high risk insurance pools??

taraHK
taraHK Member Posts: 1,952 Member
in Colorectal Cancer #1
I've just found out my private insurance company has a lifetime cap which I have just about met. I get insurance through my job, which covers about 50% of all expenses. That has just capped out this year! but kicks in again in September. I've got to cover my own expenses this summer (ouch! but manageable).

Want to know if anyone knows anything about "high risk insurance pools". She didn't know too much. I gather it's a pretty new initiative and may be different in different states - with ? first priority on kids. And and all information appreciated.Obviously, like the rest of us, I'm 'uninsurable' under traditional insurance schemes.

Other news: I'm in hospital undergoing my first cycle of FOLFOXFIRI. Going pretty well so far....

Oh and my two boys are at home (18 and 20). When they come to visit me, we laugh so hard I have to tell them to shut up. "There are sick people here!" ha ha

Tara

Comments

  • MrsJP
    MrsJP Member Posts: 157
    #2
    Insurance
    In NY they have an insurance program for uninsured, low income people/families. You pay little or no premiums based on income and rescources. Also no alot of people who are eligible for medicaid (state ins) as a secondary insurance. May want to look into the Medicare disability program. I understand it takes awhile, so apply now and you maybe eligible for benifits 6 months down the road. Hope this is helpful.
    JP
  • Buckwirth
    Buckwirth Member Posts: 1,258 Member
    #3
    Lifetime caps are no longer legal
    > new laws on annual/lifetime caps

    Key points:

    Among the first health insurance reforms to go into effect this year is a ban on lifetime coverage limits.

    Beginning Thursday, insurers can no longer cap or cut off policyholders when their expenses hit a set amount.

    Also effective next week is a prohibition on canceling policies because the insured person becomes sick.

    One more immediate change: Annual coverage caps will be phased out, ending completely in 2014.



    According to the law, insurers must cover an insured person’s medical expenses up to at least $750,000 this year. After Sept. 23, 2011, the annual cap rises to $1.45 million, and after Sept. 23, 2012, the annual cap rises to $2 million.
  • lisa42
    lisa42 Member Posts: 3,625 Member
    #4
    glad to hear you laugh!
    Hi Tara,

    I've been wondering how you've been doing- good to hear from you! Fun to hear all the laughter you share with your boys, even while doing chemo and your comment "there are sick people in here", lol!
    I know you're in Hong Kong, so I don't know how the insurance system works there with regards to the lifetime cap. It has been declared illegal now in the U.S. for the insurance companies to place a lifetime cap on you now. I don't know if it's different under the "grandfather clause"- for people holding insurance policies prior to the new law. I hope it's illegal for the lifetime cap for everyone, but I don't know that for sure. With you being insured in Hong Kong, I don't know how your system works. I've heard of people buying into insurance pools- a few people I know of here now do that- they all tend to be people who are self-employed and who don't get offered health insurance through their work. None of the people I know of who do this are dealing with cancer or other major illnesses at the moment. I've often wondered how that would work for someone in our situation who has major costs.
    Sorry I couldn't be of more help on that.
    I do hope and pray that your chemo treatments will be tolerable and that they will kick the cancer's butt!

    Hugs to you,
    Lisa
  • lisa42
    lisa42 Member Posts: 3,625 Member
    #5
    Buckwirth said:

    Lifetime caps are no longer legal
    > new laws on annual/lifetime caps

    Key points:

    Among the first health insurance reforms to go into effect this year is a ban on lifetime coverage limits.

    Beginning Thursday, insurers can no longer cap or cut off policyholders when their expenses hit a set amount.

    Also effective next week is a prohibition on canceling policies because the insured person becomes sick.

    One more immediate change: Annual coverage caps will be phased out, ending completely in 2014.



    According to the law, insurers must cover an insured person’s medical expenses up to at least $750,000 this year. After Sept. 23, 2011, the annual cap rises to $1.45 million, and after Sept. 23, 2012, the annual cap rises to $2 million.

    Buckwirth- good to know
    Hi Blake,

    I just read your reply after I already made mine to Tara. Good information to know- thanks for posting it!

    Lisa
  • Buckwirth
    Buckwirth Member Posts: 1,258 Member
    #6
    lisa42 said:

    Buckwirth- good to know
    Hi Blake,

    I just read your reply after I already made mine to Tara. Good information to know- thanks for posting it!

    Lisa

    Pertinent to some...

    just read your reply Lisa.  I had no idea Tara was in HK...

    > Hong Kong Health

    HK seems to be on the British model, so caps and the meaning of caps is very different from the US...

    Thanks
  • taraHK
    taraHK Member Posts: 1,952 Member
    #7
    lisa42 said:

    glad to hear you laugh!
    Hi Tara,

    I've been wondering how you've been doing- good to hear from you! Fun to hear all the laughter you share with your boys, even while doing chemo and your comment "there are sick people in here", lol!
    I know you're in Hong Kong, so I don't know how the insurance system works there with regards to the lifetime cap. It has been declared illegal now in the U.S. for the insurance companies to place a lifetime cap on you now. I don't know if it's different under the "grandfather clause"- for people holding insurance policies prior to the new law. I hope it's illegal for the lifetime cap for everyone, but I don't know that for sure. With you being insured in Hong Kong, I don't know how your system works. I've heard of people buying into insurance pools- a few people I know of here now do that- they all tend to be people who are self-employed and who don't get offered health insurance through their work. None of the people I know of who do this are dealing with cancer or other major illnesses at the moment. I've often wondered how that would work for someone in our situation who has major costs.
    Sorry I couldn't be of more help on that.
    I do hope and pray that your chemo treatments will be tolerable and that they will kick the cancer's butt!

    Hugs to you,
    Lisa

    Thanks Blake and Lisa,
    Yes,
    Thanks Blake and Lisa,

    Yes, I'm based in Hong Kong. My private insurance is through an international company based in the UK -- so I don't think these new reforms will apply (sadly). As you say, Lisa - who know whether they will apply retrospectively -- I hope so for all! But what I heard about is something maybe a little different -- also linked to the US health reforms, but specifically designed for those with pre-existing conditions when applying. It may still all be in infancy stages....

    Thanks again for all the useful comments, folks. I know it's stating the obvious but to have to deal with serious financial issues on top of cancer really seems unfair sometimes....

    Tara
  • tanstaafl
    tanstaafl Member Posts: 1,313 Member
    #8
    taraHK said:

    Thanks Blake and Lisa,
    Yes,
    Thanks Blake and Lisa,

    Yes, I'm based in Hong Kong. My private insurance is through an international company based in the UK -- so I don't think these new reforms will apply (sadly). As you say, Lisa - who know whether they will apply retrospectively -- I hope so for all! But what I heard about is something maybe a little different -- also linked to the US health reforms, but specifically designed for those with pre-existing conditions when applying. It may still all be in infancy stages....

    Thanks again for all the useful comments, folks. I know it's stating the obvious but to have to deal with serious financial issues on top of cancer really seems unfair sometimes....

    Tara

    ground level view?
    Tara can you give us a thumbnail sketch of Hong Kong price/practices on hospital costs, drugs and insurance? I am aware that in the mainland China area, one sees active pharmaceutical ingredients from major suppliers, at much, much lower costs.

    Asia is a mixed lot on prices e.g. low on some things, perhaps high monopoly price on something else (say certain drugs or procedure with high end equipment) in one place, ultra low price "around the corner".

    Did they ever mention a CA19-9 test and cimetidine as part of the pathology workup and cocktails?
  • Buckwirth
    Buckwirth Member Posts: 1,258 Member
    #9
    taraHK said:

    Thanks Blake and Lisa,
    Yes,
    Thanks Blake and Lisa,

    Yes, I'm based in Hong Kong. My private insurance is through an international company based in the UK -- so I don't think these new reforms will apply (sadly). As you say, Lisa - who know whether they will apply retrospectively -- I hope so for all! But what I heard about is something maybe a little different -- also linked to the US health reforms, but specifically designed for those with pre-existing conditions when applying. It may still all be in infancy stages....

    Thanks again for all the useful comments, folks. I know it's stating the obvious but to have to deal with serious financial issues on top of cancer really seems unfair sometimes....

    Tara

    There is a program
    for high risk pools, but it is only available in 23 of the states, and I believe you would need to be a resident to apply.

    As to caps being removed retroactively, they are. No one in the US has lifetime caps anymore.

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