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My wife (who has a name but will remain anonymous here) is on the Pre-Existing Condition Insurance Plan (PCIP).  She's been on it since about August.  Late last year we got a letter saying that the lower deductible PCIP was being discontinued.  For us this means an increase of over a thousand dollars per year in medical expenses.  Today we got this letter, instating a 30% copay:

We are expecting our next child in six months.  Her pre-existing condition should not impact childbirth or the health of the baby, this birth is not high risk.  On the other hand, even standard births can be expensive.  Had we known that she would be on a high deductible insurance plan, we might not have decided to have another child.  Until 2014, there are no other healthcare options that will cover her preexisting condition.  

We keep hearing a lot about personal responsibility from members of congress.  How can you be more responsible than obtaining a affordable private insurance policy (not tied to an employer) before beginning a planned pregnancy?  How can anyone have stability in a county where the rules can change on a whim?  Had this been a policy from a private insurer they would not have been able to change the copayment before the end of the insurance term.  If this had been through a state, not the federal government, it would have been constitutionally impossible for a state to alter the term of a contract that it had already entered into.

We on the left wonder why there is not more support for single payer.  Things like this are the reason.  Why should anyone support single payer if it will put their family's health in the hands of a system where no certainty and major conditions are subject to change at the whim of whomever can take a political hostage in Congress.

 

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Comment Preferences

  •  Tip Jar (12+ / 0-)

    http://www.aeinstein.org/organizations/org/FDTD.pdf From Dictatorship to Democracy, Guide to Non Violent Protests.

    by sdelear on Fri Jan 18, 2013 at 05:02:57 PM PST

  •  Well, this is Obamacare. (2+ / 0-)
    Recommended by:
    Vatexia, historys mysteries

    And it is most definitely not single-payer.

  •  They do what they want with co-pays, deductibles, (6+ / 0-)

    etc.  i just got a $750 con-pay for a cat skan.  Never had that before.  i have a chronic heart condition so I need care.  It is outrageous the way you are being treated and we must gain political stregth over time to get a beeter deal withthis stuff.  I am getting more active than i have ever been in politics and it will contnue.  Best of luck with your new baby and as a doctor told me about my child, "Enjoy your baby."  

  •  What was your coinsurance rate last year? (2+ / 0-)
    Recommended by:
    Vatexia, marykk
  •  What was your maximum out-of-pocket last year? (2+ / 0-)
    Recommended by:
    Vatexia, marykk
  •  I was accepted (2+ / 0-)

    into PCIP after two attempts wherein they kept changing the rules. I appealed and was accepted. I paid my first premium with a check and that check cleared my bank, but then I received a letter saying the first payment had not arrived in time and that I had to reapply. I have talked to nine different reps over the phone trying to find out what to do to rectify the situation, been disconnected three times, and have finally sent in a check to cover the difference between the 2012 and 2013 monthly premium after having reapplied online and done some more calling. Within the space of three months they have dropped all but one of their plans. I am sure before the year is very old they will, like insurance companies do, raise their rates again. I will not be able to afford it if it rises too much; even then I will owe thousands of dollars if I have both knees replaced. I am wondering if I should just save my money for the inevitable wheelchair since it doesn't look like this will pan out. I was praising PCIP three months ago. Now I am wondering why.

  •  Very basic coverage (0+ / 0-)

    But it is priced pretty cheap compared to basic plans, no?
    Especially compared to plans like my gold plated version.
    Did you ask about a supplemental pregnancy coverage?
    I know there are plans for normal insurance plans.

    •  Wha!! Wha!! (1+ / 0-)
      Recommended by:
      tle

        When do we start questioning the profitibility of some POS company and start talking about taking care of good american citizens????? What is wrong with you??? Why do we always get the same old insurance questions from our own people??? Becasue we are programmed for it!!! If your premium is to high then raise your deductible see how easy it is, to keep us still profitible...... When Jesus when does this stupidity stop?????

      •  Did you miss the huge fight four years ago? (0+ / 0-)

        Single payer
        Medicare for all
        Dropping the Medicare age
        All sorts of plans.  
        Now, we have incrementalism.  So, we try and muddle by til we get another chance to reopen the fight.
        Hopefully, with grace and good will

  •  Same here (0+ / 0-)

    The rate went up 15%, then the co-pay went to 30%.  Sucks slightly less than the companies that don't go through the government.

    Single payer? That would be a good start. But what I want is a U.S. NHS.

    I am become Man, the destroyer of worlds

    by tle on Sat Jan 19, 2013 at 07:22:37 AM PST

  •  This is under written by United Health??? (0+ / 0-)

      What do we expect??? See my wife and I worked for 25 years in the corporate world. We enjoyed like many others the insurance that was functional and available. Not knowing the profit that these companies made would have made us ill but, we like so many others didn't really pay attention. She became ill and we lived through that close call thank God!! But we felt with the election of President Obama we could take the chance and take our savings and start our own business a music store. We did this thinking everything through like how much savings it would take, how we would be able to rely on The New Healthcare that was going to be available to us. How this experience would enrich our lives. We soon found out that the Healthcare was going to be a problem. We thought at this point we would have to do the best we could. We kept Cobra for as long as we could. We then threw ourselves to the wolves of healthcare insurance companies. But we soon found out that this would not work for my wife since she had a pre-existing condition. So I was so relieved to find out that Obamacare did have PCIP for her and in the beginning I was a bit jealous of the fact that I was excepted by Aetna Heathcare and I didn't have as good of coverage. That soon changed first, after she waited the 6 months to become eligible she applied the last day of the 6 months and waited for a reply for about 3 weeks only to find she had been turned down?? She called and she was told she didn't wait the full 6 months???? We should have known then something was up!!! But she pushed on to reapply and to our relief she was excepted. I was jealous!!! But grateful!! We then, within 2 months received a notice of change of coverage that unnerved us but seemed exceptable. Now with no more than 8 months into her policy she has received this same letter copied above??? This time we both looked at each other and realized this is United Healthcare what do we expect a for profit company involved with the health and well being of a person just doesn't make sense. It is irrational to think that this model works!!! I was very unhappy with the way the Obamacare fiasco went but kept thinking okay baby steps. But now with these two notices I am back to wondering what is actually going to be there for us after paying all these 25 to 30 years worth of premiums for healthcare. In addition to some of the things we felt were good parts of Obamacare like preventive care for people over 50 can rely on like a colonoscopy that both me and my wife had done. We soon realized their way around this free coverage is to re code the procedure from screening to actually finding a issue like a polyp. See it is coded as a screening and is free like advertised until they find something then nothing is free it is re coded as a surgical procedure and then co-pays and deductibles kick in. And to our great surprise guess what they happen to find something in both of us??? Now what we were led to believe as free screening now becomes an expensive procedure Hmmm. I hope the fight for real Healthcare for Americans continues because if this is a baby step we have a long way to go. Pray to god for Single Payer. I hope like Howard Dean has indicated that because of Obamacare the Healthcare insurance companies will not find it profitable any more and get out of the business and we start having a real discussion about Healthcare for Americans.

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