Pre-existing Condition?

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Old 06-28-2020, 10:23 AM
Boomer Boomer is offline
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Default Pre-existing Condition?

It is highly possible, that in the relatively near future, insurance companies -- again -- will be allowed to use pre-existing conditions as their right to deny coverage.

If insurance companies are awarded the unconscionable power to deny coverage for pre-existing conditions, it is not a big leap of the imagination to think that having had Covid 19 could be termed a pre-existing condition.

Why do I think that could happen? — because we do not understand where this virus can take us. But we do know that Covid 19 can sometimes leave very serious, and possibly chronic, health problems in its wake — even after supposed recovery.

I realize that most Villagers are comfortably swaddled in Medicare or good coverage from military retirement or previous employers. But, even so, in this time of overwhelming distraction, it is important to stay informed of what is playing out behind the front-and-center chaos.

Gen X and Millennials and younger boomers who get the virus and recover could find themselves saddled with a pre-existing condition — forever— just for having had the virus — even though nothing else has shown up — yet — after recovery.

Maybe I am overthinking this. Gee, could insurance companies ever even consider reaching into such a pot of gold as Covid recovery as an excuse to deny coverage.

No matter where your loyalties lie, no matter whether you have any younger people in your life to love, please pay attention, stay informed — from a variety of sources.

The ultimate decision to protect or to take away the individual’s right to not be denied health insurance coverage due to a pre-existing condition is in the works — with powerful support to take away that right.

Be careful what you wish (wished?) for.

Cassandra Boomer

Last edited by Boomer; 06-28-2020 at 11:26 AM. Reason: typos
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Old 06-28-2020, 10:42 AM
Stu from NYC Stu from NYC is offline
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No idea if this would happen but better to stay safe.
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Old 06-28-2020, 11:03 AM
Bjeanj Bjeanj is offline
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You’re not wrong. Pre-existing conditions can be underwritten a number of ways, including denial of any coverage or possibly a higher deductible for anything involving that pre-existing condition. Since I qualified for Medicare, I feel like I made it to the medical coverage “finish line” due to the pre-existing condition of asthma.

I have a child, son-in-law, and grandchildren who could be directly affected by this for years to come, and I am concerned about this.
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Old 06-28-2020, 12:29 PM
queasy27 queasy27 is offline
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Terrible fact of life these days.

At one point in my 30s I worked for myself and was denied an individual plan because of a pre-existing condition ... heartburn.
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Old 06-28-2020, 12:43 PM
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Pre exist has never gone away, it’s just worded differently. Usually becomes your deductible, that they don’t pay for
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Old 06-28-2020, 01:08 PM
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Quote:
Originally Posted by Boomer View Post
It is highly possible, that in the relatively near future, insurance companies -- again -- will be allowed to use pre-existing conditions as their right to deny coverage.

If insurance companies are awarded the unconscionable power to deny coverage for pre-existing conditions, it is not a big leap of the imagination to think that having had Covid 19 could be termed a pre-existing condition.

Why do I think that could happen? — because we do not understand where this virus can take us. But we do know that Covid 19 can sometimes leave very serious, and possibly chronic, health problems in its wake — even after supposed recovery.

I realize that most Villagers are comfortably swaddled in Medicare or good coverage from military retirement or previous employers. But, even so, in this time of overwhelming distraction, it is important to stay informed of what is playing out behind the front-and-center chaos.

Gen X and Millennials and younger boomers who get the virus and recover could find themselves saddled with a pre-existing condition — forever— just for having had the virus — even though nothing else has shown up — yet — after recovery.

Maybe I am overthinking this. Gee, could insurance companies ever even consider reaching into such a pot of gold as Covid recovery as an excuse to deny coverage.

No matter where your loyalties lie, no matter whether you have any younger people in your life to love, please pay attention, stay informed — from a variety of sources.

The ultimate decision to protect or to take away the individual’s right to not be denied health insurance coverage due to a pre-existing condition is in the works — with powerful support to take away that right.

Be careful what you wish (wished?) for.

Cassandra Boomer
If you are under age 50 recent studies have shown that 70 to 80% of cases are asymptomatic. That means you never got sick or will have the long term damage to your lungs etc that the more serious cases have.

If you are a millennial that participated in protests in the middle of a pandemic I can't work up a lot a sympathy if you got covid doing so.
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Old 06-28-2020, 01:31 PM
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I think you are, as you say, overthinking this.
If you have had Covid-19 and you are cured, you have no pre-existing condition.
You have a former virus like all colds and flu, and to the best of my knowledge you do not have to declare them for insurance purposes.
The virus is no more!
It has ceased to be!
It's expired and gone to meet its maker!
It is bereft of life, it rests in peace!
THIS IS AN EX-CONDITION!!

(Thanks to Monty Python)
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Old 06-28-2020, 01:48 PM
Boomer Boomer is offline
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Quote:
Originally Posted by Two Bills View Post
I think you are, as you say, overthinking this.
If you have had Covid-19 and you are cured, you have no pre-existing condition.
You have a former virus like all colds and flu, and to the best of my knowledge you do not have to declare them for insurance purposes.
The virus is no more!
It has ceased to be!
It's expired and gone to meet its maker!
It is bereft of life, it rests in peace!
THIS IS AN EX-CONDITION!!

(Thanks to Monty Python)
Ah, yes, Two Bills,

Monty Python, you say. Luv Monty Python. Could it be that my OP point could be summed up as, “It’s not dead — it’s only sleeping.”

(Aw, geez, I probably need to explain how my Monty Python paraphrasing applies to my point — in a variety of ways — open to interpretation — as ye olde, critical thinking-skilled, English majors do so love. But I will just leave it at that.)

I remain,
Cassandra Boomer

Last edited by Boomer; 06-28-2020 at 05:44 PM. Reason: Just realized, I did not quote Monty directly. I paraphrased. (parrotphrased)
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Old 06-29-2020, 05:42 AM
J1ceasar J1ceasar is offline
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I think your way over thinking this not to get political but even the guy that it's the president right now has said he refuses to take away the pre-existing condition clause for any health insurance policy so we are protected 100% if you feel so strongly I suggest you start saving for your children and their children into a trust maybe 5 or 10 million dollars will do it. Or start your own insurance company
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Old 06-29-2020, 05:50 AM
J1ceasar J1ceasar is offline
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If you really want to get into the specifics of why we're so screwed with house insurance then you have to go back to the IRS and the political parties all deciding that the only way it can be deductible if it is paid through your business. Back in the mid-70s we paid $100 per month for pretty good insurance my children were born I paid only $12 for the telephone in the hospital today the average family pays 10 to $15,000 for insurance that does not include a 5 or $10,000 deductible. The second big problem is that are we consider insurance today is actually Health maintenance. In other words we want our insurance to pay for every little pill test and office visit . However true insurance should be for catastrophic events like breaking an arm a heart attack or liver cancer. If you had to pay the first 3 visits a year to your regular doctor and a modicum pause coverage for your Pharmacy say 500 a year then health insurance would be much much cheaper. Lastly one of the big faults have insurance in America is that the federal government cannot negotiate drug prices on behalf of Medicare and Medicaid for all 50 states the same as I do for Tricare and the arm defense cost. If you want to lower drug costs in America a simple off would be that no drugs can be charged more in retail and anywhere else in the world do you know that in Mexico Italy and Africa drug prices or 1/10 of what we pay? That is because the opportunity cost affordability is much less for those countries. Another way to lower Pharmacy drugs would be for the government to buy the patents out for a few million dollars a year for major drugs that treat things like diabetes cholesterol heart attacks and psychological issues Leslie you have hospitals that are non transparent in their pricing which has recently been disallowed whereas next year I believe they will have to actually post their top 100 operations and procedures on the internet as far as cost so you can shop bye-bye cost. This is just my two cents if you have other opinions as to how 2 lower our actual Healthcare cost I'd love to hear them
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Old 06-29-2020, 07:02 AM
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Saving money is always a good plan and about the only thing any of us can do about an uncertain future. All the people who are publicly in control of things seem not to be versed well in medicine or even those who are can't fix Humpty Dumpty.

So wear your masks, stay home if you are older and hope for the best. I have almost forgotten what it's like to walk free. But at least most of us Villagers are trapped in lovely homes and have computers and Television. If you have not done so, I suggest you join Facebook. It is lovely to see friends and family and keep up with them from all over the country. You can even argue with high schools classmates, if you are so inclined. Some friends and family have some mighty wild views about genetic engineering and supplements , but most of them have some pretty cool and some very funny memes. Facebook is safe. You need to exercise care there too, but at least you know who the people are that are making your day or making you mad.
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Old 06-29-2020, 07:35 AM
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I understand and sympathize with your position and I truly don't have the answer. People in general feel "entitled" and not "responsible" when it comes to health care; it's not just the younger generation. But health care is not a right - no one is entitled to the services (doctor) of another human being. People like to talk about a government program and single-payer systems. I can tell you first hand that doctors in general will not go along with this. Many will just ignore the "system" and open boutique health care offices as many already have done so. Yes, they are catering to the "rich" or at least those who can pay without insurance. But, you can't force a doctor to treat anyone or to accept a dictated fee. The OP used the phrase "swaddled in Medicare" but even that is precarious. Many doctors simply refuse to accept Medicare's low reimbursement rates. It will only get worse as more and more try to get services under that system.

However, from an INSURANCE standpoint, pre-existing conditions are anathema. Notice that I did not say that people should not have access to health care. Please do not confuse and intertwine "insurance" and "health care"; they are distinctly different issues.

Insurance is a product you buy to mitigate the economic risk of an unpredictable event or condition. Auto insurance is a perfect example. It covers costs related to unpredictable events (accidents). However, no one calls their insurance company for an oil change or engine repair. These are maintenance items and are borne by the owner. Those who don't maintain their cars have higher maintenance costs.

What concerns me is health care related to improper maintenance. NO ONE should be paying for oxygen generators for those who were foolish enough to smoke (except the smoker). NO ONE should be paying for weight loss programs for generously proportioned people (except that person). You get the idea. And smokers (even ex-smokers) should have higher deductibles for ALL care or outright denied insurance. Again, insurance mitigates risk. Smoking (example) eliminates risk and makes bad health a certainty (lungs, liver, pancreas, bone, throat, etc); it harms EVERYTHING.

For an insurance company to pay for health care due to an pre-existing condition, they would no longer be insurance companies. People are trying to change insurance companies into a government program. Obama was the worst offender in this regard. Even he knew that you had to force everyone to participate in order to fund all the pre-existing conditions. Why? Because it is then no longer "insurance" but rather a "health transfer" program; make the healthy pay for the unhealthy.

So, that's basically the end of my rant. Including pre-existing conditions requires us to absolve the use of the term insurance and come up with a new word ... something akin to welfare ... or medicare / medicaid.
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Old 06-29-2020, 07:43 AM
MandoMan MandoMan is offline
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Quote:
Originally Posted by Two Bills View Post
I think you are, as you say, overthinking this.
If you have had Covid-19 and you are cured, you have no pre-existing condition.
You have a former virus like all colds and flu, and to the best of my knowledge you do not have to declare them for insurance purposes.
The virus is no more!
It has ceased to be!
It's expired and gone to meet its maker!
It is bereft of life, it rests in peace!
THIS IS AN EX-CONDITION!!

(Thanks to Monty Python)
Unfortunately, it seems that COVID-19 is not a Norwegian Blue with beautiful plumage.

Remember how minors got black lung from working in the mines long before doctors figured out why? Remember how asbestos miners and workers got asbestosis and malignant mesothelioma? Then we began worrying about asbestos in buildings. Well, it now seems that people who had COVID-19 without knowing it but developed antibodies may also have some of the characteristic scarring of the lungs visible on x-rays. How do we know that won’t lead to millions of extra lung cancer deaths in twenty years, all of it from a “pre-existing condition”? Chronic Obstructive Pulmonary Disease? I wouldn’t be surprised if that scarring could contribute.

It seems that as many as a quarter of those hospitalized have a stroke of some sort from the virus. Recently discovered is that some virus survivors have a bunch of little blood clots in their brains. Maybe this will lead to a lot more strokes in five or ten years. Again, “pre-existing condition.”

A number of people who have had the virus and “recovered” are reporting that they are having memory problems that sound a bit like Alzheimer’s. In some cases several months have passed, and the memory deficiency continues. This could also become a long term “pre-existing condition.” Some who suffer from intense delirium and hallucinations still have them when they get home. What if this recurs after a few years?

There is so much about this disease that we don’t know. Only recently are researchers admitting what has been known in Germany since January 27: the disease readily spreads a couple days before there are any symptoms at all. It is also spread by people with asymptomatic cases, including our family members and friends.
How the World Missed Covid-19’s Silent Spread - The New York Times
‘They Want to Kill Me’: Many Covid Patients Have Terrifying Delirium - The New York Times

Last edited by MandoMan; 06-29-2020 at 09:34 AM.
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Old 06-29-2020, 07:52 AM
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What's always confused me about this is that insurance is, or has always been a bet. In the case of health insurance, you're betting that you will have medical expenses and the insurance company is betting that you won't. Or at least that your expenses will be less than what they charge you for insurance.

Forcing insurance companies to cover pre-existing conditions is like forcing someone to bet on a losing horse after the race has been run.

I don't see how there is ever going to be a solution to that issue.
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Old 06-29-2020, 07:53 AM
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One of the important things in Obama care was not being able to use pre existing conditions , the plan might have had flaws but everyone tried to sabotage it from the start , when it was ruled everyone didn’t have to join it was hurt badly , especially by seniors that had there’s and didn’t care . I had to laugh at the argument that it was unconstitutional to make people join unlike medicare ( sigh )
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