Now I'm curious. Anyone been turned down for Insurance?

Discussion in 'Fibromyalgia Main Forum' started by RedB, Apr 15, 2003.

  1. RedB

    RedB New Member

    I just read where someone with FM is being turned down by all insurance companies. Is this happening to anyone on this board? This is scary!

    Kathy
  2. Tibbiecow

    Tibbiecow New Member

    at the time but I did have migraines. I wanted to switch insurance companies to get a lower premium, and doctors office visits with a copay instead of not at all covered, and prescription drug coverage. The plan I had, which I still have and now won't give up no matter what because I know that now nobody will take me, doesn't pay for doctor's visits or drugs. It is expensive and keeps going up. Fortunately I can qualify for patient assistance programs for my most expensive drugs, which cost as much as my monthly premium! They do pay for ER visits, surgeries, etc. and have a low deductible. But I was turned down by a different company because of my migraines, and my husband because of his basal cell carcinomas. What I have heard recently is that if you try to get insurance and you aren't part of any group is that if you have seen a doctor at all in the last year or two you will get turned down. Not much we can do about this.
    Tibbie
  3. Hocking

    Hocking New Member

    Because fibromyalgia is a condition recognized by the American College of Rheumatology, Arthritis Foundation, American Academy of Family Physicians, and others, don't be surprised if you can't get insurance coverage if your current coverage has lapsed or if you have been dropped for other reasons. For a long time, fibromyalgians have wanted
  4. babyblues68

    babyblues68 New Member

    I'm betting your speaking of health insurance. I did just go to get another life insurance policy on me. What a hell to go thru. It ended up costing me more than double of my hubands policy. Yes...he's healthy. It's not like I dying of this DD. I'm just in PAIN!!!

    Tammy
  5. EllenComstock

    EllenComstock New Member

    problem with that, but then I've been here for 15 years-long before the FM diagnosis. Not sure how easy I could get insurance now.

    My husband and I did apply for long-term care insurance-thinking of our older years to come in case we have to go into a nursing home or have home care. Well, on the application they asked all about your health history, of course. At the end of this, they listed several diseases specifically (FM being one of them) and asked if you had these now. I felt I couldn't lie about it-figured they would find out later anyway. Well, my husband was accepted and I received a rejection letter in the mail. It's interesting that the insurance companies don't want us-they know how expensive and debilitating this disease can be. Now if we could just get doctors and our friends and relatives to see this, too.

    Ellen
  6. Hocking

    Hocking New Member

    fibromyalgians are upset when physicians don't
  7. Hocking

    Hocking New Member

    Of course you can be turned down for coverage--if you're buying new coverage, that is. Insurance coverage isn't a right, it's a purchase, and the seller doesn't have to sell it to a risky client. And no, I don't work for an insurance company.
  8. Plantscaper

    Plantscaper New Member

    based on a CFS diagnosis, and have not been able to find any other insurance..Once, they find out you have had that..I then went to a state program for the uninsurable, but the costs of keeping that insurance were so high ($470/month and will keep going up based on my many years with them) and I had such a high deductible,it never paid for any of my office visits/tests..and only paid 50% of medications..so I finally stopped it this year, when there is some better treatments for CFS/FM...And, now, I have not been able to get any health insurance, and I believe, based on what I have read that if I was ever able they would not cover for these DDs..which is my main costs...It is rather depressing...

    ~~AMELIA~~
  9. pam_d

    pam_d New Member

    .....at the risk of repeating myself (this question comes up often) find the best insurance broker your town has to offer, lay out your situation honestly, and have them look for options for you. The insurance company pays for this service, not you. DON'T assume ANYTHING until the broker lets you know what the reality is; every state has different insurance guidelines, and some states are much more pro-consumer than others. DO assume that if you can find a company in your state offering you private insurance with your pre-existing condition, you will pay huge premiums; you've got to decide if it justifies the cost. Many states have the "state" plan, too, but that is also expensive & covers less. Good luck----my husband & I pay more than most people pay for their mortgage every month for health coverage, but we decided it was worth it for us. And it is a BC/BS plan....but we live in a very pro-consumer state where everything isn't black & white (and here I'm just assuming you live in the U.S., sorry----you may live in another part of the world & if so, hopefully you'll get advice about that from some other folks!)

    Hugs,
    Pam
  10. kar1953

    kar1953 New Member

    We have ins. through my husband's school & he will be retiring in the next few years. We figured we'd just get ins. through my school at that time. Maybe we're screwed. Even though his school & mine use the same company they would still have the right to turn me down. Man, it's not bad enough that you have to put up with this DD, but now you have to worry about how you're going to pay for it.

    Guess I can't do anything about it tonight. Have a good one.........Kathi
  11. RedB

    RedB New Member

    My husband's company has filed bankruptcy, and is being bought up by a new owner. We are supposed to get different insurance that is pretty equivalent to what we already have. It will be interesting to see if the new insurance will cover me.

    I can't believe that they will exclude "pre-existing conditions". This is Bethlehem Steel Corp. that I am talking about -- 3/4 of the people who work there are over 50 -- there has to be a lot of "pre-existing conditions" out there!

    Kathy
  12. abjessop

    abjessop New Member

  13. Mikie

    Mikie Moderator

    If you and/or your spouse have insurance through your employer, it's a guaranteed issue and you will be covered. The reason these plans are so expensive is because they are guaranteed issue and must cover high-risk members. I am an insurance agent, and I can't imagine that any company which underwrites for risk would insure us.

    Once COBRA runs out, there are usually state-mandated guaranteed issue plans, but they are prohibitively expensive.

    I've managed to make enough passive income to retain my status as a self-employeed group of one with a guaranteed issue policy. I just received my new rates as of Jun. 1, and for me alone, the cost went from $364 a month to $549.

    I either need to go back to work or get my SSD with Medicare. I would prefer to be able to go back to work.

    One-payer systems like in other countries are not without their problems too. People in these countries pay higher taxes and are facing economic problems with the rising cost of such programs. Selection of docs and treatments is often far more limited than in the U.S. We certainly need health care reform here, but I hate to see us adopt a one-payer system and jump from the fire into the frying pan.

    Love, Mikie
  14. beckster

    beckster New Member

    than you think. I kind of agree but let me tell you some stories. I had a friend, Viet Nam vet, injured and had a little disability with a shoulder/arm but never complained, never collected anything on it. then he got this DD and got slowly worse. He was working for a small company(he had helped form--he was systems analyst and security) and was lucky in that after he got too sick to literally leave his house he worked out of his house. Then he found VERY expensive meds that helped and at first his work/group insurance paid for them. Then they refused to cover that(the usual bs, not necessary, blah blah). Little by little they wouldn't cover any of his health claims. AFter consulting with his family (who had some money and sort of knew the ways fo the world) they decided not fight that and at least he would have the coverage--ha ha-- if something else like cancer came up. Finally iN a kind of BEHIND THE SCENES THING, the underwriter told the head of the company my friend had to go or they would not underwrite the company at all, (and in that state--different states have different laws), so every one who was now middle aged, had pre-existings for themselves, their kids, spouses, would have the pre-existings excluded. My friend was so sick anyway so BEHIND THE SCENES he agreed to quit, apply for SS
    and medicare. After the usual quagmire, he got on SSD, but soon came down with an unrelated illness and hadn't yet been on SSD for two years which you need before the medicare kicks in. He was in the hospital a short time, Viet Nam vet, worked literally out of his bedroom, had to "quit" that against his will, was hospitalized before he died and the hospital told his mother to come pay his 70,000 dollar bill and come pick up his body. THIS COUNTRY NEEDS A MAJOR OVERHAUL IN ITS HEALTH SYSTEM. THIS IS A HORRENDOUS INJUSTICE. His cobra had run out before he got accepted for SSD and he needed the two years before the medicare kicks in and got sick and was hospitalized and died before that kicked in. THIS SYSTEM IS NOTHING BUT HOLES.

    I had cobra when I got sick and couldn't work anymore, thought I had, which most people are told, you have a "guaranteed" coversion package, same rates, etc. When it came in the mail (about 18 years ago) instead of being my then $70 amonth premium with a $250 dedectible it was $ll00
    a month with a $10,000 deductible. YOU READ THAT RIGHT.
    I immediatly called the state insurance commisioner (politically naive as I was at the time) and said a grave error had been made and that I had guaranteed conversion rights. He said, no, no error had been made and (and his exact words still ring in my ears) that bascially the INSURANCE COMPANIES HAD GOTTEN INTO THE POCKETS OF THE STATE LEGISLATORS and that after AIDS things had changed, the laws and so forth. Also, my Viet Nam vet friend went through the same thing, he said after COBRA " I have conversion rights (he should have been applying much sooner but I couldn't convince him THERE ARE NO such rights--everyone thinks THIS CANT HAPPEN TO THEM)and so when his packet came in the mail he immediately called me up, indignant, called various higher ups, but guess what, THERE IS NO SUCH THING.

    Want more stories???? I don't know the current stats but back in the mide l980's approximately 32 states in the union have no laws protecting people already on individual plans so even if you have been paying and been on one for years, they can outrageously raisE your rates or refuse to insure you any longer. THIS MEANS THERE REALLY IS NO SUCH THING AS INSURANCE, IF YOU PAY WHEN YOUNG AND THEN GET SICK WHEN MIDDLE AGED OR OLDER AND YOUR INSURANCE STOPS!!!!!!
    Of course, I already knew this from my own case(in the state of Iowa). When I was back up here (iowa) for my mothers open heart surgery I was talking to her roommate.
    Woman was about 60, had private plan insurance, had had it most of her life, had suddenly collapsed and it was found she need a new heart valve--open heart surgery. She had the surgery, went home to recover, it was about $50, ooo bill, her insurance had to pay it, BUT WHEN HER PREVIOUSLY PAID PERIOD (in her case she paid every two months) WAS UP, she was DUMPED. She had, legally, no recourse. And worse, she didnot improve, about 3 months later they ran more tests, (thats when she was in my mothers room for a second valve surgery)and found the inserted valve was defective and she immediately needed a second open heart valve job--
    WITH NO INSURANCE EVEN THOUGH SHE HAD PAID INTO HER PLAN
    ALL HER LIFE. I asked her, geez, what on earth are you going to do (she and her husband didn't have or make much money--part of theHARD WORKING LOWER MIDDLE CLASS). She said they had looked at their options and "the way it works" ( I remember those words) is the hospital goes ahead and does this surgery but they have to SIGN OVER THEIR HOUSE but (again the next words ring in my ears) WE GET TO LIVE IN IT AS LONG AS WE ARE ALIVE. That seemed to give her some comfort but here was a person who had played by the rules, been shafted (LEGALLY, STYSTEMATICALLY), and I thought to my self, "yeah right, so they say now, but this will probably be another illusion in the wind like "you have conversion rights." Yeah, right.

    All I can say is WAKE UP PEOPLE. Makes me sad that people dont care. At the time I mentioned this woman's story to different people and only one OF DOZENS said, yeah, that isn't right, that ought to be illegal. People figure well, its not them, and they're ok, so, so what. But, IT IS YOU.

    Don't be fooled by the Bush plan of "reform" for Medicare. Seniors in this state aren't fooled. He wants to throw it to the private insurance companies but YOU NOTICE THERE IS NO GUARANTEE OF WHAT IS COVERED(maybe they simply will exclude all expensive treatments or surgeries), that PREMIUMS WONT BE HUGE or that CONTINUITY OF COVERAGE IS GUARANTEED. In letters to the editor in our papers people wrote again things like: "Who wants medicare to go to private companies? My wife and I are 55, on a private plan, we've paid all our lives, now my wife has a few problems, and they just raised our rates from $250 a month to $1800 a month. We're looking forward to eventually getting on Medicare and we DON'T WANT A PRIVATE COMPANY."

    Hey folks, we need a huge national discussion, REAL REFORM FOR THE BENEFITS OF THE AVERAGE PERSON not the profits of companies and executives, and we need to TAKE BACK OUR OWN COUNTRY and not let it be directed by MULTINATIONAL COMPANIES.

    I guess you can disagree, but to that I would say,like the old saying, hey fine YOU CAN RUN BUT YOU CANT HIDE, and
    Good Luck!!!!!!!!!!!!!!!!! Whew, well there you have it, and I haven't even gotten into what I learned about our system when my dad was going through years of dialysis. That's another story, another day.
  15. beckster

    beckster New Member

  16. Mikie

    Mikie Moderator

    The fact that Bush's plan for Medicare is for M/C recipients join M/C HMO's shows how out of touch he is in this area. M/C HMO's have been shutting down their plans in droves over the last couple of years. Many, many areas have no M/C HMO's and those that do, have plans which have been cut to the point that they are no better than just M/C by itself.

    Our health care is a national shame. The problem is that those in charge of making laws are mostly wealthy people who make good salaries and have retirement and health care plans that are so far superior to the ordinary Joe that they don't have a clue. When M/C recipients get single-digit cost of living raises, congress votes itself 30 percent raises.

    I don't know how much more pressure our nation can take before this crisis comes to a head. Washington had better start looking at domestic issues with the same passion as it has been looking at foreign affairs. You cannot ask people to pay for wars and for tax cuts to the wealthy when they cannot afford to buy necessary medication.

    Love, Mikie
  17. beckster

    beckster New Member

    with these last thoughts of yours. We really do need a citizen discussion on domestic topics. Maybe once the "war" is over and the"peace" is also settled, although this could takes years and years, we can begin on things at home???????? the Beckster