Georgia Health Insurance 411

Posts Tagged ‘cancer’

Anthem/Wellpoint, parent of Blue Cross of Georgia, has been in the news over rescinding policies of women with breast cancer. The Reuters article made it appear as if Anthem/Wellpoint had a top secret computer program that was designed to target women who were diagnosed with breast cancer and capriciously cancel these policies.

The logic was as flawed as the reporting which led Reuters to issue a correction. The corrected article was in response to this notice issued by Anthem/Wellpoint explaining the facts.

Rescission (the cancelling of health insurance policies) is not widespread with Blue Cross or any health insurance company. All policies, not just health insurance, have provisions that allow them to deny a claim or cancel a policy if there is proof positive the applicant has lied on the application or misrepresented the facts with regard to their health.

As someone with more than 35 years in the health insurance industry, I can tell you that most people give honest responses to health questions on the application. But I also talk to those who are looking for ways to hide medical conditions in an attempt to obtain coverage. They will say things like, “If I don’t tell the insurance company (about my condition) how will they know?”.

Or sometimes it comes in the form of “I have not been diagnosed with anything so it isn’t a pre-existing condition”.

Both of these approaches will create problems down the road for the applicant and any agent that assists them in filing a fraudulent application.

In all my years I have only had one policy rescinded. The individual who applied for coverage lied about a medical condition and hid the fact they had been treated before applying for coverage. They lied to me, they lied to the health insurance company.

If you are looking for affordable Georgia health insurance we are here to help you find a plan that fits your needs and budget.

Cyberspace is a wonderful thing. You can “meet” people from all over yet still never REALLY meet.

Over the last few years I have met some really great people from all walks of life. Some of their stories will lift your spirits while others will bring a tear to your eye.

This story of “Sandi” will do a little of both. She is a very brave woman who has faced a lot in the last few months. She posts regularly on a public forum and always has such a wonderful outlook on life. She recently took someone to task who was complaining about having to pay insurance premiums and “getting nothing in return”.

Here (with her permission) is Sandi’s story.

For years and years I paid into insurance, never had a claim, beyond just the usual that they cover, checkups, etc.

THEN, one day, I went for a routine test and lo and behold, they discovered lung cancer! 2 rounds of chemo and 35 radiation treatments later, at a conservative and just a running guess in my head, around $300,000 was expended on me. Came back to edit to let you know that ONE chemo treatment for me was around $12,000 and some change.

A few months later, I went in, AGAIN, just routine test and walked out with a recent bilateral mastectomy, two weeks later, lymph node surgery, I’m currently on the “chemo pill” and looking at that for the rest of my life, working towards having myself rebuilt (my ins. company is picking up the tab for my “boob job” with a plastic surgeon that costs in my area, around $7,000, and I’m grateful for my insurance company picking up that tab, because stuffing my bra was an option as a teenager, but now, not so much. So about now, I’m probably up to around $600K, and if my CT on 11/10 confirms that there is some “movement” in my lung cancer, then I will be back in for more chemo and if so, we will hit a million!

So, should I have been “paid back” as you claim for those years of good health, only to then have them spend close to a million or more on me to keep me alive?

You keep the change, folks, I will be happy to have my insurance!! there is NO WAY that I have paid a fraction of what they have expended on my behalf.

And keep in mind, you just may walk in one day and find that you are not so healthy and you won’t be squawking about those few dollars they kept every month when you need them to expend hundreds of thousands to keep you alive and somewhat comfortable.

Disclaimer: I have no issues with paying for insurance, I have seen what it has done for me so you won’t find this old girl bashing any insurance company over a few bucks I didn’t use in the past. And it is PAST, not passed. Just thought you might like to know.

There was some back and forth where the original complainer tried to justify their position that there should be a refund for premiums paid that did not result in a claim. This person also indicated she had canceled her insurance in protest.

Here is Sandi’s retort.

I would strongly ENCOURAGE you to go back to carrying your health insurance.

You said in your post that you have lost family members due to Cancer and that in and of itself makes you more susceptible.

If you think it was tough for your family WITH insurance, can you imagine what it will be like for you WITHOUT insurance?

I am always looking for ways to cut back and cut out out of fear of what my illness may do to me.

I am continuing to talk to you about this because those years of good health can turn on you in a heartbeat. My life turned completely upside down at 10:54 a.m. on 8/18/09 when I learned about the lung cancer, and then it started, those $12,000 chemo treatments, 10 of those, I set it out for you, but not all of the other tests, mediaendoscopy (sp), CTs, PETs, MRIs, Bone Densities and blood work and after chemo shots and on and on it goes. A new chemo pill that I will be on for the rest of my life, $50 a month, doesn’t sound so bad, but that’s forever, and even a frugal person like me had to do some juggling to work it in with everything else. I had a PowerPort implanted in my chest to make my life easier…

Believe me for all of your chagrin, if you walked a day in my shoes, you would be glad to trade that money over the past 5 years for NOT living like I do.

I’m fortunate than most. I don’t have some big paying job, I’m a peon in a big DC lawfirm, but I learned to be careful with the little money I have, so when this hit, I was not then and am not, so far, yet, living hand to mouth. I was debt free then, am now, but for my mortgage and I have money in the bank, and while I’m no millionaire, I made it my business to become a good strong hundredaire and I can make it.

But this is not only about the physical, being “well”, Cancer does other things, I thought after I finished all the lung cancer treatments they could do, well, I fairly skipped to that mammyslammer in June, figured I’d be wowing the boys at the pool no later than 2:30…not to be, they needed another one to compare, then they wanted a sonigram, then they wanted to do three biopsies…my breasts looked like they had been in a bar fight. No pool for me.

It was/is Cancer. On Sept. 8th, my copay to enter the hospital to let them cut off both my breasts was $200 and the ins. picked up the tab…I won’t be wowing anyone, but thank goodness, I only had to pay that $200, the insurance is picking up the other thousands and I still have more down the road.

Not only does Cancer do a number physically that ins. pays for, there is a lot of mental things going on…I was so distraught that a vain woman like me losing her breasts I went on drugs to keep me from crying every day. Insurance pays, but I thought, it’s done now, I should be OK, I let the scripts run out…bad idea, this morning I have been sitting her with tears in my eyes because I’m having a meltdown, I’m tired, MENTALLY and Physically. But thank goodness, tonight when I get off work I will take a few bucks and pick up my scripts again and no more crying jags.

I just fear that you and folks like you have no idea what an illness can do to you, and be ever so grateful that you went those years without any claims. Walk a day in my shoes and you would say “keep the change” and thank God in His Heaven it is not you, but someone else.

In response to this: Ask yourself -if i wanted “my money” back -don’t you think i would have found a way to get it back by now?

No, I don’t think you could! Not in a billion years will you get that money back.

In response to this: Once again I did not mean to offend anybody and hope nobody takes it personal

I am not offended, I would have to give you the Power to do that and I don’t grant you that permission, and I’m not, the word is “offended”, I am just worried about you and everyone who doesn’t understand that 5 years/10 years/20 years means nothing when an illness hits.

I am talking to you because you are being very foolish and I don’t want anyone to go through what I’m going through, and despite your 5 years of good health, you are NOT immune.

I hope you will think about what I have said and be happy to pay your premium and stay in good health, and if you don’t, then have them to help you along the way…

As I said, she is a brave woman. Throughout her ordeal, she has retained her wit and positive outlook on life. I am truly blessed for having met her, and now, so are you.

Finding affordable health insurance in Georgia is relatively easy for most folks. When you adopt a bare bones approach and only pay for coverage you actually need most people are surprised to see how much money they have wasted in the past and how much they can save going forward.

But when you are out of work and without a paycheck, even the employer subsidized COBRA premium can be beyond reach.

Danna Walker of Humble, Texas lost her job at DHL and along with it her health insurance. The bi-weekly unemployment check of $688 is not enough to cover the family’s COBRA premium of $1360 ($467 after the COBRA subsidy).

Like many others, the Walkers live on a knife’s edge of risk. Without insurance to cover her high blood pressure or his diabetes, they defer doctors’ visits when possible and obtain their prescriptions – nine between the two of them – for $4 apiece at Wal-Mart.

But their primary concern has been finding insurance for Jake, who, after four operations, two stem cell transplants and round after grueling round of chemotherapy, has been cancer-free for a year.

He continues to face a significant threat of recurrence and requires regular monitoring for at least two years. His twice-a-year CT scans cost $3,000 each, and quarterly blood tests and X-rays run more than $1,000.

When you lose your job and COBRA is an option, each family member has COBRA rights independent of the other. It is rare that all family members would face insurability options, and when possible, the healthy ones should be separated from those who need coverage from the group insurance plan. Read the rest of this entry »

Not to be confused with the BeeGee’s song from Saturday Night Live, the cost of staying alive can put a major dent in your wallet. Especially if you don’t have health insurance, or have the WRONG POLICY.

All of my clients in Georgia know that there is more to buying health insurance than just getting a low rate. If the plan has holes in it, they know I will not offer it.

So just how much does it cost to stay alive if you have something like . . . cancer?

At $17,000 a month, Erbitux is one of the most expensive cancer drugs ever made. For the record, it is not the most expensive. That distinction is currently held by Read the rest of this entry »