Health Insurance

[margrace]

We hear a lot of people on here complaining that they should be free to choose their own health care and of course they are touting Health insurance. Here are some experiences in my own family about this.

My son in law was going to Africa with his wife. They went for extensive health checks and it was discovered that he had a faulty valve in his heart. That was the end of his trip, and several months later the problem became so acute that he was actually passing out just sitting in a chair. He was rushed into the operation and got a pigs heart valve and is doing very well. The doctors were fascinated that a farmer, who was used to fatty meals had such clear arteries. Three weeks later his brother came in after feeding his cattle on a nice morning and felt sick. He lay down and died immediately of a massive heart attack.

When my son in law applied for the extra health care he had been paying for from an insurance company he was turned down. They claimed that this was a pre existing condition and was not covered by his insurance, even thought discovering this condition had been a big surprise to his family. By the way the father of these two boys lived to be 90.

My husband worked for a family company with extre health care and benefits which he and the company paid for. When he developed hip problems and was told after his operation that he could not go back to work he had a terrible time with the insurance company, insisting that he apply for Canadian disability insurance. He did get his disability from the insurance company finally but they did not want to pay it. This from an insurace company that is advertizing heavily on the TV right now about how great they are.

On Market Place seveal weeks ago they did a show on mortgage insurance and showed that insurance companies will not grant you insurance if you went for any test to the doctor prior to getting insurance even though these tests had nothing to do with your condition.

This is how Canadians are treated by Private Health Insurance companies and it evidently is very common in the US for the same things to happen.

[Hydraboss]

Preexist \Pre`["e]x*ist"\, v. i. [imp. & p. p. Pre["e]xisted;

p. pr. & vb. n. Pre["e]xisting.]

To exist previously; to exist before something else.

Margrace, the conditions you describe WERE preexisting. If you apply for health insurance AFTER you have been diagnosed with a disease, your condition is preexisting and the insurance company has every right to refuse you based on the risk. He still got medical care, didn't he? The only complaint I see from you alludes to the fact that in a proper medical system (private) he could not have been paid out for a condition he already knew he had when he applied for extra insurance.

My question is this: Are you complaining about health care, or health insurance money?

edit:sp

Edited February 24, 2008 by Hydraboss

[margrace]

No my son in law did not know there was anything wrong with his heart. Do you mean to say that if I apply for private insurance and get diabetes, pre existing in my family, that I would not be covered. Or if as his brother had blocked veins that he knew nothing about he would not be given anything. My son in law does not need the money he just is pissed of that he paid premiums for something he thought would help with other expenses.

This is why Market Places advise was "DO NOT SIGN ANY INSURANCE AGREEMENT WITHOUT A LAWYER"

and even then it would not have helped him

[Hydraboss]

When my son in law applied for the extra health care he had been paying for from an insurance company he was turned down. They claimed that this was a pre existing condition and was not covered by his insurance, even thought discovering this condition had been a big surprise to his family.

When his heart was giving out, he was given a new valve and taken care of. His complaint seems to be that AFTER his surgery he was turned down for EXTRA heath care. What is this "extra health care" he was applying for? Are you referring to "care" or "coverage (read: money)"?

[margrace]

You know exactly what I mean, this is a strawman argument

[Hydraboss]

No my son in law did not know there was anything wrong with his heart. Do you mean to say that if I apply for private insurance and get diabetes, pre existing in my family, that I would not be covered. Or if as his brother had blocked veins that he knew nothing about he would not be given anything. My son in law does not need the money he just is pissed of that he paid premiums for something he thought would help with other expenses.

This is why Market Places advise was "DO NOT SIGN ANY INSURANCE AGREEMENT WITHOUT A LAWYER"

and even then it would not have helped him

When you apply for private insurance (which exists now in Canada), they would ask for disclosure of preexisting conditions and family history. If your parents, and every aunt/uncle/cousin you ever had had diabetes....ya, they would probably charge you through the roof for that coverage. The chances of you getting diabetes is extremely high. This is not to say that you will not receive care, just that you'll have to go to another, higher rate insurance company for "extra" coverage.

[Hydraboss]

You know exactly what I mean, this is a strawman argument

No, I do not know what you mean. You're failing to be specific. Please try to answer a simple question.

Or is this just a "Harper bad. Conservatives bad." thread?

[margrace]

No, I do not know what you mean. You're failing to be specific. Please try to answer a simple question.

Or is this just a "Harper bad. Conservatives bad." thread?

strawman post

[Hydraboss]

Ahhhh. The "strawman" post.

The last vestige of those unable to defend their written thoughts in any comprehensible way.

Thanks for playing Margrace.

[scribblet]

Ahhhh. The "strawman" post.

The last vestige of those unable to defend their written thoughts in any comprehensible way.

Thanks for playing Margrace.

We take out of country health care coverage every year when we go south, every knows what that entails, if you don't like it, don't travel.

If someone chooses to take out health care insurance privately, it is their problem, the point is, no one is forcing you to - it would be an option. Why would I care what someone else does with their money.

We should have options, I should be able to pay for an MRI up front if I want one, with or without insurance - why would anyone else care how I spend my money?

[margrace]

We take out of country health care coverage every year when we go south, every knows what that entails, if you don't like it, don't travel.

If someone chooses to take out health care insurance privately, it is their problem, the point is, no one is forcing you to - it would be an option. Why would I care what someone else does with their money.

We should have options, I should be able to pay for an MRI up front if I want one, with or without insurance - why would anyone else care how I spend my money?

How you spend your money, for instance buying supplemental insurance is your business, that is not what this post was about. It was about insurance companys selling you supplimental insurance and then when you go to collect reject your claim. You had better be pretty sure about that travel insurance.

If they can prove you had a precondition you didn't report such as a test for testecular cancer, even thought it came back clean, it you didn't report it to them you can be denied insurance.This is what happened to several of the people on Market Place who had mortgage insurance

Edited February 24, 2008 by margrace

[Topaz]

I understand what she is saying. I was listening to a US doctor complaining that the HMO's in the US are now asking doctors to let the HMO's know that if any NEW patients they have has serious existing health problems because they will NOT COVER that person. He thought it was disgusting of the insurance companies but after all they are there to make money not to protect and help people!

[scribblet]

How you spend your money, for instance buying supplemental insurance is your business, that is not what this post was about. It was about insurance companys selling you supplimental insurance and then when you go to collect reject your claim. You had better be pretty sure about that travel insurance.

If they can prove you had a precondition you didn't report such as a test for testecular cancer, even thought it came back clean, it you didn't report it to them you can be denied insurance.This is what happened to several of the people on Market Place who had mortgage insurance

Actually travel insurance isn't the same as buying health care coverage generally, and personally I've never thought of it as an option. All I want is to be able to be able to pay for some procedures if I want , including MRIs... I can get my dog one anytime, but I can't. I don't want insurance for it, just to pay up front at a private clinic.

We buy travel insurance every year from CAA, their main thrust seems to be about heart conditions and meds, the questionaire does not ask about testing for anything. It only asks if you have been diagnosed as having.... whatever, not have you been tested for..

[guyser]

Margrace , I am with Hydraboss on this one. You are not being specific enough for us to understand the situation.

As best I can , here is what I see.

Your SIL had a faulty valve and then went for insurance. Well, thats a pre-existing condition (PEC) and he was turned down, but only in respect to the valve. IOW , he could get insurance, but not to cover the PEC. So if he, knock on wood, had an aneurysm , the insurance would cover it.

Your husbands case is one that is confusing too. He has either short term, long term disability or both. If he was off work for 3 months or more the LTD kicks in. Pretty cut and dried, unless something is not being said.

MORTGAGE insurance is the dumbest thing any of you can buy. Did I say dumb, sorry, I meant idiotic stupid moronic.....but the bank sold it and they are doofus' when it comes to explainations. Why?

Here is the scenario. You buy $100G of mortgage insurance (MI). Lets say yuor monthly payment is $10. Lets also say your monthly mortgage payment is $1000 (P+I) . Skip ahead 99 months from now and you drop dead. What is the payout from the MI people ?

$1000.

Even though you have purchased $100,000 MI, and have been paying $10 a month for it, the MI only pays the mortgage co the balance outstanding.

Had you purchased Life insurance, then the payout would have been $100,000 and your estate would payoff the $1000 mortgage outstanding , leaving $99 grand to the kids etc.

By the way, the costs are very similar.

On top of that, banks are given master policies , say from Canada Life Ins Co, from which they sell you your policv. Here is another catch. Suppose CIBC sells 100 policies and the carrier of the insurance experiences bad underwriting results in the years ahead. CIBC will be cancelled , thus you will too. But sadly , in the meantime, your health has deteriorated. So you now hold a cancellation of your MI, and you have to find another carrier for Life,Accidental,Health insurance. Sadly, you wont be able to at a reasonable cost.

However, had you bought Life ins, then no matter what transpires with your health, you have it , and should you die, for whatever reason, including suicide (after 2y wait) then your estate will receive the payout of $100,000.

Bank managers are loathe to tell you everything. Thus , go to your bank for money, but consulta broker for insurance policies.

[guyser]

We buy travel insurance every year from CAA, their main thrust seems to be about heart conditions and meds, the questionaire does not ask about testing for anything. It only asks if you have been diagnosed as having.... whatever, not have you been tested for..

If I may..........

The questionnaires usually ask....." Have you seen a Dr for anything in the past 90 days?" (includes tests)

" Have you had any medication that has changed in the past 90 days?"

When or if you answer YES, then you are not disqualified, but rather dropped down to the next tier of coverage, which is usually still quite good.

Anyone travelling outside of their PROVINCE needs it, not just for out of the country.

Dont forget , a good travel policy covers repatriation of a body , medical evacuation coverage , pays to put you on a plane to go to your spouse/childs bedside in case no one is with him/her, and provides your meals and accomodation.

When buyin this, always buy down to a $0.00 deductible , usually 10% more money . If you are sick enough to utilize this coverage, the last thing you want to wait for is scrambling to find the $500/$1000 deductible.

On average, a 35 yr old would pay about $1.34 a day, someone 55+59 would pay about $2.28 per day. Kind of chump change if you ask me.

And if you are one of the thousands who forego this insurance, just remember, the avg daily rate for emergency treatment in a US hospital ICU is $35,000 a day. Being a Canuck will not do anything to alleviate that rate. Only illegals get away with that.

Go ahead without it if you must, but perfect your "No habla english" ...........or however it is said.

Edited February 25, 2008 by guyser

[margrace]

Margrace , I am with Hydraboss on this one. You are not being specific enough for us to understand the situation.

As best I can , here is what I see.

Your SIL had a faulty valve and then went for insurance. Well, thats a pre-existing condition (PEC) and he was turned down, but only in respect to the valve. IOW , he could get insurance, but not to cover the PEC. So if he, knock on wood, had an aneurysm , the insurance would cover it.

Your husbands case is one that is confusing too. He has either short term, long term disability or both. If he was off work for 3 months or more the LTD kicks in. Pretty cut and dried, unless something is not being said.

MORTGAGE insurance is the dumbest thing any of you can buy. Did I say dumb, sorry, I meant idiotic stupid moronic.....but the bank sold it and they are doofus' when it comes to explainations. Why?

Here is the scenario. You buy $100G of mortgage insurance (MI). Lets say yuor monthly payment is $10. Lets also say your monthly mortgage payment is $1000 (P+I) . Skip ahead 99 months from now and you drop dead. What is the payout from the MI people ?

$1000.

Even though you have purchased $100,000 MI, and have been paying $10 a month for it, the MI only pays the mortgage co the balance outstanding.

Had you purchased Life insurance, then the payout would have been $100,000 and your estate would payoff the $1000 mortgage outstanding , leaving $99 grand to the kids etc.

By the way, the costs are very similar.

On top of that, banks are given master policies , say from Canada Life Ins Co, from which they sell you your policv. Here is another catch. Suppose CIBC sells 100 policies and the carrier of the insurance experiences bad underwriting results in the years ahead. CIBC will be cancelled , thus you will too. But sadly , in the meantime, your health has deteriorated. So you now hold a cancellation of your MI, and you have to find another carrier for Life,Accidental,Health insurance. Sadly, you wont be able to at a reasonable cost.

However, had you bought Life ins, then no matter what transpires with your health, you have it , and should you die, for whatever reason, including suicide (after 2y wait) then your estate will receive the payout of $100,000.

Bank managers are loathe to tell you everything. Thus , go to your bank for money, but consulta broker for insurance policies.

My son in law took out the insurance years before when he owned his own business and thought he should be covered. He knew nothing about the heart problem until he went for testing for his trip. He was a healthy hard working person whose father and mother were still alive. The insurance should have picked up such things as meds etc. So I don't think, they would cover him for anything else as you say because they probably would use the same excuse. There was no record of the heart valve until 3 months before the operation.

My husband and his company paid into the insurance he had for 20 years. He paid part and the company paid part, it covered long term disability. When he needed it they tried to find a way not to pay his disability. However he worked for a family company and they helped him. He also had good solid proof that he could not work.He still is on the disability but they sure are not happy about paying it. At first they made him report to them every couple of months but then after three years they gave up and stopped the harrassment. Now he just has to have a doctors report for them once a year which is reasonable.

Yes I agree with you on the mortgage insurance. Never had it but was surprised to find how easily they left some pretty sick people in the lerch. The end advice was to go to your insurance broker and have him insure your mortgage.

But it certainly gives one pause to find out how exactly your insurance policy works.

[margrace]

If I may..........

The questionnaires usually ask....." Have you seen a Dr for anything in the past 90 days?" (includes tests)

" Have you had any medication that has changed in the past 90 days?"

When or if you answer YES, then you are not disqualified, but rather dropped down to the next tier of coverage, which is usually still quite good.

Anyone travelling outside of their PROVINCE needs it, not just for out of the country.

Dont forget , a good travel policy covers repatriation of a body , medical evacuation coverage , pays to put you on a plane to go to your spouse/childs bedside in case no one is with him/her, and provides your meals and accomodation.

When buyin this, always buy down to a $0.00 deductible , usually 10% more money . If you are sick enough to utilize this coverage, the last thing you want to wait for is scrambling to find the $500/$1000 deductible.

On average, a 35 yr old would pay about $1.34 a day, someone 55+59 would pay about $2.28 per day. Kind of chump change if you ask me.

And if you are one of the thousands who forego this insurance, just remember, the avg daily rate for emergency treatment in a US hospital ICU is $35,000 a day. Being a Canuck will not do anything to alleviate that rate. Only illegals get away with that.

Go ahead without it if you must, but perfect your "No habla english" ...........or however it is said.

My daughter who does have pre-existing conditions travels quite freely and has done for years. I have no idea what here premiums would be but her blood platelets can be as low as 35 normal ones are 300 I think. She could bleed internaly quite easily if they dropped any lower, And end up needing a bone marrow as her sister did.. She also has Hep C from a blood transfusion when her son was born. She is extremely healthy because like her husband she takes care of her health.

Edited February 25, 2008 by margrace

[guyser]

My son in law took out the insurance years before when he owned his own business and thought he should be covered. He knew nothing about the heart problem until he went for testing for his trip.

Insurance policies are yearly or less. And from what I know, no one makes him get tested for a trip.

So, what is it? Travel ins, employer health benefits...what?

My husband and his company paid into the insurance he had for 20 years. He paid part and the company paid part, it covered long term disability. When he needed it they tried to find a way not to pay his disability.

The amount of fraud is the reason for their actions. He has been paid so it works as it should.

But it certainly gives one pause to find out how exactly your insurance policy works.

Of course if anyone read theirs they would know that. But since most dont, they think they are surprised when a claim is made.

It works how it is spelled out. If you didnt read it........

[margrace]

The reason my son in law got checked out before the trip was because it was to Ghana. YOu know Africa where they have all those strange bugs. My daughter was taking a group of her students over there and he was going along. Every one had to be checked out by doctors before the Univercity would let them go.

His insurance was just like my husands to cover him if he got sick. He owned his own business, still does.

Yes one should read their insurance but have you ever tried. As chair of our Palliative Care it is my responsibility to check out our insurance which I tried but 200 pages to cover 30 volunteers and it costs us over $3,000 a year. I don't begin to understand the jargon.

[guyser]

Yes one should read their insurance but have you ever tried. As chair of our Palliative Care it is my responsibility to check out our insurance which I tried but 200 pages to cover 30 volunteers and it costs us over $3,000 a year. I don't begin to understand the jargon.

Yes I have. Read many more than mine too !

So you dont understand it. Why not ask the broker to come in and explain it to you and the staff.It will be done for free.

You also had one too many zeros in there, although I appreciate it makes it seem more daunting than what is reality. The policy has no more than 20 pages to read, and it is in plain english.

[margrace]

Hi Geyser, No this is a special policy for Palliative care only. It would be nice if it had only 20 pages, but that would only cover one area. We only need it to protect our volunteers and our patients when they go into private homes but, it also covers everything that has anything to do with Palliative Care and hospice. So it has at least 10 seperate areas. There are only two companies that provide this sevice to Palliative care and we have never even met a provider. We cannot get excepted from the other areas such coverage for Hospices, Hospitals etc so we pay the shot and receive the whole package.

Believe me I tried to read it to find out exactly what covered us and gave up. We belong to the cover of HAO, Hospice Association of Ontario. They are our infermation body and they look after the insurance but there is no way we can just cover what we actually do.

So yes we would be very happy to have less to pay and I am sorry I quoted the wrong cost. It is only $2000. That is about 8% of our budget.

Edited February 25, 2008 by margrace

[M.Dancer]

Yes I have. Read many more than mine too !

So you dont understand it. Why not ask the broker to come in and explain it to you and the staff.It will be done for free.

You also had one too many zeros in there, although I appreciate it makes it seem more daunting than what is reality. The policy has no more than 20 pages to read, and it is in plain english.

Marg takes the writers perogative to use ample amounts of creative license with her posts....

[Hydraboss]

Tha mo bheachd...you richtig argumentieren.

[sideshow]

s

Edited March 18, 2008 by sideshow

[Hydraboss]

Untrue. Anyone can buy private health insurance. In fact, most people already have it.

Manulife

Sun Life

Blue Cross

Employer Health Benefits

Kwebek has one of the most advanced examples of private health care. The courts have upheld that decision in your province.