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Angeleyes22 Find out more about Angeleyes22
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  • insurance

    i was wondering if you guys could help me. i lose my medicaid that i had when i was pregnant with my son this month and no other insurance will take me on becaue they know i have a heart problem. is there any insurance that will take me on? let me know
    amanda
    Cleveland Myectomy Crew july 2003

  • #2
    Re: insurance

    Amanda, did your husband go right into another job out of the military? If so, and his benefits started right away, it should cover you because you didn't have an interuption in coverage. You shouldn't be considered a pre-existing condition without the lag in coverage, I think. Hope this helps.

    Reenie
    Reenie

    ****************
    Husband has HCM.
    3 kids - ages 23, 21, & 19. All presently clear of HCM.

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    • #3
      Re: insurance

      You should call Lisa as she knows the insurance angle inside and out.

      Some states have risk pool insurance for people who can't get any other coverage. You can call your state's health and human services office to find out. or visit their web site.

      S

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      • #4
        Re: insurance

        There are may options and most issues are going to based on where you live, employment status and income. It is rather hard to go over everthing over the message board -
        Lisa
        Knowledge is power ... Stay informed!
        YOU can make a difference - all you have to do is try!

        Dx age 12 current age 46 and counting!
        lost: 5 family members to HCM (SCD, Stroke, CHF)
        Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
        Therapy - ICD (implanted 97, 01, 04 and 11, medication
        Currently not obstructed
        Complications - unnecessary pacemaker and stroke (unrelated to each other)

        Comment


        • #5
          Re: insurance

          I had my myectomy on May 21st in Rochester, MN. I tried preauthorizing the surgery with my insurance company before I left but got the run around. They have agreed to pay 50% instead of 80% due to the surgery being performed out of Washington state. If the cardiologist in WA can convince them I HAD to go to the Mayo for surgery instead of having it here, I may be able to get the 80%. I really don't understand the difference in costs since I wasn't requesting they pay travel costs!!!!!????
          Anyway after reading some of the problems people are have getting coverage for this condition I am wondering if I should be grateful for the 50% and keep quiet so I don't get cancelled for some tiny little thing in the fine print?

          Elizabeth

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          • #6
            Re: insurance

            Heck no...fight it. There is no surgeon in Washington that could have done this. Get Mayo to fight for you...they will.. In fact it is worth it to them - because they know they have a better chance getting the $ from the ins. co. than an patient (not saying you would not pay your bill..but it will take a payment plan if your like 90% of us)
            Re whey ins. co's get like this - well they have contracts with hospitals and they pay much less than you think - it is rather like buying this "wholesale" rather than "retail" - and the ins. co wants to get the best dial it can - and that is why staying in network saves you and them money.
            HOWEVER
            If they will not pay more - call Mayo and work out a deal - you will likely get off paying a great deal less than 50%. TALK to them they will work with you.
            Lisa
            Knowledge is power ... Stay informed!
            YOU can make a difference - all you have to do is try!

            Dx age 12 current age 46 and counting!
            lost: 5 family members to HCM (SCD, Stroke, CHF)
            Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
            Therapy - ICD (implanted 97, 01, 04 and 11, medication
            Currently not obstructed
            Complications - unnecessary pacemaker and stroke (unrelated to each other)

            Comment


            • #7
              Re: insurance

              Amanda,

              I assume from your post that you do not currently have any health insurance... and that medicaid covered you only for the birth of your son... and that you are now looking to buy insurance on your own. If that is not the case, please forgive me for all the rambling i'm about to do here

              First of all, i am in the same boat as you right now, and i know how frustrating it can be living with HCM and no health insurance. Since insurance companies are private, for-profit organizations, they DO have the right to turn people like you and me down if we are considered high-risk, which we are. They would not make a profit on us.

              Sarah is correct in that there is risk pool insurance in many states, but it can be expensive. In Pennsylvania, it would cost me 590.00 a month for a high risk policy. Being unemployed, that is a whole lot more than i am able to pay right now. I was however able to find some other programs through which i have been able to obtain at least a minimum standard of health care. It's not ideal, but i've been able to make it work as a temporary fix.

              For example... one local privately-run clinic offers free care to people that are without health insurance, and do not qualify for medicaid. The cardiologists that saw me there were certainly not HCM specialists, but i did get a lot of free testing (echocardiograms, stress tests, etc.) that have helped a lot in my diagnosis and treatment. Another local clinic dispenses free medication (i got all my Toprol-XL there) which they obtain as free samples from drug companies. My local OVR office has been helping me find work, and if needed, they would also provide testing and treatment for my HCM while i'm looking for a job. There are many resources and programs in place to help people like you and me, but sometimes you have to look real hard to find them.

              I'd have to say one of the best calls i've made, was to the ADA Hotline. The woman i spoke to was great, and gave me a ton of contacts in my own state where i could inquire about local health services. Give them a call, tell them your situation, and ask them specifically for resources in your home state where you can get help with these issues.

              The web address is... www.ada.gov

              The toll-free hotline number is... 800-514-0301

              Best of luck to you

              Jim
              "Some days you're the dog... some days you're the hydrant."

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