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Self-employed, Self-insured, Long Illness: Screwed?

 
 
Reply Thu 18 Oct, 2007 05:16 pm
A question for the self-employed who buy their own health insurance (or anyone else who might know):

If you have a long term illness that prevents you from working and you find you cannot afford your healthcare monthly premiums, can your health insurance agency stop paying your medical bills? Is there a separate insurance someone should have to guarantee the health insurance company gets their money so you don't end up with the hospital bills and/or dead.

I know someone going through this and it looks like her health insurance agency will stop paying for her cancer care. I know this may vary from state to state, but I would still like to pick your brains for some answers.
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Type: Discussion • Score: 0 • Views: 1,243 • Replies: 18
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Bi-Polar Bear
 
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Reply Thu 18 Oct, 2007 05:17 pm
your friend is screwed...
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Green Witch
 
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Reply Thu 18 Oct, 2007 05:26 pm
That's what I thought too. Welcome to America - anyone want to start a business here?

I'm wondering if there is some kind of separate disability insurance that covered this Corporate Weasel type loophole for dumping the sick onto the the welfare roles or into the street.
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roger
 
  1  
Reply Thu 18 Oct, 2007 05:34 pm
There's all kinds of separate medical and disability plans out there; just ask ALSCO. At a quick reading, though, they look like the might cover the loss of a left leg while on a southbound train, but not in the state of Louisana, and not when the accident doesn't occure on monday, wednesday, or friday. In other words, what BP said.
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CalamityJane
 
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Reply Thu 18 Oct, 2007 05:54 pm
A private disability insurance would have helped here. Without it
you're screwed, unfortunately.
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eoe
 
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Reply Thu 18 Oct, 2007 05:56 pm
This, my friends, is my greatest fear. Shocked
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CalamityJane
 
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Reply Thu 18 Oct, 2007 05:57 pm
Mine too, eoe, but as I said, disability insurance is almost a must for
us who are self-employed.
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Bi-Polar Bear
 
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Reply Thu 18 Oct, 2007 05:59 pm
except that insurance is not affordable.... especially for we scumbag liberals on the dole....
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Green Witch
 
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Reply Thu 18 Oct, 2007 06:09 pm
What's additionally sad is that she had to close her successful design company and this has left other people out of work and without insurance. She was told she has a very good chance to recover and work again, but she needs to continue treatment for now. She was also not a poor woman, she had been paying all her bills for over a year without working. She has some kind of disability insurance, but as Roger pointed out, it doesn't cover this specific problem. She would have been covered if she fell down an elevator shaft.

To make matters worse - She feels guilty because she once decided not to hire a person who had gone through a similar illness because she knew if she put that person on her insurance her rates would go up. How can anyone claim America doesn't have a health care crisis?
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eoe
 
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Reply Thu 18 Oct, 2007 06:11 pm
Green Witch wrote:
She would have been covered if she fell down an elevator shaft.

To make matters worse - She feels guilty because she once decided not to hire a person who had gone through a similar illness because she knew if she put that person on her insurance her rates would go up.


That reeeeally bites. My best wishes to your friend. What a shitty place to be. Sad
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Green Witch
 
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Reply Thu 18 Oct, 2007 06:15 pm
eoe wrote:
[
That reeeeally bites. My best wishes to your friend. What a shitty place to be. Sad


Yes, it triggers the bag lady phobia that so many of us occasionally feel.
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sozobe
 
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Reply Thu 18 Oct, 2007 06:20 pm
That sucks.

Glad it's not you. Which also sucks (mean to say), but my heart skipped a beat when I saw the title.
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Green Witch
 
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Reply Thu 18 Oct, 2007 06:23 pm
Thanks Soz,

Glad it's not me too, but there for the grace of God...

It's making me rethink our plan for insurance though.
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CalamityJane
 
  1  
Reply Thu 18 Oct, 2007 06:31 pm
How awful for your friend, Green Witch. I wish too that there would be
some sort of safety net for people who need extended health coverage
when in need.
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Noddy24
 
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Reply Fri 19 Oct, 2007 05:50 am
Has your friend checked into applying to Social Security for disability? Medicare might pay.
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Green Witch
 
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Reply Fri 19 Oct, 2007 06:33 am
Noddy24 wrote:
Has your friend checked into applying to Social Security for disability? Medicare might pay.


She has been talking to a social work and she is looking into various forms of bankruptcy. It seems she will first have to liquidate everything she owns, including retirement savings. She will basically have to come to them with nothing but the clothes on her back. Unfortunately, she has always chosen to rent and has no real property to sell. As she put it - "the government will only be happy when I become a Welfare Queen and then society can stone me to death". This was a very successful woman and I think she could be so again if she recovers her health. However, if she has to start from poverty level the odds are stacked against her. She's only 49 and if she loses her health insurance now she will probably not be able to afford a new premium in the future. She will be quietly blacklisted as an insurance risk by companies she could work for, and while it's illegal to reject someone for previous health reasons - it's done on regular basis in a more sneaky manner.

She has no children, but she is planning to contact an ex-husband who is wealthy and might be willing to help her out. I know I've posted a few rants about our crappy medical policy on this forum, but I think people don't understand how our health care system turns even successful Americans into beggars. It can happen to anyone and this case proves that no one is safe.
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Phoenix32890
 
  1  
Reply Fri 19 Oct, 2007 06:53 am
Social Security will pay for a person who has an ongoing disability if he/she meets certain criteria:

http://www.ssa.gov/disability/

After about 2 years of being on SSD, he/she is eligible for Medicare, at any age.
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Noddy24
 
  1  
Reply Sun 21 Oct, 2007 11:21 am
Part of this article by Kathy Kristof is about locking your friend's empty barn, but there is some information about Social Security Disability here:

http://www.poconorecord.com/apps/pbcs.dll/article?AID=/20071021/NEWS02/710210308/-1/NEWS16
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Green Witch
 
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Reply Tue 23 Oct, 2007 05:35 pm
Thanks Phoenix & Noddy.

I went for a visit and spoke to some people at the hospital. This is not an unusual situation and they have on staff advocates who try and help people in these situations. I was impressed with how sympathetic the staff was considering how often they see this happen and overwhelming the problems are. Federal and state resources are scarce and you do have to be destitute to qualify for most help. It gets really complicated when you consider her main specialist doesn't accept any insurance (she pays and submits for reimbursement), but he is willing to work out a deal with her if she loses her insurance. It's really places like labs and pharmacies that you can't negotiate with. Discount drugs are available, but by the time you qualify you can't afford even the charity price. It's a nasty Catch-22.

I think it's especially sad that she has to deal with all this when she is trying to get well. It certainly has added to her depression. She said, only half joking, that if she loses her insurance she is going to wrap herself in an American flag and set herself on fire in front of George Bush's ranch.

I wish someone running for office would come up with a viable solution to this national mess. In the meantime, everyone call your insurance agent and make sure you have some kind of umbrella coverage for situations like this. Read the fine print and get a second opinion from a lawyer.

I'll update if I learn anything new or helpful.
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