Pre-existing Condition Insurance (Oba...
Sunrise

Fort Worth, TX

#85 Jun 11, 2012
Wantstoknow wrote:
I just wanted to get a review on the PCIPs and this is what I come across: the same mean spirited dialog that goes nowhere. I've had health insurance since my 20s, I even managed to pay the premiums and the co pays and the deductables while battling breast cancer. I still had debt and I paid that off too. Now I'm 60 and my insurance company has raised my deductible to $10,000!! My crime? I AM SELF EMPLOYED. They have made it impossible for me to afford insurance. I need the PCIP and am willing to risk being uninsured 6 months to get it. Everybody who thinks we want a free ride is wrong. I don't mind paying, but paying out the ass for poor coverage is criminal. I can't shop around because you have to be cancer free 10 years and I'm at 7. So screw you Sunshine and everybody else who says we are freeloaders. I've paid and paid and paid.
I'm sorry for your health problems. You and others don't seem to understand that because health insurance companies don't know how obamacare will affect them they are raising rates and fees in self-defense in anticipation of being put out of business or having to operate with no profit. Are you sure that it is your deductible that is now $10,000? Did you agree to this or request that your deductible be raised in order to get a lower premium?
Wow

Aubrey, TX

#86 Jun 11, 2012
Some of the people in this post are absolutely heartless. I have a pre-existing condition I was born with.. and I lost my job due to the company closing. I found a new job as quickly as I could in this economy to provide for my family, but it doesn't offer real health insurance. I am denied for any health insurance due to my pre-existing condition.

How DARE I develop this pre-existing condition. You guys are right, I should just die. Maybe we should appeal the health care law and instead use money to build euthanization clinics so us with pre-existing conditions can just take care of it quickly.
Sunrise

Grand Prairie, TX

#87 Jun 12, 2012
Wow wrote:
Some of the people in this post are absolutely heartless. I have a pre-existing condition I was born with.. and I lost my job due to the company closing. I found a new job as quickly as I could in this economy to provide for my family, but it doesn't offer real health insurance. I am denied for any health insurance due to my pre-existing condition.
How DARE I develop this pre-existing condition. You guys are right, I should just die. Maybe we should appeal the health care law and instead use money to build euthanization clinics so us with pre-existing conditions can just take care of it quickly.
I'm sorry for your health issues. You did not elaborate as to the nature of your health issues. I am not heartless but even though you were born with your problems, why is it the taxpayers place to pay for your medical bills. Why can you not pay yourself? How often do you have to go to the doctor and at what cost? You indicated that you were able to work so apparently you have income and are able to hold down a job. How much money are we talking about to cover you annual doctor bills?
Wrong

Paris, TX

#88 Jun 12, 2012
Wow wrote:
Some of the people in this post are absolutely heartless. I have a pre-existing condition I was born with.. and I lost my job due to the company closing. I found a new job as quickly as I could in this economy to provide for my family, but it doesn't offer real health insurance. I am denied for any health insurance due to my pre-existing condition.
How DARE I develop this pre-existing condition. You guys are right, I should just die. Maybe we should appeal the health care law and instead use money to build euthanization clinics so us with pre-existing conditions can just take care of it quickly.
Texas already has a health insurance risk pool that guarantees you coverage regardless of pre-existing conditions. The new PCIP plan, that was created by Obamacare, will not allow you to enroll until you go six months without coverage. Those that are finacially able and responsible will enroll in the higher cost Texas risk pool plan rather than go without coverage. They will never be eligible to enroll in the federal plan, unless they go six months without coverage. Both plans cover pre-existing conditions. How fair is it to punish those who are responsible while rewarding those who go without any coverage? The federal plan forces you to buy lower deductibles and all the bell and whistles that go with Obamacare. The plan was designed to be issued at standard rates, but because it is a broader plan, the rates are higher than most can afford. The only people who were helped are those that jump into the new federal plan and had no previous coverage. They then get their condition treated and drop the plan. They wait until the next time something comes up and jump into the plan again. Why pay monthly premiums when you can just buy it after you need it?
frigginredneckss uck

Dallas, TX

#89 Oct 4, 2012
Questions wrote:
<quoted text>
I'll just bet the poster had internet service, cable tv, a nice car, cellphones, and assorted other unnecessary gadgets while he/she was risking going without insurance before he/she discovered he/she had a hereditary illness. And a hereditary illness makes you double dumb -- if you know you have a chance of a dire illness because it runs in the family, why would you not keep your insurance and let other unnecessaries go? Lack of insurance is most often a matter of misplaced priorities.
You're a effin moron. All you right-wing redneck texans are. we don't expect you to understand the intricacies of Obamacare. It would actually require an intelligent thought. So you think this guys internet service, cable tv, nice car and cellphones are just little niceties...? And you think they would add up enough to afford a $1,500/month insurance plan? FUCK YOU!
Think about it

Euless, TX

#90 Oct 4, 2012
Wrong wrote:
<quoted text>Texas already has a health insurance risk pool that guarantees you coverage regardless of pre-existing conditions. The new PCIP plan, that was created by Obamacare, will not allow you to enroll until you go six months without coverage. Those that are finacially able and responsible will enroll in the higher cost Texas risk pool plan rather than go without coverage. They will never be eligible to enroll in the federal plan, unless they go six months without coverage. Both plans cover pre-existing conditions. How fair is it to punish those who are responsible while rewarding those who go without any coverage? The federal plan forces you to buy lower deductibles and all the bell and whistles that go with Obamacare. The plan was designed to be issued at standard rates, but because it is a broader plan, the rates are higher than most can afford. The only people who were helped are those that jump into the new federal plan and had no previous coverage. They then get their condition treated and drop the plan. They wait until the next time something comes up and jump into the plan again. Why pay monthly premiums when you can just buy it after you need it?
You really haven't looked into the Texas risk pool have you? If you have a pre existing condition you can sign up, you just have a year waiting period before they will cover those. Who can afford that?
The Truth

Las Vegas, NV

#91 Nov 3, 2012
First, if anyone here thinks that an insurance company has never unjustly rescinded the policy of an individual in the name of profit is very naive or just refusing to admit the truth. Never? Really? That has never happened? What a bunch of honest upstanding pillars of the community those insurance companies are to put people's welfare above their profits. Don't tell the stockholders though. Google the LA Times articles by Lisa Girion around 2006 and see what they uncovered.

Second, whether you like it or not you are, and always have been, paying for medical treatments of the uninsured due to the 24/7 emergency room down the street. Whether someone was gambling with their health or fell on bad times you are required to pay your share to hep them through emergency care if nothing else.

It's called humanity, try embracing it sometime, you might actallty begin to feel human again you animals. And yes I have insurance, have always had insurance and will gladly pay my share to help someone out whether they were being foolish with their health or otherwise.

And I'm not even religious, I don't need a fictional character to teach me forgiveness and compassion. Love how these same guys are probably in church every Sunday singing hymns and giving their amens to the preacher and not letting a word he's saying sink in.

Everyone makes mistakes, including everyone here on their soapbox. Don't tell me you navigated the course of your life perfectly and never needed a second chance at the expense of someone else through time or money. I'm not buying it.
NoName

Fort Worth, TX

#92 Nov 3, 2012
The Truth wrote:
Second, whether you like it or not you are, and always have been, paying for medical treatments of the uninsured due to the 24/7 emergency room down the street. Whether someone was gambling with their health or fell on bad times you are required to pay your share to hep them through emergency care if nothing else.
With the 24/7 emergency room plan, we know what to expect; approximately how much extra it will cost us to go the the hospital; or in insurance premiums. With obamacare we don't know. We have been kept in the dark about what is covered, who is covered or how much it will cost.
The Truth

Las Vegas, NV

#93 Nov 3, 2012
I can see where your coming from NoName but just because we have historical data from a broken system doesn't mean we should keep doing the wrong way.

And the Congressional Budget Office has put out numerous reports on what to expect as far as the costs on expanding coverage, deficit impact (which by the way says it will lower the deficit overall), impact on businesses and a lot more. I know that's far from a lock but its better than nothing.

The plan will mandate everyone to carry insurance which goes to the heart of individual responsibility, a most conservative ideal that I'm surprised more of the right doesn't embrace. Yes it will expand medicaid for the poorer folks but again they're going to the emergency rooms which is the most expensive medical treatment you can get anyway so it may well be be cheaper to get them insured on the front end.

Most importantly the gamblers that can afford insurance but don't get it will be penalized which will help fund the care that they refuse to pay for in the first place. These are the very people everyone here is complaining about.

I would also like to note that Massachusetts has an insured rate of 98%, the very state the plan is modeled after. Romney likes to say that he did it without raising taxes but Mass. already had taxpayer money earmarked for emergency services for the poor that the state parlayed into providing them insurance on the front end as Obamacare proposes to do. They also received federal funds to help pay for their system which came from, you guessed it, American taxpayers.

So kudos to Romeny for not raising Massachusetts taxes but instead using your and my tax money to pay for Massachusetts health care. And with you guys there in Texas having the highest uninsured rate in the nation at 26% and my state of Nevada having 3rd highest at 21%, we should stand up and take notice what is happening there in Massachusetts with their 2% uninsured rate and try to expand coverage for all.

Its a zero sum game folks, we're either paying for high priced emergency care or insurance up front for the poor. Like it or not, as a society we aren't going to leave them bleeding in the streets.
Really

Paris, TX

#94 Nov 3, 2012
The Truth wrote:
First, if anyone here thinks that an insurance company has never unjustly rescinded the policy of an individual in the name of profit is very naive or just refusing to admit the truth. Never? Really? That has never happened? What a bunch of honest upstanding pillars of the community those insurance companies are to put people's welfare above their profits. Don't tell the stockholders though. Google the LA Times articles by Lisa Girion around 2006 and see what they uncovered.
Second, whether you like it or not you are, and always have been, paying for medical treatments of the uninsured due to the 24/7 emergency room down the street. Whether someone was gambling with their health or fell on bad times you are required to pay your share to hep them through emergency care if nothing else.
It's called humanity, try embracing it sometime, you might actallty begin to feel human again you animals. And yes I have insurance, have always had insurance and will gladly pay my share to help someone out whether they were being foolish with their health or otherwise.
And I'm not even religious, I don't need a fictional character to teach me forgiveness and compassion. Love how these same guys are probably in church every Sunday singing hymns and giving their amens to the preacher and not letting a word he's saying sink in.
Everyone makes mistakes, including everyone here on their soapbox. Don't tell me you navigated the course of your life perfectly and never needed a second chance at the expense of someone else through time or money. I'm not buying it.
Again it is not legal for an insurance company in Texas to rescind individual coverage unless you lied or committed fraud on your application. It can cancel you for not paying your premiums. You cannot cancel someone for claims. You cannot raise premiums on a person just because they had claims. A company can raise all polices in a state based on claims. Rates can be adjusted by age as well.

Here is a link. Read under cancelation.

http://www.tdi.texas.gov/pubs/consumer/cb005....
Really

Paris, TX

#96 Nov 3, 2012
The Truth wrote:
I can see where your coming from NoName but just because we have historical data from a broken system doesn't mean we should keep doing the wrong way.
And the Congressional Budget Office has put out numerous reports on what to expect as far as the costs on expanding coverage, deficit impact (which by the way says it will lower the deficit overall), impact on businesses and a lot more. I know that's far from a lock but its better than nothing.
The plan will mandate everyone to carry insurance which goes to the heart of individual responsibility, a most conservative ideal that I'm surprised more of the right doesn't embrace. Yes it will expand medicaid for the poorer folks but again they're going to the emergency rooms which is the most expensive medical treatment you can get anyway so it may well be be cheaper to get them insured on the front end.
Most importantly the gamblers that can afford insurance but don't get it will be penalized which will help fund the care that they refuse to pay for in the first place. These are the very people everyone here is complaining about.
I would also like to note that Massachusetts has an insured rate of 98%, the very state the plan is modeled after. Romney likes to say that he did it without raising taxes but Mass. already had taxpayer money earmarked for emergency services for the poor that the state parlayed into providing them insurance on the front end as Obamacare proposes to do. They also received federal funds to help pay for their system which came from, you guessed it, American taxpayers.
So kudos to Romeny for not raising Massachusetts taxes but instead using your and my tax money to pay for Massachusetts health care. And with you guys there in Texas having the highest uninsured rate in the nation at 26% and my state of Nevada having 3rd highest at 21%, we should stand up and take notice what is happening there in Massachusetts with their 2% uninsured rate and try to expand coverage for all.
Its a zero sum game folks, we're either paying for high priced emergency care or insurance up front for the poor. Like it or not, as a society we aren't going to leave them bleeding in the streets.
Once again you are wrong. Obamacare does not require you buy insurance. That would be unconstitutional. It can tax you under the taxing powers of the federal government if you do not purchase insurance. Originally Obamacare claimed it had the authority to enact the affordable care act under the commerce clause and it was not a tax. That was wrong. Obama's attorneys had to argue before the Supreme Court that it was indeed a tax for the law to be declared constitutional. There will still be 10-12 million people who will not buy insurance and be penalized by the IRS. It will be much cheaper to be charged a penalty than to buy insurance. Obamacare requires you buy a very expensive plan that meets federal guidelines as to benefits. They require you to buy a low deductible broad type of plan.
Really

Paris, TX

#97 Nov 3, 2012
Finally, fewer people will be covered by Obamacare than orginally due to Medicaid and Supreme Court ruling that the federal government cannot blackmail the states into lowering their Medicaid standards or face reduction in federal funding. The original cost
to the government for ACA known as Obamacare was 1.2 trillion. This was reduced down due to fewer people being covered by Medicaid to 1.18 trillion.

Obamacare is not free. There is an additional cut to Medicare Advantage plans of $711 billion to pay for it. It took this away from our seniors.
Really

Paris, TX

#98 Nov 3, 2012
The Truth

Las Vegas, NV

#99 Nov 3, 2012
Well if you think that the laws are that black and white then you are living in a candy land my friend. Here is an article about the games the insurance giants will play with people's lives in the name of profit: http://articles.latimes.com/2009/jun/17/busin...
The article even quotes one of your Texas Republican Congressman deriding the insurance company practice of denying coverage after the fact.

If you think that it's okay for insurance giants to intentionally mislead people on applications and drop individuals that have made payments for years due to minor technicalities once they make a claim then we will have to agree to disagree on that one.

Secondly I never said Obamacare will require anyone to buy insurance. And if it's a tax then it's a tax, so what, that doesn't change the end game. It's money from individuals that can afford insurance but choose not to obtain it thereby gambling with our tax dollars. It's money from them that we would otherwise not have if nothing else.

Finally, yes fewer people will now be covered under Medicaid due to the SCOTUS ruling but a lot of those folks will be picked up by the exchanges.

The overall coverage of the population will expand which in fact has grew since last year due to the ACA which has barely got off the ground: http://usatoday30.usatoday.com/news/opinion/e...

Also that CBO report you posted said that ACA was now cost effective, all other things being equal.

And regarding that 716 million taken from Medicare, that is due to money actually saved by having the ACA in the first place and only a third of it is from Medicare Advantage anyway.
http://www.washingtonpost.com/blogs/ezra-klei...

Besides Medicaid advantage has become a boondoggle and needs to be fixed regardless which is what the ACA will do. Any of the seniors that are eventually off of it will be picked up by the exchanges.

Anyway, my take is that health care in this country sucks the way that it is and with Texas at 26% uninsured you guys should especially agree. And if you guys want to complain about the number of people gaming the health care system and then complain about a cost effective law designed to penalize (tax) them then come up with a better plan.
Really

Paris, TX

#100 Nov 3, 2012
The Truth wrote:
Well if you think that the laws are that black and white then you are living in a candy land my friend. Here is an article about the games the insurance giants will play with people's lives in the name of profit: http://articles.latimes.com/2009/jun/17/busin...
The article even quotes one of your Texas Republican Congressman deriding the insurance company practice of denying coverage after the fact.
If you think that it's okay for insurance giants to intentionally mislead people on applications and drop individuals that have made payments for years due to minor technicalities once they make a claim then we will have to agree to disagree on that one.
Secondly I never said Obamacare will require anyone to buy insurance. And if it's a tax then it's a tax, so what, that doesn't change the end game. It's money from individuals that can afford insurance but choose not to obtain it thereby gambling with our tax dollars. It's money from them that we would otherwise not have if nothing else.
Finally, yes fewer people will now be covered under Medicaid due to the SCOTUS ruling but a lot of those folks will be picked up by the exchanges.
The overall coverage of the population will expand which in fact has grew since last year due to the ACA which has barely got off the ground: http://usatoday30.usatoday.com/news/opinion/e...
Also that CBO report you posted said that ACA was now cost effective, all other things being equal.
And regarding that 716 million taken from Medicare, that is due to money actually saved by having the ACA in the first place and only a third of it is from Medicare Advantage anyway.
http://www.washingtonpost.com/blogs/ezra-klei...
Besides Medicaid advantage has become a boondoggle and needs to be fixed regardless which is what the ACA will do. Any of the seniors that are eventually off of it will be picked up by the exchanges.
Anyway, my take is that health care in this country sucks the way that it is and with Texas at 26% uninsured you guys should especially agree. And if you guys want to complain about the number of people gaming the health care system and then complain about a cost effective law designed to penalize (tax) them then come up with a better plan.
The articles you posted talk about recession of coverage because somene left off facts about their health. Again, in Texas leaving off a material fact about your health is a reason to rescind coverage. The time limit on certain defenses limits the time an insurer can rescind coverage to 2 years. Directly from your article.

But rescission victims testified that their policies were canceled for inadvertent omissions or honest mistakes about medical history on their applications.

The article you posted was mainly about Wellpoint that owns Blue Cross and Blue Shield of California.

I don't live in candyland. I live in the real world. People lie about their health trying to get covered. Yes, sometimes an insurance company also goes overboard in a decision to rescind. That's why we have courts and state insurance boards. Should you be treatly unfairly you have recourse.

Medicare Advantage was mainly for low and low middle income. Most plans capped what you owed in medical costs and many had prescription coverage. Cutting the program forces these people back into traditional Medicare Parts A & B. They then have no cap on their out of pocket expense and have to purchase a Part D prescription plan and a medicare supplement. Most cannot afford to do so. Obamacare robbed from our seniors to give to under 65 demographic. Truth sometimes hurts.
Really

Paris, TX

#102 Nov 8, 2012
NoName wrote:
<quoted text>With the 24/7 emergency room plan, we know what to expect; approximately how much extra it will cost us to go the the hospital; or in insurance premiums. With obamacare we don't know. We have been kept in the dark about what is covered, who is covered or how much it will cost.
PCIP covers about 86,000 nationwide at this point in time. Texas has 7,731.

http://www.healthcare.gov/news/factsheets/201...

Not about cost. Here is a study released in Sept. 2012 with data thru June 2012.

Medical Loss Ratio: 460% nationwide average
Cost per member per month:$2632
Texas Cost per member per month:$3738

What does this mean? Nationwide for every $1 paid in premium $4.60 is spent on claims. This does not include the cost of administration or other expenses. Every member enrolled nationwide cost $2632 PER MONTH. It cost $3738 per member per month in Texas. This also does not include cost of administration. Administration and expenses normally run around 10% so add another $200-$300 or so to the cost per member per month.

Folks coverage is not free. Someone has to pick up the tab for the difference in cost vs what is charged to people for the coverage. Stay tuned for the insurance exchanges with no pre-existing. Cost will be driven significantly higher. Government will then pay subsidies to some to pay for their coverage. They have to take the money from someone else to do so.
Really

Paris, TX

#103 Nov 8, 2012
Here is the link to the study.

http://www.commonwealthfund.org/~/media/Files...
Smarterthanyou

Argyle, FL

#104 Jan 10, 2013
What ignorant replies about pre-existing insurance.

There are hundreds of reasons someone is affected by this. One being changing insurance companies because they no longer offer coverage in these areas.

Just because you have a cobra, there is no guarantee another insurance company will cover your pre-existing conditions.

The idiot who ask why someone would open a business prior to checking on whether they can afford insurance is also ignorant. That rarely comes into play when deciding nor should you let an insurance company run your life.

Most group policies through the business will cover pre-existing conditions, but the government has allowed insurance companies unreasonable qualifying rules for businesses to purchase such as the number of employees.

You people making the ignorant remarks should research before you open your mouth. Only confirms how many morons voted for NObama.
Jacquelyn

North Fort Myers, FL

#105 Jan 23, 2013
Wondering wrote:
<quoted text>
A pre-existing condition means you didn't have insurance when you were diagnosed. Any reason you didn't? All I can say is, you took a risk and you got caught. Now you expect the taxpayer to subsidize your lack of planning. That's what's wrong with the whole Obamacare mess.
A pre-existing condition does Necessarily mean that you didn't have insurance when you were diagnosed. I was 16 when I was diagnosed with a pituitary tumor and had my parents United Healthcare. I work full time for a dentist who doesn't offer health insurance. He'd rather run home with all of his money than ensure the wellness of his hard working employees. I have signed up for the PCIP insurance. Just wanted you to understand that it doesn't mean you are irresponsible if you don't have insurance(necessarily). It might mean that you lost the insurance that you once had.
tracker

Granbury, TX

#106 Feb 1, 2013
This is about the PCIP plan. It's for people who cannot get insurance because of a pre-existing condition. What's all the crap people are posting about...
"A pre-existing condition means you didn't have insurance when you were diagnosed. Any reason you didn't?"
and
"Lack of insurance is most often a matter of misplaced priorities."

Understand this...
YOU CAN'T GET ON PCIP UNLESS you have a pre-existing condition that DISQUALIFIES YOU FROM GETTING INSURANCE in the private market.

Do you see that the people applying and qualifying for PCIP are people that CANNOT get insurance elsewhere? You must prove you can't get insurance elsewhere and must prove you have the condition that disqualifies you.

Geez, clueless ignoramuses, it's not about choices, it's about sh__ that happens in life that you have no choice or control over. I reiterate, people who need the PCIP didn't choose to not get coverage elsewhere, we can't -with the exception of the high risk-pool.

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