Health Insurance with a pre-existent condition

lrhall41 · Dec 22, 2007, 10:50 AM

My son is in Utah this week skiing with his girlfriend and her family and got injured last night. He was taken tot he hospital and it was determined that he busted his knee (ACL) but because he has no insurance there was not much that they could do for him.
They are flying back tomorrow and he is concerned that he won't be able to get health insurance with his pre-existing condition. He is going to require surgery and therapy. He know that he is going to probably have to pay a high premium for his condition, but I don't even think that they will insure him.
He has a stable job, but they do not offer health insurance and him being young (26) didn't think that he was going to need health insurance anytime soon. He won't qualify for Medicare/Medicaid because he probably makes too much money (not that he makes tons of money, but he has an income). Also, he won't qualify for state assistance. We are in Florida. What happens when people need surgery and do not have insurance? Can he be put on a payment plan or something like that?

lrhall41 · Dec 23, 2007, 08:12 AM

Oh I know about the privacy issue, and he already told me that he wanted me there, so I don't see any problem with me being there. If the hospital has a problem, then I will just wait in the waiting area....at least he knows that I am there for him. Thanks.

geoffmalter · Dec 24, 2007, 06:23 AM

Does Florida require health insurers to offer HIPAA plans as California does? What this program is is that every insurer selling health insurance in California must offer at least one HIPAA plan if they decline coverage under a standard policy.

If they do, your son could apply for coverage, being sure to say "yes" to the question "would you accept HIPAA if you're declined...."? HIPAA plans offered are identical to their standard coverage counterparts, except that the premiums are very high. But if your son is facing surgery and PT afterwards, the high premiums should be dwarfed by savings in hospital bills. Most all plans have a stop-loss provision per calendar year. The earliest effective date for him will be January 1st. Good luck.

lrhall41 · Dec 25, 2007, 10:02 AM

Update!!!! I took him to the hospital and they saw him, but since he didn't have any insurance, they said that there wasn't much they could do for him. They did refer him to get an MRI and then go to an orthopedic surgeon (duh!). They said that if he had the MRI done there the bills would be too high and he was better off shopping around different places to see who had the best deal. When he talked to the financial advisor, the guy was really negative just telling him, " I don't know why you are here, since you were seen by a doctor in Uthah. If it was me, I would go straight to an orthopedic doctor." I was livid when I heard that, and he almost discouraged my son to be seen ther, but I talked him in to staying. My son was honest with him and told him that he made aprroximately $30,000 a year, even though he has been working only for 6 months, but he has mortgage and other bills to pay and that at the end of the month, all he has left is like $200. So because of that, he doesn't qualify for the county health or charity.
The doctor that he talked to though, said that he might not need surgery, that sometimes those things can get fixed with time and if he is not into professional sports, he could probably live with a little discomfort. Of course, he said that based on the X-Rays that my son brought from Utah, but that an MRI could give them a better idea of how badly his knee is.
So the rest of the week I will be calling MRI and radiology places to see how much a knee MRI is and if they have any kind of program or financial deal.
I still do not understand what HIPAA is.

kelly naples · Feb 19, 2008, 06:54 AM

Quote:

Originally Posted by lrhall41

My son is in Utah this week skiing with his girlfriend and her family and got injured last night. He was taken tot he hospital and it was determined that he busted his knee (ACL) but because he has no insurance there was not much that they could do for him.
They are flying back tomorrow and he is concerned that he won't be able to get health insurance with his pre-existing condition. He is going to require surgery and therapy. He know that he is going to probably have to pay a high premium for his condition, but I don't even think that they will insure him.
He has a stable job, but they do not offer health insurance and him being young (26) didn't think that he was going to need health insurance anytime soon. He won't qualify for Medicare/Medicaid because he probably makes too much money (not that he makes tons of money, but he has an income). Also, he won't qualify for state assistance. We are in Florida. What happens when people need surgery and do not have insurance? Can he be put on a payment plan or something like that?

my wife has a fattyn tumor on her finger and neither of us have health insurance at present but are looking NOW to acquire some could you please help us as to where to look? Thank you, kelly.



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