Insurance and how to handle it

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Sg Brix

I?m glad I found this site via the general newsgroup. Great group and much help are given I see. After much searching I don?t find much about costs and insurance trouble. So this is my first feeble attempt to start here.

I was diagnosed in ?99 with having to have vale replacement done after extensive testing for which I paid in cash knowing that this would give me time on my insurance to figure things out. I?m self-employed and to be out of it for such a lengthy time my business would be in trouble. The doctors office made a mistake and used my insurance info after all. The result was that my insurance for me and my family 4 went up from @465/m to $790/m the first month, $ 1860/m the second month and $2980/m the third. I was insured with Blue Cross at the time. We just could not handle it and had to cancel.

It took me 2 years to find another insurance company that did not find this record, and now it have been long enough time for ? existing? problems to be able to use this insurance so I again can approach a new cardiologist. In the meantime it have been hell to survive. I can?t go up a flight of stairs without being complete shot. My feet are constantly swollen. I have shortness of breath that make it hard to sleep and have been in and out of asthma attacks resulting from my heart. I have come down with all the symptoms that one possible can have resulting in stenosis of your valve. But I still have had to continue working to support my family. Mostly I sit or stand forward panting.

For those of you that actually have to pay insurance by yourself. How have it worked after an operation? Do the insurance company hit you high then as well? What are the post-operative medical costs if you had to pay out of pocket? Also since this operations will have to be done again, how high do these premium go up? Will it be so that one have to walk away again and this time I know it will be impossible to get a new insurance with a valve replacement to declare?

Email me privately if you feel it is not kosher to discuss this subject on an open board here. I really would appreciate any insight in how to handle this.

SG Brix
 
been there

been there

Go into the hospital and schedule an appointment with a social worker. They can be your best friend! If you find them caring more about the bottom line then you can always contact a "lic social worker in privet practice". They are experts with knowing all the programs the state and other agencys offer. Do not fret! But do not pay those kinds of premiums !!!!! Your waisting your money. ther are programs to help with medical bills at all levels city, county in a big way, state in a big way, and medicare and medicaid which is fed.

Med
 
Options

Options

Keep your doors open - you have options. Some states have state-sponsored health insurance. Usually this is major medical insurance, but it beats paying the whole cost. Your insurance should cover you, but make sure that there are no "pre-existing' clauses. Some policies will not cover pre-existing conditions within the first 30, 60, 90 days. It sounds like your insurance company doesn't know about your history, though. Also, there is a thread on the forums that references a man who traveled to India for his heart surgery. Turns out you can have it done there for ~$6,000.

I was also self-employed when I had heart surgery. You might also want to seek out short/long term disability insurance before you get "diagnosed" - the loss of income can be painful.

Sounds like you are long overdue for some treatment - best of luck.
 
SG,

Welcome to the group. Truly hope you get your issues ironed soon.

Hi Melissa!

Good to see you!

Just wanted to comment on the waiting period. We have switched ins 3 times since my OHS. Had no issues with waiting periods for the pre-exsisting. Key is not to let your current policy lapse for one second! If you have a COBRA option...pay your bill. ;) They take all forms of payment.
 
Insurance

Insurance

I would call your insurance department and ask for the consumer division. They will provide you w/ specific information about the laws of the state which dictates how insurance companies can operate. You can also find out about company claim complaints. Keep in mind that the insurance agent is not always a dependable source. They only represent a small fraction of the total companies operating in the state.

Getting in touch w/ the hospital and working w/ them is a great idea. I plan to do this when I go out of state to get my operation at a hospital that specializes in minimal invasive surgery.

Best of luck and keep us posted on your experience. This is an area that I am surprised there has not been a lot of questions submitted to the forum.

Jim
 
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