posted on April 28, 2008 02:41:22 PM new
There is a good article in today WSJ on hospital asking for cash upfront when it comes to treating cancer patients.
One lady 52 years old from Tx ,she quitted her job as a school bus driver to stay home to take care of her mom,her hubby retired as a heavy equipment operator.
She feels fine so she took out AARP medical advantage plan underwritten by United Health Group Inc,monthly premium $185 with a maximum annual payout of #37,000.
Last year she felt tired and bruised easily and the local hospital diagnosed her as having acute leukemia and referred her to MD Anderson which is world renowned for cancer treatment.
MD Anderson looked at her health insurance and the annual limit and said this is not an insurance policy and qualified her as 'uninsured'
She did not qualify as a charity case as she and her husband own 2 rental properties(house and an apt building) which gross $11,000 a month and an investment portfolio yielding $30k in investment income per year.
They asked her to bring a cashier check of 45,000.
She did and they ran some tests on her which confirmed she has acute leukemia.
Then they asked for additional 60k for treatment.
She was confused and cried and her husband started shouting and they backed down and asked for $30k instead.
OK,she got her treatment and afterwards received chemo treatment lasting a year.
Sometimes she will arrive at the hospital and found her appt was blocked,meaning she has to come up with the money before they can treat her.
One day she learned there is an organisation which would help to reduce patient hospital bills so she contacted them and they started to review her medical bills-they found since she is uninsured,she is charged $20 for latex gloves,$120 for saline pouches and $360 for blood tests.
If she were insured,the insurer would have paid just 20 for the blood test.
They also found a strange item with no description,when deciphered,it is a PENIS CLAMP FOR INCONTINENCE!
MD Anderson said this is a typo error,it is really a cathether,not penis clamp and waived the charge.
Since then she has switched to Blue Cross and Blue Shield which picks up most of the expenses but she still owed over $145k which she pays $2k a month.
$2k a month is a long way of paying down $145k so MD Andersom suggested she sell some of her rental property!
In the mean time,her cancer has come back.
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What I dont understand is -if she is paying 185 a month for a medigap policy ,why cant she find a real policy with high deductible say 5k and get the Health Savings account tax deduction on her income tax return,it would come up to be the same or may be even cheaper given her age (52)?
With the kind of networth and income,she could easily foot the high deduction either from the income or borrow from her property?
posted on April 28, 2008 09:43:17 PM new
While in training a nursing instructor told the class that if you get very sick & need to be hospitalized be either very rich or very poor. If your in the middle class your screwed. Sad to say, this lady is screwed.
posted on April 29, 2008 05:49:24 AM new
But with that kind of income from investment and rental ,she could have switched to a better insurance policy before this incident!
The time to get a good policy is when you are healthy,she is paying $185 for a policy which has a max payout of 37k per year,she could have used that $185 for a better policy.
At her age (52),she should not just assume she feels fine and get an inadequate policy.
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Lets all stop whining !
posted on May 3, 2008 08:46:04 PM new
Good point, hwahwa. 37.000 will just about cover a broken finger. Being a property owner she should have known how important having the right amount of insurance is.
A friend of mine has her health insurance through a group, the BBB. She has Blue Cross Personal Choice including Rx coverage for herself & son. She pays 1290.00 a month & her husband isn't even on the policy.
Her son is 18 & a senior & will be dropping off the policy soon. I keep telling her husband he better join, he's over 50 & even a short hospital stay is very costly.
They own over 50 low rent properties, many section eight so their income is good, but not that good if you really get sick or injured. Keep in mind they have mortgage payments on many of the properties as well as taxes.
It's a do or die situation you can see what the lady in your post had to do to save her life. No free lunch for the middle class & property owners.
posted on May 3, 2008 09:22:20 PM new
A friend of mine points out that this lady may have been rejected when she tried to apply for a better policy,thats why she opted for the AARP inadequate policy of $37k max per year.
My friend was turned down by the insurance company for reason that 'SHE IS NOT TALL ENOUGH FOR HER WEIGHT !"
She took out a policy which only covered hospitalisation for 3 years,until recently she finally got approved for a better policy,1k deductible per year,monthly premium is $500 dollars.
(She swam and hired a trainer to show her how to lift weight and lost a few sizes)
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Lets all stop whining !
posted on May 3, 2008 09:28:20 PM new
On the topic of rental property ,there is a lady in town 12 years ago and she has parkinson disease.
She owns 12 older houses not in the best neighborhood but she thought she has enough to stay at a fancy nursing home where they have gourmet dining every night under the chandeliers etc etc.
The cost back then is around 85k a year and she lasted 2 plus years and moved to a cheaper home.
Houses do not appreciate much in Houston,even if she sells one house per year,she could still outlive all her 12 houses.
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Lets all stop whining !
posted on May 4, 2008 06:46:02 PM new
No doubt she was rejected & the only way you can get into a group, where they have to accept you even if your on your last legs, is to work somewhere where they offer & belong to a group insurance plan. My friend is uninsurable privately, too many health problems. A group was her only chance.
The Better Business Bureau that we belonged to & had our group insurance with is how my friend got in. To qualify she had to work for us for 3 months & be reported on our quarterly tax returns. We joined the BBB so we could offer health insurance. They offer ins to small groups as little as two. It's expensive, but believe it or not cheaper than if you enroll when they upen it to the public for a short time & I'm not even sure if they do that anymore. I belive the coverage goes up to 1.000.000.00
We used to be a C-corp, but not any longer & when your in a group & quit the job you can still keep the coverage.
posted on May 4, 2008 07:42:11 PM new
Costco has a plan for small business,someone on Vendio looked into it at one time.
It is good that your BBB has a good group plan,as many so called groups do not get group rate like University alumni association or Ebay tried one time for its powersellers,and the underwriters said there is such a diverse group of people there is no way to quote a fair rate!
One million life time benefits is not enough -you figure a person could easily have 2 mishaps in his life time-cancer and heart disease,each would exceed 500k .
There is an article on a Valero energy salesman who was infected with staph and did not do anything until it was too late.
They have to operate on him to cleanse his organs and accidentally broke his pacemaker leaving a small piece inside his tissues.
Then they have to go thru open heart surgery to remove that broken piece and so now it is more than just staph,it is also heart and he exceeded the Valero group policy limit of one million life time benefits.
But one day he received a phone call from hospital saying he qualifies for charity?go figure,me thinks some big shot at Valero pick up the tab,he has been a good worker for 26 years!
posted on May 5, 2008 10:31:21 PM new
Maybe it's nore than a million, not sure. She has had the policy for about 9 years & each year it goes up between 1 & 2 Hundred dollars.
As for the screw up on the pacemaker, why is it that the hospital & doctors are seldom responsible for their mistakes.
Another friend had open heart surgery, the next dat her vital signs were so out of wack they took her back to the OR & she was leaking blood where the artery was stitched. The really big danger here is that you can throw a clot while on the table & have a stroke, she did.
She can walk, but not very well & her left arm is useless. Her life as she knew it is over all because of a medical mistake. The hospital & doctor took no blame.
