The TRUTH About Preexisting Conditions.

146 responses to “The TRUTH About Preexisting Conditions.”

1. NS Murali

   March 8, 2010 at 2:00 am

   Excellent article. Facts are accurately stated. I wish the author had been invited to the Blair house!

   Reply
   • csteventucker

     March 8, 2010 at 2:04 am

     Thank you! Paul Ryan did a pretty good job though.

     Reply

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3. Linda Walker

   March 17, 2010 at 10:26 pm

   Excellent Article!!!!

   Reply
4. csteventucker

   March 17, 2010 at 10:34 pm

   Thank you Linda! Now if we could ONLY get this information to EVERY American Consumer it would be much more difficult for President Obama to repeat his statement that “Health Insurance Companies deny you coverage and you’re LEFT WITH NO OPTIONS.” I truly believe that if more consumers KNEW their legal options regarding Pre-existing conditions we would have EVEN less support for the current health care “reform” bills. As with all things knowledge truly is power.

   Reply

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6. Dorothy

   April 3, 2010 at 7:42 pm

   My question is this: at what cost to the individual can the uninsured obtain health insurance coverage?

   Reply
7. csteventucker

   April 3, 2010 at 7:52 pm

   Hi Dorothy,

   The risk pool in your State is called “Inclusive Health”. Here is their website where you can run rates with their convenient premium calculator: http://www.nchirp.org/ratequote.php

   Again, this is Risk Pool coverage and should only be pursued if you have a medical condition that would render you declined for Health Insurance in the private market.

   Even if you have controlled conditions such as Hypertension or Hyperlipidimia it will be cheaper to insure yourself with one of the MANY Health Insurance carriers who cover those conditions from day one of policy ownership (if duly disclosed on your application). :o)

   Reply
8. Dan G

   April 3, 2010 at 9:55 pm

   Deb,

   You apparently don’t know what insurance is. Do you get a refund on your Home Owners insurance or auto Insurance if you don’t have a claim for 7 years? It is protection from “unforseen risk”…..it is not: I give you $3,600 and you pay out and unlimited amount of money forever no matter what the contract says (FYI you will pay between %5,600 and $7,800 per year for the same policy under this law.). No business can survive that and our federal government can’t either. It’s not about “hate” it’s about “math”.

   If you think this new law “fixes” what you are talking about you haven’t read the bill. Real reform is possible without a wholesale takeover of your individual choices and the free market.

   This “Law” states that YOU MUST buy insurance:
   it doesn’t add any doctors to the system, but it does fund between 10,ooo and 16,000 IRS agents.

   It does not “bend the cost curve”: The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by $234 million in 2019.“Bends the cost curve” is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries.

   In 2009, health care costs were 17.3% of GDP.

   Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP)

   Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP)

   Access to the “high risk pool” is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012: Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012.

   The Plan has been compaired to and uses the the “Massachusetts” sytem as a model: Many Massachusetts residents forgo health care because they can’t afford it.A 2009 study by the state of Massachusetts found that:

   ■21% of residents forgo medical treatment because they can’t afford it, including 12% of children
   ■18% have health insurance but can’t afford to use it.

   The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised.

   Annual premiums in 2016, status quo / with bill:

   Small group market, single: $7,800 / $7,800

   Small group market, family: $19,300 / $19,200

   Large Group market, single: $7,400 / $7,300

   Large group market, family: $21,100 / $21,300

   Individual market, single: $5,500 / $5,800*

   Individual market, family: $13,100 / $15,200*

   No one wants the “status quo”, but this plan does not fix many of the major problems that the Federal Government can “regulate” and takes control and mandates things that the Federal Government can’t. This law is designed to “control” the system, not fix it. Spending 2 TRILLION dollars to insure 10% of the population does not require you to dominate and controll the other 90%.

   When you take away the “personal” aspects and focus on the math and the law, you will find that what you THINK the law does and what it ACTUALLY does are two different things.

   I find that being INFORMED is more important than being OPINIONATED….perhaps you should read more of the actual documents vs. the pundents. It’s all in there….all 2,300 + pages of it.

   Respectfully,

   Dan G.

   Reply
9. csteventucker

   April 3, 2010 at 10:06 pm

   Kudos Dan. Your stats are SPOT ON! Thank you for your BRILLIANT response. KUDOS KUDOS KUDOS

   Reply
10. PCL

    April 4, 2010 at 8:27 am

    Mr Tucker:
    I read this article and your piece on MSA plans. I agree that the Obama plan simply shovels more money and cost shifting into a system that’s already broken. However, I believe your analysis of the problems and proposed solutions overlook the effects of self selections and blame our escalating health costs on hypochondriacs rather than on the the ballooning expenses of the chronically and catastrophically sick. The money consumed by a Terri Shaivo or a Nataline Sarkisyan would pay for hundreds or thousands of hang-nail and sniffle cases. It’s no wonder that MSAs save their holders money; they tend to only attract reasonably healthy patients. It’s also no surprise that where there is a choice (in Colorado) patients who opt for coverage of substance abuse treatment would cost twice as much, since not only are nearly all of them individuals or families with an ongoing substance abuse problem, but they are also most likely sicker in other ways (as substance abusers tend to be). So, it would be unreasonable to expect the cost savings from either MSAs or policies without substance abuse coverage to be nearly as great if either model were applied to the population at large. While the MSA model offers some incentive for cost savings, it also encourages patients to put off preventative treatments that would save money in the long run. More importantly, it has the same inherent problem as most private health insurance in the US: the insurance is purchased on an annual basis. This encourages patients buy the cheapest coverage until they get sick, hoping some government program or mandate will cover them after that. The only way private insurance can work in a sustainable, stable and reliable way in this country will be to base it on life-long contracts requiring insurers to cover their clients even after they are no longer profitable while requiring the insured to chose what coverage they’re willing to fund and what restrictions they’re willing to tolerate before they get seriously sick. This would encourage both sides to focus on long term costs and might end the prevalence of substance abuse, risk taking, obesity and other self abuse amongst Americans.

    Reply
    • csteventucker

      April 4, 2010 at 11:06 pm

      Great comment PCL and thank you for reading.

      I think your information regarding MSA’s (Medical Savings Accounts) is a bit outdated. This being the case, I wanted to expand on your thoughts a bit.

      Firstly, the IRS laws pertaining to the design of MSA qualified HDHP’s (High Deductible Health Plans) were significantly improved under the former Bush administration. They are also no longer referred to as MSA’s. The new acronym is HSA or Health Savings Account.

      Whilst you are correct that under the old MSA legislation people would indeed put off treatment for Preventative Care. That problem has long since been remedied by an adjustment in the IRS laws pertaining to the design of Consumer Driven Health Insurance products.

      For example, it is now (and has been for quite some time) the norm for HSA qualified HDHP’s to provide “first dollar” Preventative Care benefits. “First dollar” meaning NO deductible required.

      For example, United Healthcare is one of the many HSA qualified HDHPs’ that includes the following Preventative Care benefits on their plan for each insured family member with NO deductible required:

      An annual Routine Preventative Care checkup. The checkup will cost only a $35 co pay (with no deductible required). In addition, X-ray & Lab costs associated with each Preventative care checkup will also be covered at 100% on a “first dollar” basis. Also, the following charges for preventative care that are performed in conjunction with the Preventative Care office visit are exempt from the deductible as well, whether performed in the doctor’s office or elsewhere:

      Child (under age 19) and Adult immunizations.
      Mammogram, cervical and Pap smears.
      Urinalysis and blood tests.
      Bone Density screens.
      EKG and cardiac stress tests.
      PSA tests and digital rectal exams.
      FDA-approved screenings for HPV.

      These first dollar Preventative Care benefits have been the norm in the industry for many years now. So the concern about delaying preventative care is no longer an issue.

      You also stated that these types of products only attract “reasonably healthy patients”. To that I must state that either my entire block of business is reasonably healthy OR there must be another impetus for the vast majority of my clients asking for and maintaining HSA qualified HDHPs.

      That impetus is the desire to have not only significantly lower premiums BUT to be in control of the cost of every day procedures and to take the savings they would spend on a “Gold Plated” health plan and PAY THEMSELVES.

      That is the concept behind Consumer Driven Health Insurance plans and contrary to popular belief, purchasing and maintaining a Consumer Driven Health Insurance plan REDUCES the out of pocket expense for the average consumer. Most especially when you compare “apples to apples”.

      Let’s break down the out of pocket costs to a family of three using United Healthcare again as an example and compare their “HSA 100″ qualified HDHP to the typical “Traditional” (non HSA qualified) health insurance plan:

      Maximum Annual out of pocket with “Traditional” Plan with $2,500 deductible 80/20

      Annual deductible: $2,500 (1st family member)
      +
      Annual deductible: $2,500 (2nd family member)
      +
      Annual deductible: $2,500 (3rd family member)

      = Annual Family Deductible Risk of $7,500

      Then we need to add the additional “coinsurance” out of pocket risk per family member:

      20% of the first $15,000 =$3,000
      +
      20% of the first $15,000 =$3,000
      +
      20% of the first $15,000 =$3,000

      = Total Annual Family coinsurance risk of $9,000

      TOTAL ANNUAL Family Risk:
      $7,500 (in total Deductibles)
      +
      $9,000 (in total coinsurance out of pocket risk)
      = $16,500 in TOTAL Family Risk EACH YEAR.

      The total monthly premium for a Traditional plan with above arrangement is $633.24/month.

      In contrast, if we compare that total calendar year annual risk to that included with the “HSA 100″ qualified HDHP with the $7,000 calendar year HDHP deductible. Here’s how that looks:

      Annual “common family” Deductible: $7,000
      +
      Annual “common family” coinsurance: $0 (None since the plan provides 100% coverage for the entire family after the “aggregate” or “common family” deductible is satisfied)

      = TOTAL Family Risk EACH YEAR of $7,000

      The total monthly premium for the “HSA 100″ plan with the above design will be $439.44/month

      The premium savings per month between both products is $193.80 or $2,325.60 annually. And as the comparison above shows, the total calendar year risk to a family is $9,500 less each year.

      In addition, once you have an HSA qualified Health Insurance plan. The IRS allows you to open the aforementioned Health Savings Account (a.k.a. Medical IRA) if you choose to do so.

      This is an option. It is however a very good option to select because not only can you deposit the annual premium difference between both plans ($2,325.60) in to the optional Medical IRA (HSA) at the bank of your choice. But a family can also add an additional amount of $3,694.40 this year, in to a 100% tax deductible, tax deferred, interest bearing Medical IRA. It behooves them to do so for the following reasons:

      a.) All funds deposited in to your Medical IRA (HSA) are 100% tax deductible.This means less taxes and more money for retirement. It’s always better to pay yourself than the insurance company.

      b.) Unlike any other IRA, a Medical IRA (HSA) allows you to withdraw funds at any time with no penalty for “qualified medical expenses”. To find a list of IRS “qualified medical expenses” click the IRS link below: http://www.irs.gov/publication/p502/index.html

      Most importantly, when you withdraw your HSA funds to pay for any of the qualified medical expenses on that list, those expenses themselves become 100% tax deductible.

      c.) Here’s the key point though. If you have just ONE year without any large claims (most families have MANY years without large claims) and you fully fund your Medical IRA, then if the worse case scenario occurs, you will have those funds available and be able to withdraw them with no penalty and use that money to help pay your calendar year “common family” deductible.

      In year two with no large claims, you will be that much farther ahead of the risk management game. In fact, no other kind of Health Insurance actually lowers your risk the longer you own it.

      I say this because, there is no other kind of IRA that you can withdraw from at any time with no penalties. This being the case, the longer you fund a Medical IRA (HSA), the lower your risk becomes by owning an HSA qualified Health Insurance plan. Simply due to the fact that each year you fund the IRA, the more money will be there if the worse case scenario occurs.

      This is so because each year your remaining balance rolls over and continues to earn tax deferred interest. To help you further understand how Medical IRA (HSA qualified) HDHP’s (High Deductible Health Plans) work please watch the easy to understand videos in the right hand column of the following HSA Center web site: http://www.hsacenter.com/

      Please also watch the 1st six videos here: https://csteventucker.wordpress.com/2010/03/23/universal-health-care-would-it-ever-work-for-the-united-states/

      One of those videos is the story of John Mackey (CEO of Whole Foods) who decided to adopt this concept and was initially lambasted by his employees for “taking away their copay”. A few short years later though, not only are his employees very happy with their HSA qualified plans but they are sitting on thousands of dollars in their HSA accounts and they are actually negotiating prices with medical providers because they KNOW that whatever they DON’T spend on medical expenses is THEIRS TO KEEP for their retirement and or future medical expenditures.

      Regarding your comment about “purchasing health insurance on an annual basis”. This is always an option for the consumer but it is most certainly not the norm. In fact, those with Consumer Driven HSA qualified plans keep the same policy in force for many years since they keep building a larger and larger HSA account with money that they would given to an insurance company for a low deductible, low co pay plan.

      So for them, they have the option at renewal of simply raising their deductible (and lowering their premium) to offset any premium increase that may come from the insurance company upon annual renewal. They can do this comfortably because they have been “hedging their bets” with money that would have otherwise given away to the insurance company for a low copay low deductible traditional health insurance plan.

      Consumers also always have the option (and should exercise that option annually) to shop for another plan with a lower introductory price.s As long as they purchase another HSA qualified plan they get to RETAIN their HSA balance and continue to build it with their new HSA qualified plan.

      All things considered, HSA qualified HDHP’s are simply the most intelligent way to insure anyone. Most especially a family. This is why their popularity has skyrocketed in the last decade.

      This is also why I believe HSA qualified plans are a key pillar in REAL health insurance reform. I list the other key pillars to REAL reform here: https://csteventucker.wordpress.com/2010/03/02/intelligent-health-insurance-reform-using-free-market-principles-and-limited-government/

      One of the MOST important pillars being the EXPANSION of HIPAA portability laws to include individual health insurance plans (bullet point number 4 on that page).

      This simple adjustment to outdated HIPAA law would allow consumers to move from one individual plan to another individual plan without fear of being denied due to a pre-existing conditions. The same “freedom” applies to ALL Group Health Insurance plans and should also apply to Individual plans.

      This would provide an impetus for consumers to CONTINUE to pay into the system as they do on group health insurance plans (knowing that maintaining coverage with no lapse of more than 63 days would guarantee them coverage for pre-existing conditions on the new plan). This is the case with current HIPAA portability laws pertaining to GROUP health insurance and it should also be so with Individual plans.

      Instead, with the new health care “reform” law their is little to no impetus for a consumer to continue to pay into the system by regularly paying health insurance premiums. Simply due to the fact that the “penalty” for NOT purchasing health insurance is significantly LESS than the cost to purchase AND the consumer can simply buy a policy the moment they get sick. NOTHING could be more actuarially UNSOUND.

      Imagine purchasing a new Mercedes, driving it down the express way. Smashing it and burning it and then being able to call your Car Insurance agent and buy a policy to “cover it”. Such a concept is PURE insanity and yet that is EXACTLY what the new “reform” law allows.

      Regarding “life long contracts”. All Health Insurance policies available on the market today are already “life long contracts” since there are Federal laws that were passed more than 13 years ago that PREVENT any insurance company from canceling your coverage when you get sick. This being the case, the only person who can end the contract is the policy holder themselves (except in the case of insurance fraud).

      If they wish to keep a policy for their entire life they can. Or they can simply purchase a variety of other plans as their needs chance. This is the IMPORTANCE of maintaining consumer choice by PROMOTING healthy competition.

      Regarding “substance abuse”. It is simply unfair to require other consumers who do not lead unhealthy lifestyles (such as drug and alcohol abuse) to PAY MORE for their health insurance coverage when they CHOOSE to lead healthy lifestyles. THIS is the problem with State imposed mandates that REQUIRE all policy holders to pay SIGNIFICANTLY higher premiums for THEIR coverage when they lead responsible lifestyles.

      And it is these KINDS of mandates that have DRIVEN up the cost of ALL health insurance plans and brought about the development of lower priced HSA qualified plans.

      As with all actions there are equal REACTIONS. If you choose to follow an unhealthy lifestyle or dabble in alcohol or drug abuse. The REACTION to your ACTION should be HIGHER premiums FOR YOU not for those who lead healthy lifestyles.

      Mandating that ALL pay more, is EXACTLY what drives health insurance companies OUT of a State, leaving consumers with fewer and fewer options. Case in point California. Since the mandates in California REQUIRE health insurers to cover things that are CLEARLY NOT medically necessary, the VAST MAJORITY of Health Insurers simply choose NOT to offer their products in that State, leaving thousands of consumers dramatically fewer choices, dramatically higher premiums and poor customer service. Why?

      Because the few carriers left that are willing to take the extra risk develop an UNHEALTHY monopoly on the market specifically due to the LACK of competition. NOTHING drives down quality and drives UP prices like LACK of competition.

      This is why one of my pillars of health insurance reform calls for the purchase of all health insurance plans from all 1,300 Health Insurance companies to be sold anywhere in the U.S. across ALL State Lines. In fact, if MORE competition were allowed and there were REAL incentives to consistently pay in to the system insurers may actually be able to cover substance abuse and other self inflicted woes for a more reasonable price.

      As with ALL things, personal responsibility is the KEY to all pillars of reform. To require a healthy responsible family to pay significantly more for their health insurance because another leads a life of substance abuse is not the answer. In fact, KNOWING that your lifestyle choices would be subsidized by another gives those who lead such lifestyles little to no reason to attempt to curb such unhealthy lifestyle choices.

      Reply
      • PCL

        April 10, 2010 at 10:39 am

        Thanks for your quick response. I’m glad to read of the improvements in HSAs over MSAs. They are probably an under appreciated option for those seeking individual policies. I agree with your contention that individual plans should get all of the tax advantages that group plans currently receive. I see some potential cracks in the protections against cancellation and the treatment of pre-existing conditions, though. Do the laws preventing insurers from canceling coverage as soon as a patient gets sick also require them to renew coverage indefinitely without a rate increase beyond what other patients without such a condition would have gotten? Can policy holders attempt to game insurers by picking the cheapest options when they’re healthy and upgrading them as soon as they get sick? If a patient who has just come down with cancer attempts to “shop for another plan with lower introductory prices”, I assume that he or she wont find a lot of insurers eager to offer coverage for an affordable rate. This is why I call this coverage “year to year”, if either party can cancel, raise rates arbitrarily, or change coverage, there is no guarantee a given condition will be covered affordably beyond the end of the year. Of course, if the new law prevents exclusions for pre-existing conditions without a requirement for previous coverage, that just moves us to the other extreme, with costs continuing to explode. John Cochran (the economist, not the OJ lawyer) has proposed at least two systems whereby the insured could switch carriers without sticking the new carrier with the bill for an ongoing condition; it would probably be worth adding one of them to the HSA model if lifetime contracts are considered too restrictive. Either choice would force patients to choose (or refuse) the coverage that suits their beliefs and lifestyle (rather than current condition) before they need it, whether it be drug rehab coverage, heroic end of life treatment or any other controversial coverage. For the nation, I would like to see Medicare and Medicaid replaced with a two tier system in which the government covers all the cheap, non-controversial care (like immunizations and broken arms) for all while requiring individuals to buy private insurance (possibly HSAs) for anything beyond that. Since (from what I’ve read) 75% of our health costs are for the chronically or terminally ill (the figure is probably higher for Medicare), this should drastically reduce the government’s health expenses while giving people the choices and incentives to take care of themselves. I believe that if Obama had proposed a long term transition to such a system, phased in by generation (to avoid enraging those currently depending on Medicare), he would have avoided the public wrath he and his supporters will receive when the mess that passed last month starts to fall apart.
11. James Roswell Quinn

    April 4, 2010 at 11:38 pm

    Dear Steve,

    I commend you on your thoughtful and caring response to someone who was insulting you. I thank you for giving him a real answer to his problem.

    I hope Dr. Zoe has the courage to put aside his assumptions about conservatives, and will instead take the path of due diligence that you recommended.

    Afterwards, rather than an apology, I hope he has the integrity to THANK YOU for helping him find the solution for his terrible situation.

    Keep up the good fight.

    James Roswell Quinn
    Keynote Speaker, Author, and Success Coach.

    Reply
    • csteventucker

      April 4, 2010 at 11:54 pm

      Thank you Sir!

      Reply
12. Mckinley Hutter

    April 5, 2010 at 7:30 am

    Your site was extremely interesting, especially since I was searching for more info on this just sa few days ago.

    – existing franchises for sale

    Reply
    • csteventucker

      April 5, 2010 at 11:22 am

      Thank you Mckinley!

      Reply
13. Linda

    April 7, 2010 at 8:33 pm

    Hello Steve, I am considering canceling my family’s health insurance in the next couple of days because we can no longer afford it. Most peoples mortgage payments arn’t as much as my monthly insurance payments. I went online to see if I could find anything on the company we’re insured with (Mid-West Nat’l Life) and I found you. I have been reading your articles and blog, and I’m totally lost! Our insurance started out at about $500 a month and now it’s right about $1400 a month. It almost tripled over the last ten years. Do you have any suggestions? My husband (53) is a fishing guide in the Florida Keys, I’m (50) and unemployed and my daughter is (24) and is in graduate school. I can’t stand Mid-West Nat’l, I feel they’re taking advantage of us. Thanks so much for for your help!

    Reply
    • csteventucker

      April 7, 2010 at 9:23 pm

      Hi Linda,

      I am sorry to here about the problems you are having with Midwest National Life. Your experience is most certainly not an isolated one: http://www.nowpublic.com/tech-biz/mega-life-midwest-national-life-health-markets-insurance-fine

      I will contact you via your email with some recommendations that will FAR better suit your needs. I am THRILLED that you decided to do some due diligence on finding a better option. I only wish more people would do the same thing.

      My recommendation will be a move to a consumer driven tax qualified health insurance plan. This is the smartest (& lowest priced) way to insure anyone. I do need your home zip code but I will obtain that private information from you via email.

      Meanwhile, here’s some more info about Consumer Driven Tax Qualified Health Insurance: http://www.sbisvcs.com/hsa_qualified_hdhp.htm

      Please watch for an email from me shortly.
      My email addresses are: smallbusinssvcs@aol.com
      and
      steve@sbisvcs.com

      Reply
14. lori

    April 15, 2010 at 9:53 pm

    Saw you at the Tea Party! My question is this:
    I have an individual policy through BCBS. My oldest son (22 a Toyota salesman) left my policy for his own BCBS policy when he left college and moved to his own residence. BCBS has since changed the age I can carry my kids to 26yrs. I want to put him back on my policy to help him with the costs. They keep raising his rates, etc. I am wondering if this is a wise decision in the long run. What if he develops a preexisiting condition and does not qualify for his own policy again? Should I put him back on my policy?

    Reply
    • csteventucker

      April 15, 2010 at 10:22 pm

      Lori!

      Thank you so much for coming out and supporting SMALL Government and FISCAL RESPONSIBILITY! The answer to your question is YES! It will be much cheaper for you to insure your son on your existing policy. You should not have any concerns about pre-existing conditions so long as he does not suffer from a pre-existing condition now. If he is healthy, he will be perfectly fine on your policy. The only time you have to worry about a policy rescission is if he had a condition NOW and fails to disclose it. Since he is healthy, you are good to go! Please feel free to ask any other questions you may have in the future. Have a GREAT day Patriot!

      Reply
15. www.health-insurance-buyer.com

    August 10, 2010 at 1:50 am

    to be fair it may have been simply a matter of not being infomred at the right time, anybody can make a mistake there.

    Reply
    • csteventucker

      August 10, 2010 at 6:33 am

      Normally, I would agree with that. However, Mr. Raddatz’ sister gave her testimony to Congress regarding the fact that her brother’s coverage was NOT “canceled”, nor was his “treatment delayed”, nor did he “die because of it”. She gave this full testimony only 3 months before the State of the Union Speech. This being the case, it simply is not possible that the President did not know this information. He simply was lying once again. He is very, VERY good at that. Source: Wall Street Journal
      http://online.wsj.com/article/SB125314896131518267.html?mod=googlenews_wsj

      Reply
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17. csteventucker

    October 3, 2010 at 6:52 pm

    Thank you!!!

    Reply
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19. Jerry Schiffler

    October 17, 2010 at 3:19 am

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    Reply
20. csteventucker

    October 17, 2010 at 4:15 am

    Yes. My other page @ http://www.TRUTHaboutObamaCare.com has more information.

    Reply
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25. Linda

    December 31, 2010 at 2:57 am

    Steve,
    I was diagnoised with Breast Cancer in February of 2010. I health insurance from my employer to cover the costs of the chemotherapy and 3 surgeries. I was involuntarily terminated by my employer because I wasm’t able to return from my FMLA when they determined me to do so. I was scheduled for my second surgery to remove cancer cells two days after my sceduled return back to work. I couldn’t afford to obtain cobra health insurance because of the high costs. Now I have a pre-existing condition and I am jobless and I have no health insurance. High Risk pools sound good, but the increased costs of the premiums due to my illness makes it impossible for me. I live in Californiam, and there are the high risk pools. I have read that I have to be without insurance for 6 months to be able to qualify for these pools. Is it true the cost of this type of insurance is 125 to 200 per cent hight than the free market prices?
    The only way I can see for me to have any health insurance is by being employed. Do you know any aternative, other than me going bankrupt in the process? I’m single, and living off what little money I make on unemployment insurance paymests.
    Thanks in advance for your attention.

    Reply
26. csteventucker

    December 31, 2010 at 4:14 am

    Hi Linda,

    I am very sorry to here about your diagnosis and the problems you are facing trying to obtain health insurance. At this juncture, you have 3 separate options to pursue. They are as follows:

    1.) Many States have programs that are designed to provide free or low cost treatment for women with low income who have been diagnosed with Breast or Cervical Cancer. The California chapter is known as the “BCCTP”
    (Breast & Cervical Cancer Treatment Program) Please visit this link:
    http://www.dhcs.ca.gov/services/medi-cal/Pages/BCCTP.aspx
    I recommend that you contact them immediately to begin receiving the treatment you need at little or no cost to you.

    Once you are able to work again, your new income may render you ineligible to continue qualifying for their subsidized help. Or, you may find employment where no health insurance is offered. This being the case, I wanted you to know your insurance options as well. They are as follows:

    2.) You are correct that High Risk Health Insurance Pool premiums are significantly higher than health insurance you can purchase on your own in the private market. This is so because only those with costly pre-existing conditions apply to these programs. Without any healthy applicants within these pools it is very difficult for the actuaries to keep premiums low. That stated, California now has two separate High Risk Health Insurance pools and while the premiums are indeed high, they are lower than many Cobra continuation premiums. Since you have been uninsured for more than 6 months you qualify for both High Risk Health Insurance Pools.
    For comparison details between both plans visit this link:
    http://www.pcip.ca.gov/PCIP_Program/PCIP_MRMIP_Comparison.aspx

    3.) Since the new new “PCIP” (Pre Existing Condition Insurance Plan) has been subsidized with $5 Billion of our tax dollars, the premiums are lower than the the existing “MRMIP” (Major Risk Medical Insurance Program) and the coverage is also far superior with an unlimited lifetime benefit.
    This being the case, if you can afford the premium my recommendation would be to enroll immediately in the new “PCIP”. For all the details and to complete BOTH applications (there are 2 required) please visit this link:
    http://www.pcip.ca.gov/PCIP_Program/default.aspx
    For the monthly premiums required for this new subsidized pool visit:

    Click to access PCIP_Premiums.pdf

    Please feel free to contact me again if you have any additional questions. I wish you much strength & God’s speed in your recovery.

    Reply
27. Camilla Gadue

    December 31, 2010 at 7:41 am

    Hi I just dropped by and wanted to say you to have a Merry Christmas. Let all your wishes make come true for you and your family and lets hope the next year be prosperous for all us.Merry Christmas

    Reply

28. Pingback: Truth About Obamacare Blog 2010 Year In Review | Health Insurance Tips & Advice

29. socjologia

    January 13, 2011 at 7:31 pm

    Can I just say what a relief to find someone who actually knows what theyre talking about on the internet.

    Reply
30. ogloszenia o prace

    January 14, 2011 at 8:53 pm

    Good website. I saw the link on Twitter.

    Reply
31. Denise Simpson

    January 15, 2011 at 6:03 am

    I love getting my SSI benefits. Thanks for the post.

    Reply
    • Sam

      September 10, 2013 at 3:37 pm

      I hope you also enjoy the hassle, red tape and worry with being on the government dole.

      Reply
32. Derek Bowman

    July 7, 2012 at 8:28 am

    I agree 100% with what you say in your reply! I paid $900+ a month in insurance premiums and every year it would go up 10%-20% more depending on if we had to use the insurance or not. The health insurance in this country has got to change and it’s too bad they couldn’t have fixed it a long time ago before many (I’m guessing millions) had to file bankruptcy because of medical bills. I, for one, am glad to see this discussion is taking place!

    Reply
33. Chris Gallacher

    August 29, 2013 at 11:19 pm

    I have a son that is bipolar and has asthma. He turned 26 a couple of months ago and is not eligible under my insurance any longer. We are in California. His meds are 300-500 dollars monthly. We did get a free month from the drug company but don’t know what to do after sept 16 2013 when he will be out of medication. What can he qualify for before Jan 1 2014?? He lives at home and works part time.

    Reply
    • csteventucker

      September 6, 2013 at 1:43 am

      Chris,

      As of January 1, 2014 your son can qualify for any health insurance plan available on the market during the first national “Open Enrollment” period which lasts from 1/1/14 to 3/31/14. There will be no preexisting conditions during this time period. He can qualify once again during the second national ‘Open Enrollment’ period from 10/7/14 to 12/15/14.

      Reply
34. Angel

    September 10, 2013 at 3:35 pm

    Mr. Tucker,
    While I agree with some of your statements concerning availability of healthcare, I have some disagreements concerning affordability. I am a 15-year sufferer of heart disease and require a pacemaker. I recently lost my SSI due to my husband’s income increasing, hence I also lost Medicaid. The high risk pool in the state of Mississippi had a 10k deductible for a female in her mid-30s and a larger premium than I could afford with raising a family of 4 on 35k a year. I do not qualify for SSDI as I have worked very little due to my condition. I have also been denied private insurance specifically because of my condition so I am left uninsured and paying out of pocket for now. Mississippi does not provide Medicaid coverage for someone in my income bracket, nor will they be expanding Medicaid with the inclusion of the healthcare exchange simply because partisan politics got in the way. I will be taking the chance to apply to the federal healthcare marketplace in October in hopes of obtaining the insurance coverage I need. Please do not respond with how wrong I am or any other form of “you don’t know the facts.” I am a trained insurance coordinator and I know the current laws as well as you do. It is wrong for anyone to assume that similar circumstances apply to all individuals and that everyone can afford risk-pool insurance. While I may not like Obamacare as a whole, I can appreciate the decision to eliminate pre-existing condition clauses.

    Reply
    • csteventucker

      September 10, 2013 at 6:05 pm

      Angel,

      If you visit http://www.TruthAboutPreexistingConditions.com you will find my solutions to improving our current health care system. One of them pertains to funding High Risk Pools with more grants so that the premiums are more affordable for Risk Pool insured members. And, making sure that there is either a well funded High Risk Pool or Guaranteed Individual Mandate in the 5 states that do not have them already.

      Or we can simply add one sentence to existing HIPAA law so that ALL policies, whether purchased individually or through an employer have full “Portability” when it comes to preexisting conditions. Right now, only those who have employer sponsored plans (90% of the American insured) have these protections against preexisting conditions so that they can ‘port’ their coverage from plan to plan. And, so that all Americans will have to KEEP their plans in place in order to retain that ‘portability’. Allowing one to drop a health plan when they want and to buy a plan when they want (presumably when they ‘need’ it) without proof of prior coverage – as Obamacare does – is NOT a solution.

      These are simple, concise solutions that will cost FAR less than the $2.6 trillion that Obamacare will cost us over the next 10 years. The $1.08 trillion in additional taxes and the $4.95 trillion that will be cut form Medicare over the next 20 years in order to fund the new APTX – Advance Premium Tax Credits – inside the new health insurance exchanges. The solutions as presented by Obamacare will not work because the 2.7 million ‘young invincibles’ that are desperately needed to lower the cost of health insurance to everyone else will not be buying insurance in the exchanges. They will not do so for three primary reasons:

      1.) The ‘fine’ (TAX) for not buying a QHP – Qualified Health Plan – will be only 1% of one’s MAGI – Modified Adjusted Gross Income. This means that a ‘young invincible’ making $30,000 a year will pay less than $300 a year to NOT buy health insurance in the exchanges as opposed to $2,000 to $6,000 a year (depending on where they live) price for a QHP. Prices are this high because of “Community Rating” – a regulation that has already failed in all 8 states it has been implemented in before.

      2.) We are not repealing EMTALA. Meaning that these young invincibles can still recieve ‘free’ health care services at any Emergency Room in the country.

      3.) We are providing 2 national “Open Enrollment” periods from 1/1/14 to 3/31/14 and from 10/7/14 to 12/15/14 where they can receive health insurance on a guaranteed issue basis.

      This being the case, there is no impetus for them to buy expensive QHP’s and there is no impetus for them to KEEP their expensive QHP’s.
      This means that only older and sicker people will be left inside the national risk pool and premiums will increase for them. This is precisely what happened in all 8 states where “Community Rating” and “Guaranteed Issue” were implemented before.

      Again, access to qualified, affordable health insurance and health care for EVERYONE is the desired solution. Obamacare will NOT provide that and will instead leave 27 million Americans uninsured, even after it’s full implementation. Even after we spend $2.6 trillion over the next 10 years, $1.08 trillion in additional taxes (many of which will be paid by the middle class) and we cut $4.95 trillion form Medicare over the next 20 years (according the chief Medicare actuary).

      You state that you are as well versed as I in health care policy. If so, you should have your own solutions. Please feel free to post them here. I look forward to reading them.

      Reply

35. Pingback: Champion News | The TRUTH About Preexisting Conditions.

36. Concerned Citizen

    November 15, 2013 at 1:08 am

    Who ever said conservatives are “greedy” has obviously never met anyone like Mr. C Steven Tucker. Thank you for not only enlightening everybody on health care and health insurance (you sure know your stuff!), but for helping out those less fortunate, those who have lost their insurance and need coverage, and those who need better rates in order to sustain themselves and their families. Our healthcare system needs more people like you, not another government bureaucracy, heavy taxation, or overhaul! Keep up the fine work, and God bless.

    Reply
    • csteventucker

      November 15, 2013 at 1:21 am

      Thank you for your kind words. It is my honor and privilege to do so.

      Reply

37. Pingback: The TRUTH About Preexisting Conditions | Illinois Tea Party

38. Clark

    November 15, 2013 at 5:09 pm

    At least three times in these comments you include the following link: [First time is April 3, 2010 at 8:52 pm] https://csteventucker.wordpress.com/2010/03/02/intelligent-health-insurance-reform-using-free-market-principles-and-limited-government/

    I get “Page not found” when I go through that link. A couple other attempts to find the post failed. I would very much like to read that post.

    Reply
39. JP

    November 15, 2013 at 7:50 pm

    Reblogged this on et cetera* and commented:
    Read This!

    Reply
40. Clark

    November 16, 2013 at 5:11 am

    Here is right link:

    Intelligent Health Insurance Reform

    Reply

41. Pingback: The TRUTH about Preexisting Conditions

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114. Pingback: Drudge: I’ve Opted Out Of Obamacare For Life

115. Jeremy Hubbard

     January 7, 2014 at 6:35 pm

     Millions of Americans rot in prison for minor crimes yet Obama openly gets away with continual treasonous acts……where is the justice?

     Reply
116. Lakhana

     January 7, 2014 at 8:09 pm

     Here is the PDF copy you can download from the gov site:

     Click to access PLAW-104publ191.pdf

     Reply

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123. driving-lessons-stapleford

     June 26, 2014 at 10:35 pm

     It’s nearly impossible to find well-informed people for this subject, however, you sound like you know
     what you’re talking about! Thanks

     Reply

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126. Sara Noble

     November 5, 2014 at 12:41 pm

     Thank you for including me Steven and thank you for this website and all you do. Together, all of us who are paying attention, can save our Republic and I don’t think I’m being hyperbolic in saying it needs saving.

     If we can only get through these next two years.

     You are a fighter for our rights! God bless!

     Reply
     • csteventucker

       November 5, 2014 at 12:42 pm

       Thank you Sara. Last night was a crucial first step in restoring our Republic. I feel GOOD.

       Reply

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133. Robert Smith

     December 18, 2019 at 5:43 am

     The cost for group health insurance is now commensurate with individual health insurance.

     Reply