I started a contract position last July, just about the same time my COBRA ran out. My daughter has a pre-existing condition (had heart surgery at birth) and so AARP rejected the entire family and the private insurance co's all rejected her on any policy I tried to buy, so I had to get her insured through state of Texas high risk pool. For minimal coverage, I pay $500/month, just for her. Another $1000 per month for medical, dental, and vision coverage for the rest of us. Then add in disability and life insurance... and I only wish I had the high bills you are reporting. btw, this all happened before the "Obama Care" rules took effect (eg the rejecting for pre-existing condition).
Sucks man. It's definitely ridiculously challenging and expensive to get individual insurance when a pre-ex exists. Sorry to hear it. Obamacare didn't make it better for your daughter unfortunately. The individual plans in the state of Texas simply stopped being offered for minors because of Obamacare's pre ex rule.
Those plans were terrible and weren't cost effective. For basically negligible coverage you were paying astronomical prices. Instead of pooling people with pre-existing conditions together, they're pooled with everyone now which effectively spreads the risk across a larger group of people. (which means lower health care costs for those with pre-existing conditions) My Dad was in the same boat and was denied health insurance based on his diabetes. He has health insurance now with his employer's health insurance (since they can no longer deny him coverage) so he's way better off under the new health care reform
Out of the 10 responses before yours, maybe 2 qualify under this standard, and I don't think either of those posters necessarily call themselves liberal.
How much is your company paying, and how much were they paying last year? Over the last 2 years, one of the ways companies have cut their own expenses is to simply pay less towards employee health insurance plans. So it may be that the actual plan went up, or it may be that the employer contribution simply went down.
1. What are "those plans?" I don't know what you are referring to so I can't respond 2. Where does your dad work? Texas? If so, unless his company is self insured (meaning they don't do insurance through an insurance company like BCBS, Aetna, Humana, etc.) then his employer's health insurance could not deny him anyway. Obamacare did not change that. Texas has been a guarantee issue state for years on the group side. If your dad told you that before Obamacare his company's fully insured plan would not allow him to have coverage because of diabetes, he either lied to your or his company broke the law.
As someone who suffered from probable medical negligence not too long ago (and is still suffering, occasionally) I can especially attest that tort reform was, indeed, a crock.
I had Tufts for my family and it increased 20% last year. From $682 to $818 each month. It's been skyrocketing every year so I'm expecting it be near $1K this enrollment period. I might have to switch to a high deductible plan.
Those plans I'm referring to are the Texas high risk pools. Those things were absolute trash. Also my dad works in Texas but he left his insurance to join my mom's plan. He then wanted to switch back and got denied. The condition you cite only applies to the first time you are eligible for your company's insurance plan. If you leave for any reason, they can then deny you if you re-apply. Consequently he was only able to successfullly re-apply after the new provisions on pre-existing conditions went into effect.
Then yes, absolutely, the high risk pools are trash. I don't understand what you meant though about the pooling? The high risk pool was created specifically to give coverage to people who couldn't get it elsewhere. You want the risk pool to include healthy people as well? This is also not true. On a group plan they could not apply medical questions to him if he came back. The reason he potentially could have been denied is because you aren't free to jump from employer sponsored plans at will. You have your annual open enrollment and then you can switch due to qualifying event. For example, if your dad left his old plan because his wife got a renewal that offered better coverage he could do that. Then at his open enrollment he could come back on the plan, or he could come back if her rates changed again, or they got divorced, etc. He can't just jump back and forth at will though utilizing whichever benefit suits him best, and for good reason. Now, again, at open enrollment or due to a qualifying event, he cannot be denied due to pre-x. There is no "applying." He's either eligible to switch because of open enrollment/qualifying event or he isn't. His medical issue would not come into play. The plan also couldn't exclude his pre-x condition once on the plan as he had prior creditable coverage. Again, I'm sorry to burst your bubble here, but what you are saying is flat out wrong. You either don't really know the circumstances of what happened with your dad because you misunderstood or he lied, or he was lied to by his company or didn't understand.
Clearly you know more about this stuff than I do. But I remember specifically reading the letter from Blue Cross Blue Shield that point blank said he was denied due to a diabetes condition. I don't know what else to tell you. He's also an employee of the state if that makes a difference. I understand enrollment periods but he was asked about his medical conditions and received a letter of denial. It wasn't even a conditional acceptance letter (giving coverage on certain areas but not the area where there was a pre-existing condition) Again I'm a novice here so I can't really argue with you. I can only speak from what I saw.
