Loosing insurance

My wife has this pacemaker and she is about to loose her insurance. They allowed her to pay big bucks for the last 6 years of her pacemaker. Now that it is getting close to replacement time, they are ending her coverage. We could have had over half the necessary money if we had not paid for the insurance all those years. Can anyone furnish any info on continuing insurance privately? Does anybody know if the continued insurance will cover the replacement in the next couple of years? Is there any recourse for the employer's cutting of hours in order to cut off the health insurance?

8 Comments

insurance

by trish - 2015-06-26 09:06:25

Perhaps affordable care act (Obama Care) cannot deny because of pre existing condition. Trish

continuity

by Tracey_E - 2015-06-26 10:06:36

Can she get on through your work? Or stay on her current policy at her expense? I don't know how it is different since new ACA rules, however the rule used to be that if there is no gap in coverage, they can't deny pre-existing conditions which meant stay on what you have even if you pay out of pocket until you find something new. Go the ACA website, it will tell you your options.

No, there is no recourse. Employers aren't bound to offer any particular number of hours, and the new laws have made it hard for some businesses, esp smaller ones, to afford to keep too many full time employees so I think unfortunately this is going to become more common.

Good luck getting it worked out.

Great changes in healthcare insurance

by sanjosemike - 2015-06-27 08:06:13

Over the last few years there have been great changes in the healthcare insurance industry. Another poster recently stated that Obamacare will NOT permit insurers to deny your wife based upon past healthcare issues.

The US Supreme Court just yesterday re-affirmed that Federal subsidies are still allowed, even for states that have not provided their own insurance panel options.

In addition, families that have family businesses can cover 2 or more people on major medical insurance...if they operate a "family business." This kind of business can be anything at all, from delivering people to the airport to Amway...anything.

Your employer may NOT be allowed to discontinue your insurance, even with fewer hours, depending on how many employees the business covers. A health-insurance consultant can also help get you information on that subject.

You don't have to take this "lying down." There have been enormous chances in healthcare insurance. It is hard to actually keep up with them. That's why you need to call an insurance salesperson for advice...even if you don't buy from them. It is their job to keep up with the changes.

Good luck,

sanjosemike

And if all that fails

by Grateful Heart - 2015-06-27 08:06:35


Contact your local and state representatives. They supposedly have all the answers.

Good luck to you. There are many people going through this burden now.

Grateful Heart

what about Cobra??

by holly99142003 - 2015-06-28 12:06:14

I thought if you lost your employer's group health plan -insurance you would be eligible for COBRA... is that an option? If so since COBRA is expensive perhaps her EP would consider changing her PM sooner rather than later.

Good luck & God bless...

Obamacare

by pacehubby - 2015-06-30 02:06:38

Thanks for all the wonderful information. I have heard from an insurance person that if we buy any insurance it will be controlled by Obamacare. I have also been told that they cannot deny my wife for pre-existing conditions. My question is even though they cannot deny us coverage, can they deny coverage on the pre-existing condition. Why would an insurance company cover someone knowing that they will definitely have to pay out much more than they will every collect? My wife has been on her insurance for a long time and much of her pacemaker replacement would have been paid by her. She is now within 2 to 4 years of needing a replacement.

re: Cobra

by pacehubby - 2015-06-30 02:06:43

In reply to the info on Cobra, it only lasts for 18 months which would be just short of time for pacemaker replacement. On top of that, they would leave us pennyless to even make a down payment. Thanks for the though anyway. If my wife was really close to replacement, it might be a plausible option.

insurance

by islandgirl - 2015-07-01 07:07:44

Due to a divorce, I lost my insurance and continued COBRA as long as I could. I now have "Obamacare". I made sure the policy I obtained was accepted by my EP. Check the insurance plans available in your County and their physician and hospital lists. I had no problem with my pm implant (on emergency basis) in Feb. My insurance is through Aetna and nobody would ever know that I had healthcare through the Government program. It is actually slightly cheaper than my COBRA and a better policy. If you travel outside of FL, make sure the insurance you select crosses state lines with no problem. I know there are limits with FL Blue. (I live in FL).
I opted for a lesser deductible, since I was paying 2 deductibles this year, which makes my policy pre. I will increase my deductible for 2016 which will lower my monthly premium.
No preexisting on any insurance, which was also a great relief, and they are not supposed to increase your policy cost due to your previous claims/health issues.
Also, my EP staff said they didn't take Obamacare, however, they became educated through me with the different levels of insurance. They don't take the lowest plans.
Good luck


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