Close to Home

Bob and I have probably blogged the heck out of the health insurance issue, but here’s a story that hits close to home.

The other night at dinner I sat next to my nephew who happens to run his own pizza shop here in Columbus. He doesn’t have the luxury of working for a big corporation with a group insurance plan or a mid-size business that might offer their employees health insurance. He has four employees who are young like he is and don’t want coverage cause they are all healthy, but he has to carry his own insurance, because he is not quite twenty five and has a pre-existing condition called crohn’s disease.

Currently he pays $350 per month, that’s $4,200 a year for medical coverage that is not all that great and they keep raising his premiums. So he is trying to do what any smart businessman would do, try to find better coverage at a lower cost to reduce his out of pocket expenses.

Unfortunately he is not having much luck because when he puts down crohn’s on his health questionnaire¬† so far each and every insurance carrier will offer him medical coverage with an attached exclusion that no claims related to his crohn’s disease will be covered even though he is taking medication to control his condition. I could tell he was visibly frustrated by this.

He asked me if I knew what the age was for dependents to be covered under their parents plan with the passage of the Health Care Reform Act and I told him it was twenty six so he has asked his mother if she would call and add him to their policy.

There will be no cost to his parents because their two daughters are currently covered and they have family coverage through his dad’s employer. By doing this he said it will give him more time to try to find better coverage as opposed to paying the high premiums for his current plan not to mention saving the premiums he would have to pay for the next year or so.

I’ve read Bob’s blog about the government statistics being unrealistic, however having been a medical underwriter for many years for a large insurance company here in Columbus I don’t agree with Bob’s conclusions. Most people are probably not aware that height and weight are a major reason why people can’t get health insurance and it has been mentioned recently that by 2015 three out of four Americans will be over weight.

Another condition which makes it hard for a very large number of individuals to get medical coverage is high blood pressure. It’s estimated that 65 million Americans have high blood pressure and from my experience most are not even aware they have this condition.

Of course being America everyone is entitled to there opinion and Bob to his, but I saw an article on the internet the other day that census bureau statistics through 2009 showed 50.7 million Americans with no health insurance coverage and in my mind there is just something terribly wrong with that.

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1 thought on “Close to Home

  1. I am interested in the problem of health insurance coverage for a person with Crohn’s disease. This chronic illness requires consistent high level medical supervision. The North Carolina State Health Plan, a PPO through BC/BS, recently changed its coverage to severely restrict paying doctors who practice in a hospital setting. These are the best specialists because they are teachers AND doctors. Yet patients much reach a $600 decuctible and $60 co-pay before the coverage for their services kicks in.

    So, YES we have coverage thank goodness, but NO, we are restricted to using low level specialists with less experience, who in our experience sometimes make poor treatment decisions. Is anyone else having to give up their life saving specialist because the NC State Health Plan refuses to pay for hospital based doctors??

    Like

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