Insurance and Healthcare

Jim · 2007-08-03, 11:57 AM

I decided to let everyone know about this just in case it can help anyone.

As everyone knows by now, I have some large medical expenses here and coming soon. I had what I thought was a decent health plan. At first, they seemed to pay for everything. It had a crappy prescription plan but I was told that if something catastrophic came around, a different policy would take effect and it would cost a little more. Basically, I was swindled.

After I received a $6k bill for a blood test, I called the "Patient Advocate Foundation". They then called our insurance company and found out there were very low caps on everything they pay for. And, it was already maxed out for the calender year.

A little known fact about New York state is that as long as you have some sort of health insurance for 11 continuous months, you can not be turned down by any insurance company for any reason. And, the new insurance company has to pay for pre-existing conditions. The problem is...we started our health insurance in March of this year.

As I tell everyone to do, went to my local chamber of commerce. They told me to call their broker and see what could be done. The lady I spoke to was very sympathetic and told me there was one Insurance company that had NO pre-existing condition clause. Who ever heard of such a thing? Why would an insurance company take someone with a serious illness when legally they didn't have to? I didn't believe it and searched online. I found 6 documents pertaining to this company saying that they had NO pre-existing condition clause.

This company actually pushed our application through in one day after the broker told them about expensive meds and surgery coming up Yesterday they called to give me our new insurance numbers to use. They backdated it to 8/1 and said they wanted to get it setup quickly so I didn't have to pay for the expensive meds and gamma knife surgery that my wife has to have.

I watched Sicko and thought all insurance companies were scum. These people bent over backwards to help us. This is a real major medical insurance company. But, they only cover NYS and Vermont.

As for using the chamber of commerce...every county in the US has one. In NYS they are all tied together and act as an employer to over 100,000 people. I assume that most states are the same. With so many people, they have some pull with insurance companies. Everyone knows that if you get insurance on your own, they can raise the rates to anything they want. Being in a group of over 100,000 stops that. Really, if you don't have insurance or if you got it without going through a group, check out your chamber of commerce.

Anyway, these past few weeks have been really tough for my wife and myself. When I found out that I had no insurance, I started selling things and felt like I could no longer cope. My only real fear was that my wife would not get the treatment she needs. And now that fear is gone.

Don't get me wrong...I still have huge bills for up to 8/1. But, I can deal with that.

2007-08-03, 11:57 AM	#1
Jim Banned Join Date: Aug 2003 Location: Mohawk, New York Posts: 19,477	Insurance and Healthcare I decided to let everyone know about this just in case it can help anyone. As everyone knows by now, I have some large medical expenses here and coming soon. I had what I thought was a decent health plan. At first, they seemed to pay for everything. It had a crappy prescription plan but I was told that if something catastrophic came around, a different policy would take effect and it would cost a little more. Basically, I was swindled. After I received a $6k bill for a blood test, I called the "Patient Advocate Foundation". They then called our insurance company and found out there were very low caps on everything they pay for. And, it was already maxed out for the calender year. A little known fact about New York state is that as long as you have some sort of health insurance for 11 continuous months, you can not be turned down by any insurance company for any reason. And, the new insurance company has to pay for pre-existing conditions. The problem is...we started our health insurance in March of this year. As I tell everyone to do, went to my local chamber of commerce. They told me to call their broker and see what could be done. The lady I spoke to was very sympathetic and told me there was one Insurance company that had NO pre-existing condition clause. Who ever heard of such a thing? Why would an insurance company take someone with a serious illness when legally they didn't have to? I didn't believe it and searched online. I found 6 documents pertaining to this company saying that they had NO pre-existing condition clause. This company actually pushed our application through in one day after the broker told them about expensive meds and surgery coming up Yesterday they called to give me our new insurance numbers to use. They backdated it to 8/1 and said they wanted to get it setup quickly so I didn't have to pay for the expensive meds and gamma knife surgery that my wife has to have. I watched Sicko and thought all insurance companies were scum. These people bent over backwards to help us. This is a real major medical insurance company. But, they only cover NYS and Vermont. As for using the chamber of commerce...every county in the US has one. In NYS they are all tied together and act as an employer to over 100,000 people. I assume that most states are the same. With so many people, they have some pull with insurance companies. Everyone knows that if you get insurance on your own, they can raise the rates to anything they want. Being in a group of over 100,000 stops that. Really, if you don't have insurance or if you got it without going through a group, check out your chamber of commerce. Anyway, these past few weeks have been really tough for my wife and myself. When I found out that I had no insurance, I started selling things and felt like I could no longer cope. My only real fear was that my wife would not get the treatment she needs. And now that fear is gone. Don't get me wrong...I still have huge bills for up to 8/1. But, I can deal with that.