Posts Tagged - ‘pre-existing conditions’

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Athletes Struggle To Find a Health Insurance Plan

Tuesday, October 26th, 2010

Image: Studio Finch under CC 3.0

Intuitively, most marathon runners and other serious athletes would be a good bet for health insurance plan providers. They are extremely fit, making them less likely to develop chronic health conditions like diabetes. On the other hand, they are actively working towards better health.

However, there’s a catch in that model of an ideal investment: injuries. So far, health insurers have reserved the right to deny coverage based on pre-existing conditions, and a severe injury or accident could qualify. Either the policy will cover everything except treatment related to the injury, or they will be denied a policy altogether. (The healthcare reform law looks to end this in 2014.) In addition, even minor sprains or other injuries require doctor’s and hospital visits, driving up health insurance costs.

On the bright side, many distance runners buying individual health plans tend to be on the young side, making their coverage cost less.

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Individual Health Insurance Coverage Denials Rose Since 2007

Thursday, October 14th, 2010

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Over the past two years (ending in 2009), four major health insurers’ rates of denying coverage to individual health insurance plan applicants rose by 50%.

A report from the House of Representatives Energy and Commerce Committee claims that WellPoint, Aetna, UnitedHealth, and Humana purposely refused to sell coverage to over 600,000 people with pre-existing conditions. Up to 425 health conditions could disqualify a person from coverage under one insurer, and some would not conduct further internal review before denying coverage.

On the one hand, the insurers may have seen the writing on the wall when President Obama was elected, and wanted to maximize their profits as much as possible before regulations would limit their ability to discriminate based on pre-existing conditions.

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Should Pro Wrestlers Be Given Health Insurance Plans?

Wednesday, October 6th, 2010

Image: David Seto under CC 3.0

Although the story lines of professional wrestling are fake, the health risks are as real as can be. During the course of their job, wrestlers are often injured.

Strangely, in an industry that puts its workers at risk, they are not provided with health insurance plans. That is because pro wrestlers are generally considered independent contractors (although they cannot work for competing companies–this is especially the case under World Wrestling Entertainment). The biggest stars can afford to pay for their health care outright, but mid-card wrestlers will find it very difficult to find health coverage–due to their myriad pre-existing conditions and high-risk occupation. Former WWE executive Linda McMahon is currently running for the Senate in Connecticut; as a Republican, this status of her workers has been criticized.

Former WWE wrestler Mick Foley claims that being reclassified as an employee–and therefore having employer-sponsored health insurance–isn’t all positive. Currently, wrestlers receive potentially lucrative royalties for every usage of their image; WWE, especially, regularly releases DVDs and paid Internet and On Demand TV screening. As employees, they would lose that income stream. In other words, the grass always looks greener on the other side of the fence.

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Can Healthcare Reform “Repeal and Replace” Promises Be Trusted?

Friday, September 24th, 2010

Image: Keven Law under CC 3.0

The Republican party is staunchly against the Obama administration’s healthcare reform law. So much so, that its politicians promise that if they regain the majority in Congress, one of their first tasks will be to repeal “Obamacare”. Then, they promise that they will replace it with a more moderate, business-friendly solution.

What they promote sounds like a good idea–retaining the popular measures, such as making it easier for people with pre-existing conditions to buy a health insurance plan; while dropping the potentially troublesome elements like the individual mandate.

However, history may make some skeptical of the GOP’s pledge. After helping to torpedo President Bill Clinton’s health insurance reform proposal in the early 1990s, they basically ignored the issue for over a decade of controlling the House of Representatives and the Senate. In the meantime, the issue became more pressing–and may need more drastic solutions than it did back then.

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Are Child-Only Health Insurance Plans Falling By The Wayside?

Thursday, September 23rd, 2010

Image: Pink Sherbet Photography under CC 3.0

Several health insurers, including Aetna and Anthem Blue Cross, will soon stop selling dedicated health insurance plans to children. These plans often appeal to parents who believe they cannot afford health insurance for the entire family, but decide to sacrifice for the sake of their kids. Still, children’s health insurance is a relatively small market by itself.

They blame newly effective provisions of the healthcare reform law that prevent them from denying coverage to children with pre-existing conditions, which means that those plans will no longer be cost-effective for them to offer.

Which states will lose this option? So far, they are:

  • California
  • Florida
  • Connecticut
  • Illinois
  • Virginia
  • Pennsylvania
  • Texas
  • Tennessee
  • Colorado
  • Arizona

Although there is a legitimate argument for the moral hazard of allowing adults with pre-existing conditions to forgo paying into the system when they are healthy and joining when they are sick, children have no choice in the matter. (The individual mandates that discourage this practice won’t go into effect until 2014–and may not survive a Supreme Court challenge.) Furthermore, unlike adults, children never contribute to their own health status by choice.

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Is The Govt. High Risk Health Insurance Plan Too Expensive?

Friday, July 2nd, 2010

Image: Sam Felder under CC 3.0

It looks as if healthcare reform was not the immediate panacea for high-risk patients that many hoped for. The temporary health insurance pools for people with pre-existing conditions have started to go live.

The good news: many of those who have been previously shut out of the market can now purchase a health insurance plan. Unfortunately, that plan may be prohibitively expensive; according to the federal government’s website ( Depending on the state–since rates are based on standard premiums in the area–and the person’s age, premiums can vary widely. For example, Florida health insurance rates under the program could be up to $675 per month for a 50 year old!

Although guaranteed issue health insurance can be costly, it pays to shop around. The high-risk pools may not save you as much as you think.

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Pre-Existing Condition Insurance Plan Has Launched!

Thursday, July 1st, 2010

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Today is the official launch date of one of the most heavily hyped elements of affordable health insurance reform: the temporary pools for up to 350,000 uninsured people with pre-existing conditions. Only citizens or legal residents who have lacked insurance for over six months are eligible to sign up.

29 states will run their own health insurance pools, while 21 others have left the responsibility up to the federal government’s Department of Health and Human Services. Those living in the latter states can apply today for coverage that begins next month, while others must wait until later this summer. Many of the latter were leery of supplementing their existing high-risk pools with another one that met the new requirements (that rates charged are similar to the rest of the market, etc.) However, the rates charged in each state will vary widely, based on several factors–including age.

These pools are intended as temporary solutions for health coverage, until reforms take full effect in four years. By 2014, these stopgap solutions should no longer be necessary, since health insurers will no longer be allowed to deny coverage to high-risk patients.

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How To Prevent Short Term Health Insurance Buyers From Gaming The System

Wednesday, June 30th, 2010

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With reform beginning to take effect, subsidized guaranteed issue insurance for people with pre-existing conditions is set to become available. Unfortunately, there is a serious concern: the issue of people gaming the system.

In some places, such as Massachusetts, people will buy short term health insurance when they are knowingly sick and cancel shortly after they receive treatment (under one year later). Insurers pay for their treatments, while receiving little in premiums for reimbursement. Therefore, the costs are passed onto steadily insured consumers.

The prevalence of this practice has skyrocketed over the past several years. Legislators are proposing several solutions, including an open-enrollment period that would allow individuals to buy temporary coverage solely during one or two months out of the year. There would be exceptions included for major life changes.

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High-Risk Health Insurance Pool D-Day

Monday, June 28th, 2010

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Today is the deadline for states to decide whether or not they will participate in one of the initial changes of healthcare reform: they need to tell the federal government if they are planning to create new health insurance pools for high-risk patients with pre-existing conditions.

So far, 18 states have flatly refused. Qualified uninsured people from those states will buy into a national pool, which will open on July 1st. Utah and Texas are still undecided, but they’re running out of time.

The states that will create new temporary pools for high-risk health insurance plans will receive part of a $5 billion grant set aside in the law for that purpose.

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How Many People Have Pre-Existing Conditions?

Friday, May 28th, 2010

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A recent study from Families USA found that up to 57 million people in the United States suffer from pre-existing conditions. These issues have prevented them from buying individual health insurance on the open market.

Proponents of health insurance reform will take this statistic as proof of why comprehensive action was necessary. In 2014, health insurers will no longer be allowed to refuse any consumer, regardless of health status. In addition, the premiums charged can’t be significantly higher.

The figure excludes the elderly, whom are already covered by Medicare.

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