not have any health insurance. He does have homeowner's insurance since he moved to a beach where hurricanes are an issue.
Posted on 5/3/17 at 2:25 pm to Zach
So it is now a conservative issue to make sure we protect the profits of health insurance companies? I've always considered health insurance companies to be second to Satan in evil. The insurance companies have the true death panels. And now yall have decided that if you have a health problem, you shouldn't be able to access treatment. Sorry guys, I'm off this train.
Posted on 5/3/17 at 2:29 pm to TBoy
quote:
And now yall have decided that if you have a health problem, you shouldn't be able to access treatment.
Where did anybody say this? If you have a health problem or not doesn't determine whether or not you can access treatment. That's a silly argument.
Neither does if you have insurance or not. There are people who have never had health insurance, and they had access to treatment.
ETA
I'll go one step further. If people wanted health insurance before ObamaCare, they could have bought it. They didn't need the government to make it mandatory.
This post was edited on 5/3/17 at 2:32 pm
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