Consumer Query: Options for Male, 55, in CA

G

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I am a 55 yo male in CA, currently taking levothroid (thyroid issue), lovastatin (cholesterol issue) and tamsulosin (urinary issue, no significant prostate enlargement). During the past 12 years or so, I have had two routine "trigger finger" surgeries. I also have herniated disc issues.

I have been enrolled with Kaiser for approximately 20 years, though not continuously. On a recent self-pay visit to a doctor outside of Kaiser, he suggested that I transfer from Kaiser to Blue Cross Blue Shield or Aetna or another plan, as my experience with Kaiser has been less than satifactory and Kaiser does not cover/recognize the kind of non-traditional disc procedure I would like, to try to resolve the herniated disc issue (while Blue Cross, Aetna and several others apparently do).

This doctor told me that under the new Obama Administration guidelines, my pre-existing conditions would not prevent me from joining a new plan with Blue Cross, Aetna, etc.

I am wondering whether this is really so, whether I would really have the option of coverage through another plan, given my situation.

Any guidance would be appreciated.
 
Your doctor is very wrong, I hear this all day and am constantly shaking my head.

The new bill only permits adults guaranteed acceptance after 2014. You very well may have serious problems switching companies as they are not going to want to cover your risk and pending treatments at a financial loss.

Your doctor needs to freshen up on the pending laws of his own industry. Sorry for the news ...
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Final note you should verify what I say with a licensed CA agent. Plenty are on this board. Good luck either way.
 
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This is exactly correct. You would have difficulty being underwritten by a new company.

I'll make your doctor a deal. I won't prescribe medicine and he shouldn't "sell" insurance.

Rick
 
Your doctor is very wrong, I hear this all day and am constantly shaking my head.

The new bill only permits adults guaranteed acceptance after 2014. You very well may have serious problems switching companies as they are not going to want to cover your risk and pending treatments at a financial loss.

Your doctor needs to freshen up on the pending laws of his own industry. Sorry for the news ...
- - - - - - - - - - - - - - - - - -
Final note you should verify what I say with a licensed CA agent. Plenty are on this board. Good luck either way.

Could the doctor be confusing GA for adults with the part of the bill that will offer coverage in Sept (in AR) for those who have no insurance coverage and have been turned down for health coverage. Maybe I'm confused.
:skeptical:
 
The change which requires GI for kids (under age 19) kicks in 9/23/10. Perhaps AR has something different for adults.

Either way, the doc has no business doling out insurance advice. This happens way too often. Just because a lot of them think they are God does not make it so.
 
Could the doctor be confusing GA for adults with the part of the bill that will offer coverage in Sept (in AR) for those who have no insurance coverage and have been turned down for health coverage. Maybe I'm confused.
:skeptical:
The Dr very well could be confusing the new PCIP that is allowing enrollments in CA in August for a Sept Roll out..But here is the rub a condition of applying is being without coverage for 6 months prior to applying...

This brings up a question Person A is responsible and carries coverage all his life and has conditions that have prevented him from switching carriers and now pays more than the standard rate because they were rated up. Person B has not carried coverage and is very unhealthy realize he needs some major condition done and now applys for coverage under PCIP...Who ends up paying less?
 
The Dr very well could be confusing the new PCIP that is allowing enrollments in CA in August for a Sept Roll out..But here is the rub a condition of applying is being without coverage for 6 months prior to applying...

This brings up a question Person A is responsible and carries coverage all his life and has conditions that have prevented him from switching carriers and now pays more than the standard rate because they were rated up. Person B has not carried coverage and is very unhealthy realize he needs some major condition done and now applys for coverage under PCIP...Who ends up paying less?

Here's my guess...

PERSON A
If his medical treatment(s) cost more than his rate up and if his deductible/coinsurance/copays aren't too high, he is better off than PERSON B.

PERSON B
He is better off than Person A if his medical treatment(s) cost more than his PCIP premium and if his deductible/coinsurance/copays aren't too large.

I guess the bottom line is whoever pays the least amount of their personal income each year for health insurance and medical treatment gets the better deal financially.
 
Or...
Get a job that provides group health coverage with somebody outside of Kaiser.

Here is my medical advise though, since the Doc gave insurance advice.

Trigger finger cure: Stop texting, single biggest cause. I'll guess you send over 1000 texts a month?

Dan
 
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