Next time, I'm gonna lie...

Discussion in 'Community' started by LethalWolfe, Sep 14, 2005.

  1. LethalWolfe macrumors G3

    LethalWolfe

    Joined:
    Jan 11, 2002
    Location:
    Los Angeles
    #1
    Okay, so I recently moved from a staff to a freelance position w/my employer so I had to go find my own health coverage. As it so happens CostCo started selling health insurance (Pacificare is the provider) in CA so I apply for that online. Then I get a call and do a phone interview thingy. No sweat.

    So I get a letter in the mail today saying that I don't qualify for their coverage. I'm pretty shocked. I've never been denied coverage before. I in my mid 20's and healthy. I rarely end up at the doc's. I don't smoke and I rarely drink. I'm not in a high risk profession. So why did I not get coverage you might ask?

    Because I have year round, mild nasal allergies. I am denied coverage for Mild. Nasal. Allergies.

    This is complete and utter crap.


    Lethal
     
  2. mad jew Moderator emeritus

    mad jew

    Joined:
    Apr 3, 2004
    Location:
    Adelaide, Australia
  3. wordmunger macrumors 603

    wordmunger

    Joined:
    Sep 3, 2003
    Location:
    North Carolina
    #3
    Tried this one?

    There was a great feature on the Daily Show on it. Sounds like an EXTREME health care plan, DUUUUUUDE!
     
  4. gwuMACaddict macrumors 68040

    gwuMACaddict

    Joined:
    Apr 21, 2003
    Location:
    washington dc
    #4
    interesting... will that have any effect on you getting coverage in the future?
     
  5. LethalWolfe thread starter macrumors G3

    LethalWolfe

    Joined:
    Jan 11, 2002
    Location:
    Los Angeles
    #5
    I wish I wasn't but I'm not. I've been taking Flonase (prescription nasal allergy med) for about 5 years now and in that time I've probably changed healthcare providers 6 times. Never had a problem before.

    This is just astounding to me. What kind of health liability am I that I get the sniffles around cats and fresh cut grass if I don't use Flonase (which at 100% out of pocket costs 'bout $90 every 2 months)?

    I have half a mind to call and try to get a legit answer as to why I got denied coverage, but I don't really wanna waste the time 'cause I highly doubt I'll get them to change their decision.


    Lethal

    EDIT: gwuMACaddict, I don't know, but hopefully it doesn't effect my chances to get covered by other providers.
     
  6. iGary Guest

    iGary

    Joined:
    May 26, 2004
    Location:
    Randy's House
    #6

    Yeah, I got denied because I put down a period in my early twenties when I was on anti-depressants.

    Next time, I lie about it all. :D
     
  7. Bote macrumors regular

    Bote

    Joined:
    Sep 11, 2005
    Location:
    Philadelphia PA
    #7
    In the States, i believe if you were treated(had a prescription) for this within the last six months, with another insurance carrier, it is considered a preexhisting condition and they should not be able to deny you coverage. Or you could try another carrier and then suddenly develope alergies after you get coverage. Health care is such a joke in this country. It is embarasing. :mad:
     
  8. iGary Guest

    iGary

    Joined:
    May 26, 2004
    Location:
    Randy's House
    #8

    The reason you didn't get denied is because you joined a group. They cannot deny you when you enter a group, but will deny you out of general principle as an individual. Welcome to the world of independent contracting. Nobody gives a **** but you.
     
  9. Moxiemike macrumors 68020

    Moxiemike

    Joined:
    Jan 1, 2002
    Location:
    Pittsburgh, PA
    #9

    gary. you're right on with the independant contractor line. next up? try and get mortgage.....watch how fast they scoot you out the door.

    m
     
  10. LethalWolfe thread starter macrumors G3

    LethalWolfe

    Joined:
    Jan 11, 2002
    Location:
    Los Angeles
    #10
    Half the time I joined into a group the other half I joined as an individual. My sister works for an insurance company and she said things were getting bad, but I never expected anything this stupid.


    Lethal
     
  11. Zaid macrumors 6502

    Joined:
    Feb 17, 2003
    Location:
    London
    #11
    Thing is that IF, for what ever reason, they find out you have lied, then depending on the wording of the contract, they could declare the whole thing null and void, even if the the lie has absoluetly nothing to do with your claim
     
  12. Abstract macrumors Penryn

    Abstract

    Joined:
    Dec 27, 2002
    Location:
    Location Location Location
    #12
    Haha, null and void.

    Guess what? He doesn't even HAVE coverage now. That sounds just as bad as being "void."
     
  13. Zaid macrumors 6502

    Joined:
    Feb 17, 2003
    Location:
    London
    #13
    No true, but if he lied and got found out he'd not have insurance anyway, even if it was unrelated.

    It may well be worth taking the risk, especially if nobody want's to give him insurance, (which i doubt for something as trivial as allergies). Otherwise i'd just move on to another insurer.
     
  14. FoxyKaye macrumors 68000

    FoxyKaye

    Joined:
    Jan 23, 2004
    Location:
    San Francisco, Terre d'Ange, Bas Lag, Gallifrey
    #14
    One thing I've learned about health care companies (HMOs, PPOs, whatever) is they spend the majority of their time trying to figure out ways to not cover you. Getting individual coverage was a PITA for me when I was on my own, COBRA was a greater financial drain than simply paying cash at the Dr.'s office, and now with group insurance what is actually covered as real medical conditions are a joke.

    They lie, cheat and steal from you, I see no reason to not return the favor.

    Sorry you were denied coverage, that really sucks...
     
  15. IJ Reilly macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #15
    Exactly. From my own experience, I can testify to the fact that health insurance companies will gladly spend more money denying a claim than it would cost them to pay it. A matter of principle, don't cha know? They aren't in the business of providing health care. They're in the business of preventing health care. And they work damned hard at it.
     
  16. emw macrumors G4

    emw

    Joined:
    Aug 2, 2004
    #16
    Reminds me of a quote from, of all movies, The Incredibles:

    "Don't talk to me about their policies, Bob, talk to be about how you're keeping Insuricare in the black."

    Health care insurance is no different than any other insurance - their business is to make money. Lots of it. And since they control the rules, you have little say in the matter.
     
  17. IJ Reilly macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #17
    Yes, but it's also counterintuitive for them to decline coverage for a minor claim, and in the process spend more time and money in the effort than if they simply paid the claim. It's like they're trying to teach you a lesson, which apparently is, "next time, don't even ask."

    I don't honestly know how anybody expects us to get any health care at all from such a system, with virtually all of the incentives weighing on the other side of the ledger.
     
  18. FoxyKaye macrumors 68000

    FoxyKaye

    Joined:
    Jan 23, 2004
    Location:
    San Francisco, Terre d'Ange, Bas Lag, Gallifrey
    #18
    Hee, hee - I think in the same paragraph, he also says, "They're penetrating the burocracy!"
     
  19. e²Studios macrumors 68020

    e²Studios

    Joined:
    Apr 12, 2005
    #19
    I'm fairly certain that the big money insurance companies lining politician pockets are one of the major reasons why the USA is the ONLY 1st world country without any form of national insurance. It's really a shame that the government doesnt wake up and realize that its people need an affordable somewhat comprehensive plan that is availiable to everyone, not just those that can afford the outragous private insurance costs.

    I would gladly pay more in taxes for national healthcare, and for the paranoid that think "the government will be able to track me" maybe they should realize that they already can track you if they wanted to, its called a Social Security Number.

    To me its somewhat sad that an illegal immigrant can come to the States and end up getting more health care from the government than people who are citizens.

    Ed
     
  20. ColoJohnBoy macrumors 65816

    ColoJohnBoy

    Joined:
    Mar 10, 2003
    Location:
    Denver, Colorado
    #20
    Is being an ******* exclusive to PacifiCare? I'm glad I had the insurance BEFORE I started taking medication for depression and allergies, otherwise, I'd have been screwed. I have a few gripes with them nonetheless...

    1) A couple years ago, I started developing horrible headaches. I mean, absolutely unbearable. I went to the doc, but she couldn't find anything wrong. She was aware, though, of a viral condition spreading around rapidly. 72 hours from infection, it would cause severe brain hemorrhages and, well, kill you. She ordered a CAT scan for that same day; Two weeks later, PacifiCare approved it. Of course I didn't the condition, but it isn't something with which I would've toyed around.

    2) Last year, I got a staph infection, a nasty strain known as MRSA. It manifests itself as extremely painful abcesses all over the skin. Lucky me, they mainly showed up on my ass. The medicine required to get rid of it is nasty. There's either Vancomycin, an IV antibiotic done over a course of six weeks, at a cost of $7500 per week, that doesn't work on every strain of MRSA; or Zyvox, a twice a day oral antibiotic taken for two weeks at $2800 total. Both require insurance approval. Two months after I first went to my doc, PacifiCare approved the referral to see an infectious disease specialist. Another two months later, they approved a course of antibiotics. But get this: they approved the Vancomycin. It, of course, didn't work. I had the worst strain. The abscesses came back, and PacifiCare finally approved the Zyvox. Got rid the staph in a snap. But really. How much should it take?
     
  21. LethalWolfe thread starter macrumors G3

    LethalWolfe

    Joined:
    Jan 11, 2002
    Location:
    Los Angeles
    #21
    Hmmm... I no longer wonder why I hear people refer to them as PathetiCare. Time to talk to my fellow freelancers and see who they are getting coverage thru and their rates.


    Lethal
     

Share This Page