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Is allowing those with pre existing conditions health insurance a good thing?

Posted by on Jul. 28, 2009 at 5:40 PM
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There could be some serious questions and potential problems raised with doing away with the pre existing condition clause. For one, if you're covered now by insurance, your insurance rates across the board for everyone may have to rise in an effort to comply with President Obama's plan to allow no one to be denied health insurance. With insurance companies now having to cover those who are high risk, the cost has to be absorbed somewhere.

There is also talk that deductibles may be raised. If you have a $1,500 yearly deductible, you may have your deductible raised to up to $3,000 a year. If you have a $5,000 deductible, you could see your deductible raised to up to $10,000 a year. That could place an additional hardship on those with diabetes. For instance, our family currently has a $1,500 yearly deductible. January 2nd of every year, we place our 3 month order for supplies, insulin, and reservoirs. The cost? About $1,500 for the order. But it's great for us because we are done and we've met our deductible for the year with that one order.  The rest of the year we pay very little for our supplies and have the relief of paying off that deductible well behind us. How would that affect us if we had to come up with $1,500 twice in one year? How would that affect those with Flexible Spending Accounts who use that additional money above and beyond  their deductible for surgeries, eyeware, and other procedures? The healthcare industry as a whole may suffer when those people put off needed elective procedures because they can't afford to have it come out of their pocket and what would have come out of a Flexible Spending Account will now have to come out of their own pocket.

Insurance companies are also considering limiting your current coverage in an effort to recoop costs. Since insurance companies now won't be able to deny you insurance, they may try to limit exactly what they will cover and how much. For example, your Humalog insulin may be covered at 80% now, but once the proposed plan goes through, it may only be covered at 50%. How would this affect diabetics?

Sorry, couldn't post the rest. Great article, good questions raised.  http://blog.diabeticparents.org

by on Jul. 28, 2009 at 5:40 PM
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musicmaker
by on Jul. 28, 2009 at 7:39 PM

Are you kidding???  As a person with diabetes, YOU are a person with a pre existing condition. God forbid you should lose your health benifits. My husbands job decided it could no longer afford to provide health coverage for it's workers.  He has had three heart attacks. So, according to you, my husband does not deserve to have health coverage.  I could not dissagree with you more.

SouthernMommy06
by on Jul. 28, 2009 at 8:25 PM

Um, thats not what shes saying. Its hard enough for us with Diabetes to get diabetes as it is. In the state i live in i can only get insurance thru my own or my husbands work. And i have all these stipulations on where my medication comes from, i have to have my insulin MAIL ORDERD to me to save the insurance company money. 1traciw is stating that Obama wants to put into action a universal health care like they have in Canda, but they want to change the rules for people that have PRE EXSISTING conditions. Your DHs heart attacks are not pre exsisting. Hes prone to heart attacks due to some reason, so your deductible would be high, as someone with Diabetes, ours would be 3x or more higher than yours. Plus, 2 bottles of insulin without insurance costs over 200$. And if the insurance companies change the % coverage, since the deductable will go up, its going to cost us 100+ dollars. I get 9 bottles of insulin from my DHs mail order company thru his work for 150 dollars. And that keeps me alive. And its bull shit that you said that God Forbid, us people with pre exsisting conditions, loose our health care. You dont get it. We barely can get health care as it is, becuz of something we ahve no control over. And your DH does deserve to have health coverage, just as much as i do becuase im diabetic. Our wonderful president is stating, yah you pre exsisting people can have insurance with stipulations, which is totally biased and unfair. Excuse us for wanting to live to see our kids grow up, and be healthy and not loose feet, legs, or hell even Die. Its an unfair system that caters to the rich and "healthy" when half of the people lie about whats really wrong with them.

Oh and if you noticed, she stated she couldnt post the rest of the article, so maybe you should read it.

Quoting musicmaker:

Are you kidding???  As a person with diabetes, YOU are a person with a pre existing condition. God forbid you should lose your health benifits. My husbands job decided it could no longer afford to provide health coverage for it's workers.  He has had three heart attacks. So, according to you, my husband does not deserve to have health coverage.  I could not dissagree with you more.


1traciw
by on Jul. 29, 2009 at 10:25 AM

Funny, that's not what the article states. But it is worth thinking about. Right now, we're covered under great insurance. Under Obama's new plan if the above goes through and I have to pay a higher deductible and more for my supplies, it would hurt us A LOT financially to have to be paying that much more than we currently are. But I agree that health insurance should be offered to all--I just think the article raised a lot of good questions for those of us who have insurance. How much will you be affected financially by this new plan if you already have insurance? That is a lot to give up and have to pay out. To essentially have my benefits cut significantly would be really, really hard for our family. It's worth the cost, if the system is set up right. But the govt doesn't have a great track record on running anything...(think social security).

sacdp29
by on Jul. 29, 2009 at 12:17 PM

My only comment with the pre-existing conditions....I am a newly diagnosed diabetic but I have alot of other health problems (fibromyalgia, osteoarthritis, bi-polar-to name a couple) and when my husband changed jobs a few years ago, I couldn't get insurance for a year because of my pre-existing conditions.  That was a hardship on me because of the medications I needed but couldn't buy.  My husband works at a better place now and there was no wait or anything for me on insurance.  I was so glad. 

 

julie148
by admin on Jul. 31, 2009 at 2:09 AM

WOW, ITS GETTING TO THE POINT WHERE YOU DON'T WANT TO GET OR BE SICK.  ITS A SAD ERA WE LIVE IN.    bad

heatherdkahl
by on Jul. 31, 2009 at 7:07 AM
This whole universal health care scares the crap out of me! For one, not only would we be hit financially up front with deductibles and so on, but if you read the bill carefully it stipulates that the gov will be controlling who gets how much medication. Translation...all insulin dependent diabetics are allowed so much insulin per month as long as they fall within certain guidelines. So, if you have a bad month when you get sick and are taking more insulin, you may run out of insulin and have to pay fully out of pocket for the difference if you can even get approved by a Dr. to get it. See, they would only be allowed to prescribe so much per person because it isn't preventative care. People with Asthma better hope they don't get an attack too often or they're screwed. Heart condition? Oh yeah, if you don't meet criteria (you are too old, weigh too much or have some other condition that MIGHT make you high risk) then they can deny you treatment because it isn't "worth it".
For all those diabetics that don't have health insurance now...contact the manufacturer of whatever meds you are using. You can get it for free if you don't have any insurance. My husband and I went through a phase where we had crap insurance where we were paying $600 a month just for coverage for 2 people and then were still paying $80 a bottle for insulin and $40 for strips with him making barely above minimum wage. If we didn't have insurance at all we could get the supplies for free, but we would have to deal with the pre-existing clause with the next job that he got. We made less than $5 a month too much to get help from the gov but were still able to get some assistance from the manufacturer in that they gave us a couple of bottles a month for free so I wouldn't have to buy as many.
Point being, there are options now to try to find a way to make it work. Under new plan, even if you had the $ the Dr. may not be authorized to prescribe you more. Why do you think people with UH go to other countries to get meds and procedures all the time?
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