Quote:
Originally Posted by will76
Why were you denied coverage if you are healthy and 31 years old? Are you talking about the group you were in being denied, or you individually. I don't see why you, individually would be denied if you are healthy and young. If your group keeps getting denied you most likely are better off on your own and not part of the group.
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I was denied a surgery I needed and told I could either sign a waiver saying I would never ask them to pay for that surgery again and keep my insurance or they would drop me and refund the premiums I had paid.
I let them drop me and refund my premiums, then I applied for "medically needy Medicaid" which I was approved for and Medicaid paid for my $30K surgery... which the doctor f'd up and had to be redone... again, all paid by Medicaid.
I grew up on Medicaid and we could go to the doctor, dentist, or hospital at any time and never get a bill or denial for services. This is for coverage of children, of course. Adults don't have it as easy with the Medicaid system. If you're pregnant you can get it. If you're disabled you can get it. If you're "medically needy" you can get it. If you're a single mother with children you can get it. Poor men are almost never approved, in my experience.
If I couldn't afford insurance and one of my children fell deathly ill... I would be better off quitting my job and applying for Medicaid and other benefits (food stamps, AFDC, WIC, housing vouchers, etc) under the current system. That's a problem. I should be able to get *necessary* care without taking it to that level. To be clear, I can afford insurance and I do have insurance but there are a lot of people who simply cannot afford to pay the high cost. I've been in that boat too and it's not a fun place to be.
The bigger problem IMHO is that even those WITH insurance can find themselves in a situation where they cannot afford to pay all the co-payments and deductibles and other "patient shares" these insurance companies are requiring. OR they can be completely denied necessary procedures and have to try to come up with that kind of money on their own.
I don't know what the right solution is but I don't know how anyone can argue that these private companies are screwing it up just as much as the government is on their side with Medicaid and the other government run programs. The private companies have proven they need legislation and oversight. The government has proven they need checks and balances in place. Either way, a private company with shareholders breathing down their necks is NEVER going to work for the best interests of the people. That's just good logic.