Originally Posted by ECUgirl

Yes, that Social Security has been a great success! Is that why none of us on this board will likely see any of it?

You hire a man to mow your yard. Over time you buy more land around your house and the man gets a larger mower to compensate. For a few years he's able to keep up with the increased demand, so you decide to ask him to clean your pool, trim your bushes, and clean out your gutters. Overwhelmed with the work load of all the tasks you gave him the work he does becomes increasingly worse off. You start to fear that with your continued growth of property that the man just wont work out long term. What do you do?

 

Originally Posted by norcaljeff

Quick q: so now if someone has aids or cancer they have to becovered, right? By ins or a gov exchange, i think? So how much do they have to pay? I skipped last 8 pages so sry if this has been asked/answered

my understanding is it's the average of everyone in their community? something like that?

 

Originally Posted by norcaljeff

Quick q: so now if someone has aids or cancer they have to becovered, right? By ins or a gov exchange, i think? So how much do they have to pay? I skipped last 8 pages so sry if this has been asked/answered

There will be either a state or federal run exchange for health insurance with a mandate that all people must have the insurance. One of the problems with the ACA is that the penalty for not having insurance isn't currently enough to "force" people to take the insurance. With the mandate in 2014 is the elimination of pre-existing conditions. So you may run into a problem of people choosing to pay the fine and not have insurance.

To answer your question nobody really knows how it is going to be priced but without allowing companies to disqualify someone based on there health (which is what we have now) it is going to increase overall. There are conditions within the bill that will give lower income people a break in the overall cost of the coverage but for those who do not and are currently covered in the individual market it could go up 20-40% (our insurance commissioner said 50-100% but I don't think that much).

That said reform was neccesary in some states. Some states did not have a secondary market for those deemed unhealthy and if they didn't work for someone who offered insurance or weren't poor enough to qualify for Medicaid or other assistance didn't have access to health insurance and that needed to be fixed.

It will be priced the same for everyone regardless of health. Health will no longer be a factor insurance companies can use in pricing. There will be other things that insurance companies can use in factoring pricing but health will not be one. For example someone 65 will still pay more than a 20 year old. There are other factors besides age but I cannot remember them all

 

Originally Posted by ECUgirl

That sucks. As far as I know, they are violating the law. I believe if you've had no lapse in coverage, then pre-existing condition clauses aren't applicable. It shouldn't be this much of a pain to get it worked out, I agree, but it sounds like it's just a matter of time. Everything nowadays is a pain in the ass to get worked out, it's not just insurance companies. It seems like every large corporation or government entity that you deal with is a nightmare and the right hand doesn't know what the left hand is doing. I don't trust that the federal government will do any better, or that issues like this will be resolved. It'll just be a new bureaucracy to contend with, screwing things up.

**I admire you all for your optimism, though. I've had first-hand experience lately with mortgage companies, the federal government and any number of large entities that I need to get stuff done for me. I can't imagine this law making it better, it may actually make it worse, because now we'll theoretically have MORE people participating in the system that already is run by a bunch of incompetent ninnies. Adding more people to the mix is going to IMPROVE this system? Doubt it.

 

Originally Posted by CaptinMorgan

Not sure how this hasn't been resolved but there is a federal law against what they are doing. I have to assume it is a mix-up in paperwork and if you request a certificate of prior coverage from your wives insurance company and submit it to your insurance company this problem should go away.

If it doesn't you can call your states insurance department or the department of labor.

The law that you guys are talking about is HIPPA

 

Under HIPAA, a plan is allowed to look back only 6 months for a condition that was present before the start of coverage in a group health plan. Specifically, the law says that a preexisting condition exclusion can be imposed on a condition only if medical advice, diagnosis, care, or treatment was recommended or received during the 6 months prior to your enrollment date in the plan.

 

Although HIPAA adds protections and makes it easier to switch jobs without fear of losing health coverage for a preexisting condition, the law has limitations. For instance, HIPAA:
Does not require that employers offer health coverage;
Does not guarantee that any conditions you now have (or have had in the past) are covered by your new employer's health plan; and
Does not prohibit an employer from imposing a preexisting condition exclusion period if you have been treated for a condition during the past 6 months.

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

Right now after talking to our insurance company we are caught in a 9 month exclusion period. Even though we did not go more then 63 days without coverage.

My wife went to the doctor a week before we switch insurance plans but the diagnoses and the scheduled surgery was after we switch insurance plans. Since the appointment was before the healthcare plan switch it was considered a preexisting condition. It is not illegal for a insurance company to deny you coverage, they just have to do it with certain time frame even if you had previous insurance.

I guess my wife was unlucky to get sick at a inconvenient time.

 

Originally Posted by Dyzalot

So you did no research on what might not be covered if you switched? Or you knew pre-existing conditions would be a problem and switched anyways?

Damn Dyz when shit goes wrong it's either the consumer or Governments fault right?

 

Originally Posted by Realbigfish4

You hire a man to mow your yard. Over time you buy more land around your house and the man gets a larger mower to compensate. For a few years he's able to keep up with the increased demand, so you decide to ask him to clean your pool, trim your bushes, and clean out your gutters. Overwhelmed with the work load of all the tasks you gave him the work he does becomes increasingly worse off. You start to fear that with your continued growth of property that the man just wont work out long term. What do you do?

This whole analogy means nothing because the government would of hired 10 people at first to mow the lawn and 100 more to trim the bushes.

In the private industry one would simply hire another person or two depending on the work load. government does not work that way.

When the private industry decreases their work load/sells off some land than people would get laid off. Not so much with government.

So whatever point you were trying to make should be going on deaf ears.

Unless you are forced to chose one provider/business/service/etc whotf else's fault could it be?




Dyz ownd this thread.

 

Originally Posted by jay_bear

The law that you guys are talking about is HIPPA

Does not prohibit an employer from imposing a preexisting condition exclusion period if you have been treated for a condition during the past 6 months.

I know the law I'm referring to. I would advise you to call the DOL. You are (and quite possible the insurance company) not interpreting the law correctly. Yes they can if you don't have other qualified insurance, no they can't if you do. Assuming the facts as you present them are correct and you had other qualified insurance and have had that coverage for the last two years. Assuming that is accurate they cannot impose a waiting period for pre-existing coverage
.

 

Originally Posted by jesterwords

Funny thing about people is that they seem to go about doing what serves them best first. The truly altruistic, non selfish person in power, just does not exist. I wonder if any ever did.

many biology scientists (most?) believe there is no such thing as "altruism"; everything individuals do is selfish.

I haven't read the recent stuff related to altruism but I tend to think there is no altruism - seemingly altruistic acts can be explained by natural selection (often indirect).

 

Originally Posted by CaptinMorgan

I know the law I'm referring to. I would advise you to call the DOL. You are (and quite possible the insurance company) not interpreting the law correctly. Yes they can if you don't have other qualified insurance, no they can't if you do. Assuming the facts as you present them are correct and you had other qualified insurance and have had that coverage for the last two years. Assuming that is accurate they cannot impose a waiting period for pre-existing coverage
.

Thanks, I looked this up and you might be right. But I don't look forward to fighting with these guy over the issue.

 

Originally Posted by EyeKnows

many biology scientists (most?) believe there is no such thing as "altruism"; everything individuals do is selfish.

I haven't read the recent stuff related to altruism but I tend to think there is no altruism - seemingly altruistic acts can be explained by natural selection (often indirect).

Empathic Civilization, IMO

 

Originally Posted by above_films

ironic that conservatives also claimed that america would become like the soviet union after the implementation of social security, medicare and medicaid. they also fought against brown v. board of education and the voting rights act of 1965. why are you people always on the wrong side of history? each time you claim a program will bring about the destruction of the country, you're proven absolutely wrong. don't you ever grow tired of having egg on your face?

Huh?

 

Originally Posted by Realbigfish4

You hire a man to mow your yard. Over time you buy more land around your house and the man gets a larger mower to compensate. For a few years he's able to keep up with the increased demand, so you decide to ask him to clean your pool, trim your bushes, and clean out your gutters. Overwhelmed with the work load of all the tasks you gave him the work he does becomes increasingly worse off. You start to fear that with your continued growth of property that the man just wont work out long term. What do you do?

Sell property.

 

Originally Posted by above_films

ironic that conservatives also claimed that america would become like the soviet union after the implementation of social security, medicare and medicaid. they also fought against brown v. board of education and the voting rights act of 1965. why are you people always on the wrong side of history? each time you claim a program will bring about the destruction of the country, you're proven absolutely wrong. don't you ever grow tired of having egg on your face?

just makes shit up as she goes.

.

 

Originally Posted by Realbigfish4

Based on what this analogy was geared towards Im assuming your foolishly suggesting population control?

Huh? No. Missed the analogy. No idea what we are talking about.