The Reward for Donating a Kidney: No Insurance

[KamaAina]

If you think this kind of crap is okay, then be sure to vote for Rmoney.

http://www.pdamerica.org/news/item/473-the-reward-for-donating-a-kidney-no-insurance

Ms. Royer, now 31, regained her kidney function, no longer needs dialysis and has been able to return to work. But because of his donation, her father, a physically active 53-year-old, has been unable to obtain private health insurance.

Like most other kidney donors, Mr. Royer, a retired teacher in Eveleth, Minn., was carefully screened and is in good health. But Blue Cross and Blue Shield of Minnesota rejected his application for coverage last year, as well as his appeals, on the grounds that he has chronic kidney disease, even though many people live with one kidney and his nephrologist testified that his kidney is healthy. Mr. Royer was also unable to purchase life insurance....

Susan Galbreath, a 42-year-old from New Boston, Mich., who is on dialysis, said a friend was going to donate a kidney to her but changed her mind after a conversation with an official from her insurance company, who said her future coverage would be determined on a “claim by claim” basis.

“The conversation left her feeling very very uneasy, and I told her she shouldn’t do it if anything made her uncomfortable,” Mrs. Galbreath said.

[unblock]

1. i wonder if for-profit health insurance would work better if it had to be linked to life insurance.

that is, if they try to save money by skimping on health benefits and you die, then they have to pay out big time on the life insurance part.

THAT might at least somewhat better align their interests with the patients'.

[KamaAina]

5. Intriguing.

We need a forum where innovative ideas like that can get some exposure -- not just at DU, but Web-wide.

[TexasProgresive]

2. A lesson I learned when I was 8 or 9 about insurance companies.

This was about 54 years ago. Few people had major medical in those days, but my cousins had Blue Cross/Blue Shield. The wife had a diseased kidney which was removed. BC/BS paid for the operation and dropped her coverage.

From that time on I hated insurance companies. Their only purpose is to fleece people.

[KamaAina]

3. "You've got peace of mind!"

My dear old friend Suz had the insurance co's pegged to a T. "You've got peace of mind! Of course, if anything bad happens to you, we aren't actually going to pay you anything, but in the meantime, you've got peace of mind!"

[Warpy]

7. I've been uninsurable since 1987.

I did some math a few years ago figuring out what I'd paid out of pocket versus what I'd have paid an insurance company. I was well into the six figures in my favor.

Unfortunately, it's also meant I had to live in penury even in good times with good wages because I knew the next disaster was right around the corner, that the bottom would always drop out. And it did.

The whole insurance mess is just another symptom of the wretched way this country treats its citizenry.

[unblock]

9. i had to sue to collect. i was a passenger in a cab that was rear-ended.

poorly maintained cab stalls out on the freeway and a car behind doesn't stop in time.

is there any question the passenger in the cab is not at fault?

yet they dragged it out for 3 years until finally paying.

why?

because delay only works in their favor. i might have given up, settled for less, or best of all, just died in those 3 years. worst case scenario they pay out what they always owed, but only after collecting 3 years of interest on it.

AT A MINIMUM, insurance companies need to pay interest back to the date of the claim, to at least reduce the incentive to delay for no reason whatsoever (beyond unjustified profit).

[geardaddy]

4. Mr. Royer can apply for Minnesota Comprehensive health care

as someone with a pre-existing condition.

http://mchamn.com/

[KamaAina]

6. That is apparently what he has done

but he's paying more for less insurance, as I imagine you are as well.

[geardaddy]

8. I pay more, but I get a decent amount of insurance.

The only problem is I have a $1000 deductible.

I would kill for single-payer though.

[dixiegrrrrl]

11. FWIW..Medicare has a 1500.00 deductible for hospital insurance.

that's Part A.
which does not cover any in hospital dr. services.
Granted, Part A is no premium.

Part B, which does cover Dr. services in and out of hospital, is 100.00 or slightly more a month premium and 140.00 annual deductible.

Good figures to base any private insurance costs on.

[tru]

15. Medicare

Part A isn't exactly no premium, we've been contributing that over our working lives.

Also you are ignoring the part of medical bills that Medicare doesn't cover. It is not 100% insurance. I think it covers 80%, but I may be wrong.

I pay:

Plan A: aforementioned $0.

Plan B: about $100 a month.

AARP Medigap: $149 a month for the type of policy that covers the deductibles and copays and whatever else Medicare doesn't cover, like the 20% of each bill. I.e. with this you are out of pocket $0, except there are a few things this package doesn't cover, but you have to be in really catastrophic territory for that and it still covers I think 80% of stuff even then.

[dixiegrrrrl]

17. Have not had a chance to test drive all of the Medicare A&B yet....

[mrmpa]

19. what about a medicare advantage plan?.........

I've read a few posts here that ranted against these advantage plans. My mom has one, and her Plan B ammt. is taken from her social security. Her copays are $10 for her GP, $30 for specialists, $250 for any hospital stays or outpatient surgeries. She had a $63,000 procedure, contracted price was $23,000, her responsibility was $250 (our hospital discounts this by 15% if you pay within 10 days of getting the bill) so she paid $212.50.

As for prescription coverage, she is covered by one our states's plans (PACENET). There is a monthly fee associated with it, but only when you use it. However, if the first time you use it is in March, you would have to pay January and February's ammounts. But, I don't let her use it. It is cheaper for her to get her generic drugs for $10 for a 3 month supply at Medicine Shoppe than to pay for PACENET. She will only use Precscription coverage, if she has to take a non-generic drug that is was too expensive.

There is one drug that she can't get for 3 months $10, but she uses a prescription drug discount card without the card the cost is $53.00 using the card it's $12.13.

[tru]

22. medicare advantage

What's your Mom's premiums for her medicare advantage plan?

I rant against them because my understanding is they cost the taxpayers 14-17% more than Medicare + Medigap for the same services. Also, the way they are set up, the private insurance company has to preapprove various things, resulting in delays or denials. Several times an office scheduler has said, well it will take United Healthcare some time to consider an approval and then when I said I had a medigap plan (UHC just administers it, it does not set policies) the scheduler has said Oh! and scheduled it right away. When you're in pain or scared or looking at a serious diagnosis possibly, speed matters.

[mrmpa]

23. Mom pays $96.50 each month........

We've had no problems with it at all. She's had some major health issues, too. Three hospitalizations, two surgeries. Her mammograms are done yearly, her eye exams, her cataract removal. She uses an oxygen machine while sleeping. She sees the doctors of her choice. It is not a national plan, but the insurance company is a regional plan.

I am a bit leery right now, because she got a letter from the health plan, telling her tht she will be gettin a call from a visiting nurse to set up an appointment to be seen in our home. I'm not sure why.

[tru]

24. nurse

I would not worry too much about the visiting nurse. My plan has a 24/7 nurse hotline, and they have actually called me a few times to ask if they can help with things they've seen happening, like suggestions for back pain, etc.

I'm sure part of their goal is to keep costs down, but I am happy if they can suggest things that help me.

[whathehell]

10. No good deed goes unpunished!

[RagAss]

12. This is "No Country for People"

Other than that it's a great fucking place to live.

[KamaAina]

13. Aren't you forgetting something?

Corporations are people too. For them, it's the best country in the whole wide world!

[RagAss]

14. Yup !

[Liberal_in_LA]

16. horrible. damn insurance companies

[Bozita]

18. OUTFUCKINGRAGEOUS!

If you have a better one word description, let's see it.

[KamaAina]

20. SUPERCALIFRAGILISTICEXPIALOUTRAGEOUS!!!

[Loryn]

21. Criminal?

Not that it's better than outfuckingrageous.