"Sicko" movie

[jenny82]

Originally Posted by sarahp

I'm on my husband's health insurance, and have a heart condition. If my husband changed jobs and had to change health insurance companies, would seeing specialists still be covered or would it be considered a pre-existing health condition and therefore wouldn't be covered?

You will have to look at all of the health insurance companies (and the plans they offer) that are offered by your husband's new job. You may or may not be able to keep the same health insurance company and plan that you have now. When looking at the options, make sure that your specialists would be covered. You may have to talk to each individual health insurance company to find out the details. I know, it is a real PITA.

Good luck to you!

 

[sarahp]

Originally Posted by Jenny82

You will have to look at all of the health insurance companies (and the plans they offer) that are offered by your husband's new job. You may or may not be able to keep the same health insurance company and plan that you have now. When looking at the options, make sure that your specialists would be covered. You may have to talk to each individual health insurance company to find out the details. I know, it is a real PITA.

Good luck to you!

He's not changing jobs, I was just curious if someone has a health condition whether they are stuck in their job in fear that they'll lose their benefits...

 

[jenny82]

Originally Posted by sarahp

He's not changing jobs, I was just curious if someone has a health condition whether they are stuck in their job in fear that they'll lose their benefits...

Oh I see. It's possible that could happen, but I don't think it is likely. Most things are covered by multiple health insurance companies/plans.

ETA: I meant you might be stuck in a job, but I don't think you'd be stuck in a particular job.

 

[cdubbie]

"I was just curious if someone has a health condition whether they are stuck in their job in fear that they'll lose their benefits..."

It's common, even if you are healthy

Depends a lot on the state and the health condition you refer to also.
And, you might be fine, but your child has asthma for example.

Some states, pre-existing clauses are illegal. Others, pre-exist denials exist for the first 12mns you are on the plan, and so on.

 

[carolpetunia]

I saw the movie today. As furious as I already was about healthcare, as much passion as I put into my post about it earlier in this thread, this movie made me even angrier!

Everything I said is true, but far MORE true than I even realized. Everyone in America needs to see SICKO -- because it's vital that we all understand just how completely unregulated the healthcare and insurance industries are, just how thoroughly those industries are literally killing us, and just how disgustingly craven and corrupt our government is.

One thing that I don't think was mentioned in the movie, though, is the fact that Congress gets top-quality free healthcare for themselves and their families -- for life. If we took that away, by heaven, there would be healthcare reform in a heartbeat!

GO SEE SICKO! Whether you're a Democrat or a Republican, you will be shocked... and educated.

 

[fred&nermal]

I am planning on seeing Moore's movie, but haven't seen it yet. As a Canadian, I feel blessed with our health care system as I have had to pay almost nothing for care when needed. We still have to rely on company/work benefits for dental and prescription drug plans, but in regards to seeing the doctor or for surgical needs the cost is free (though we have more taxes than our US neighbours as a result).

There are a lot of pros and cons to our Canadian health care system, but all and all I feel more confident knowing that when I am sick I can receive care knowing that it won't bankrupt me AND that I don't need my job to assure me of this fact.

I'm not going to get into this further (as it is late), except to mention that I have heard that the Kennedys were quite interested in studying how our Canadian health care plan worked, and I believe at least one of the brothers visited Canada to learn more. I don't think this ever saw fruition, due to the assasinations, etc. Too bad.

In regards to Cuba, I travelled there a few years ago and was struck by how many of the civilians were well educated and healthy, despite being poor. Unfortunatly for Cuba, they don't have much power in the trade business anymore, and struggle to survive in our modern global economy due to their political differences with the US. But, I will commend them on thier quality of intellectual and physical lifestyle, despite thier lack of material wealth and freedom.

It's all food for thought, so to speak. I'm glad Moore is making his documentaries (as one-sided and biased as they are) as they open doors to realization and investigation on the part of us citizens in North America.

Moore definetly is a manipulator, but I don't fault him on this as pretty much everything in our media-society is at the moment, and at least he brings forth a different side that reaches a large audience and hence makes us question the way things are and the way things could be.

As a Canadian, I won't deny feeling lucky about things like our health-care system. Honestly however, I see us as being not far off from our US neighbours in the fact that we are going down the same path of blind commercial existence which inevitably defeats our value for human life.

I won't go further with this as it is definetly getting into the catagory of IMO!

 

[jellybella]

Originally Posted by CDubbie

"I was just curious if someone has a health condition whether they are stuck in their job in fear that they'll lose their benefits..."

It's common, even if you are healthy

Depends a lot on the state and the health condition you refer to also.
And, you might be fine, but your child has asthma for example.

Some states, pre-existing clauses are illegal. Others, pre-exist denials exist for the first 12mns you are on the plan, and so on.

Most employer-based plans are prohibited from imposing preexisting condition clauses (this was very common in the past). In most cases, if you can show proof that you've had continuous coverage --and your last insurer is legally bound to provide a letter to this effect-- they can't impose any pre existing condition clauses or waiting periods for specific treatment.

This doesn't mean you can't have an overall waiting period, of say a month, before your coverage with the new employer starts.

This is all made even more murky by the patchwork of state and federal laws that circumvent each other and whether or not the employer is fully insured (meaning they pay a company to take on the risk and pay out any claims) or self insured (where the ins co. is a third party administrator, but the risk and $$ paid out is from the company itself). Many large companies are self insured and not subject to state mandates (they are covered by a federal law).

 

[cdubbie]

Originally Posted by JellyBella

Most employer-based plans are prohibited from imposing preexisting condition clauses (this was very common in the past). In most cases, if you can show proof that you've had continuous coverage --and your last insurer is legally bound to provide a letter to this effect-- they can't impose any pre existing condition clauses or waiting periods for specific treatment.

This doesn't mean you can't have an overall waiting period, of say a month, before your coverage with the new employer starts.

This is all made even more murky by the patchwork of state and federal laws that circumvent each other and whether or not the employer is fully insured (meaning they pay a company to take on the risk and pay out any claims) or self insured (where the ins co. is a third party administrator, but the risk and $$ paid out is from the company itself). Many large companies are self insured and not subject to state mandates (they are covered by a federal law).

Oh that is good to hear! I have experience in four states only. And no kidding on the patchwork of state and federal laws that you gotta work into contracting agreements - ugh - headache!

I used to council people NOT to go with a TPA - since they are not governed by law at all and I saw major devestation to families as a result (myself included after my husband fell ill). Now though, I have a TPA, but I work thru a hospital so it is great.

Essentially, no one I know IRL will choose a plan during open enrollment until they call me first

 

[carolpetunia]

One of the saddest stories in SICKO is about a woman whose insurance plan was fully under the control of the executives at the hospital where she worked, and they STILL allowed her husband to die rather than approve his treatment. They were right there, she was their employee, she was able to beg them directly, the man was not a faceless policy number... and it made no difference at all.

How do people like that go home, after sentencing someone to death in the name of corporate profit, and actually sleep at night?