Freethought & Rationalism Archive

WinAce · 10-23-2005, 04:05 PM

My main hope for getting that life-saving transplant (see www.save-allan.org) is getting private insurance to cover the tab. And the only way I could get it--with my pre-existing condition--is marrying Jess, for her coverage. (It doesn't guarantee success, as they could refuse to pay for it too, and almost assuredly will given the precedent, but it's a possibility.)

Yet, by marrying her, I'll obligate her to pay potentially hundreds of thousands in my medical bills. Whether or not it works, she will be stuck paying off an ungodly sum--complicated further by the recent changes in bankruptcy law, making them more difficult to obtain--which bears heavily on my decision not to proceed. (This would apparently hold true whether or not I pursued a transplant, even.)

Do gay people really inspire that much hatred, that evangelicals would blatantly overlook the positive (as opposed to bitter and reactionary) things they could do to allegedly "protect" or "promote" marriage?

Any chance of the conservative Christian Republicans among us taking up my cause, too? I hear they're very big on "culture of life" issues.

seebs · 10-23-2005, 04:40 PM

Hmm. Tough question. You end up stuck with a marriage which MIGHT give you coverage, and MIGHT stick Jess with bills. Not pleasant!

I recommend to you that you, in the mean time, have a rude wedding, which is to say, a non-civil one. Get some friends together, get married. You are not obliged to inform the state of every petty detail of your life.

Bright Life · 10-23-2005, 05:19 PM

Seebs would know. That's a Quaker-type way of doing things!

Plognark · 10-24-2005, 04:51 AM

I wouldn't do it. Most insurers I know of have some really harsh restrictions of pre-existing conditions of any sort, especially those granted through private companies.

I think it'll cause more problems and, most likely, provide no benefit.

Still, you could take a careful look at the language in the contracts. I wouldn't waste too much time pursuing this option though. :banghead:

WinAce · 10-24-2005, 06:48 AM

I believe HIPAA sets stringent limits on the type and duration of pre-existing condition exclusions if a person has had continuous health coverage with a gap of no more than 63 days, Plognark. They can only last a year or two, and if you have a "letter of creditable coverage" (i.e., something certifying you were medically covered before) you can cut that time by the amount you already had with your old coverage.

That is, if the waiting time before you could get benefits was 9 months, and you were on insurance the past 6 months, they could only make you 3 months. If you were on insurance the whole time, though, you're home free.

The bigger problem is that, while I'd get the insurance, there would be no guarantee it would pay for this specific operation. Especially given the precedent Medicaid set, they could just as well refuse again, calling it "too experimental and risky" in order not to pony up half a millon bucks.

I like the idea of a nud... err, rude wedding though.

Plognark · 10-24-2005, 06:53 AM

Quote:

Originally Posted by WinAce

I believe HIPAA sets stringent limits on the type and duration of pre-existing condition exclusions if a person has had continuous health coverage with a gap of no more than 63 days, Plognark. They can only last a year or two, and if you have a "letter of creditable coverage" (i.e., something certifying you were medically covered before) you can cut that time by the amount you already had with your old coverage.

That is, if the waiting time before you could get benefits was 9 months, and you were on insurance the past 6 months, they could only make you 3 months. If you were on insurance the whole time, though, you're home free.

The bigger problem is that, while I'd get the insurance, there would be no guarantee it would pay for this specific operation. Especially given the precedent Medicaid set, they could just as well refuse again, calling it "too experimental and risky" in order not to pony up half a millon bucks.

I like the idea of a nud... err, rude wedding though.

That sounds right. I'm a commercial and life/disability insurance drone, so this isn't my specialty. My company doesn't even do health insurance, but I know plenty of people who've worked with it before.

Bright Life · 10-24-2005, 06:55 AM

Does Jess now have insurance?

WinAce · 10-24-2005, 03:19 PM

Her job in Raleigh offers Blue Cross/Blue Shield health benefits. But those guidelines [PDF file] state they don't cover lung transplants in cases of “Pan-resistant Burkholderia cepacia in patients with cystic fibrosis.�?

So, where Medicaid would be bitches and deny me for reasons not even in their official guidelines, Blue Cross would be similar bastards, but at least honest ones, since they state up-front they won't.

Not-For-Prophet · 10-24-2005, 04:06 PM

I know this may be a long shot, but Jess may want to look into companies in your area that offer domestic partner benefits. It is becoming much more common, in fact two of the last three companies I've worked for offer domestic partner benefits to unmarried couples and same sex couples. I haven't looked for info, but I would think you may be able to find resources online on who has these benefits. The first thing that comes to my mind would be gay and lesbian advocacy groups.

10-23-2005, 04:05 PM	#1
WinAce Beloved Deceased Join Date: Feb 2002 Location: Carrboro, NC Posts: 1,539	*A real* problem with marriage, not involving gays.** My main hope for getting that life-saving transplant (see www.save-allan.org) is getting private insurance to cover the tab. And the only way I could get it--with my pre-existing condition--is marrying Jess, for her coverage. (It doesn't guarantee success, as they could refuse to pay for it too, and almost assuredly will given the precedent, but it's a possibility.) Yet, by marrying her, I'll obligate her to pay potentially hundreds of thousands in my medical bills. Whether or not it works, she will be stuck paying off an ungodly sum--complicated further by the recent changes in bankruptcy law, making them more difficult to obtain--which bears heavily on my decision not to proceed. (This would apparently hold true whether or not I pursued a transplant, even.) Do gay people really inspire that much hatred, that evangelicals would blatantly overlook the positive (as opposed to bitter and reactionary) things they could do to allegedly "protect" or "promote" marriage? Any chance of the conservative Christian Republicans among us taking up my cause, too? I hear they're very big on "culture of life" issues.

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10-23-2005, 04:40 PM	#2
seebs Contributor Join Date: May 2002 Location: Saint Paul, MN Posts: 24,524	Hmm. Tough question. You end up stuck with a marriage which MIGHT give you coverage, and MIGHT stick Jess with bills. Not pleasant! I recommend to you that you, in the mean time, have a rude wedding, which is to say, a non-civil one. Get some friends together, get married. You are not obliged to inform the state of every petty detail of your life.

10-23-2005, 05:19 PM	#3
Bright Life Veteran Member Join Date: Sep 2003 Posts: 8,345	Seebs would know. That's a Quaker-type way of doing things!

10-24-2005, 04:51 AM	#4
Plognark Contributor Join Date: Jan 2004 Posts: 14,952	I wouldn't do it. Most insurers I know of have some really harsh restrictions of pre-existing conditions of any sort, especially those granted through private companies. I think it'll cause more problems and, most likely, provide no benefit. Still, you could take a careful look at the language in the contracts. I wouldn't waste too much time pursuing this option though. :banghead:

10-24-2005, 06:48 AM	#5
WinAce Beloved Deceased Join Date: Feb 2002 Location: Carrboro, NC Posts: 1,539	I believe HIPAA sets stringent limits on the type and duration of pre-existing condition exclusions if a person has had continuous health coverage with a gap of no more than 63 days, Plognark. They can only last a year or two, and if you have a "letter of creditable coverage" (i.e., something certifying you were medically covered before) you can cut that time by the amount you already had with your old coverage. That is, if the waiting time before you could get benefits was 9 months, and you were on insurance the past 6 months, they could only make you 3 months. If you were on insurance the whole time, though, you're home free. The bigger problem is that, while I'd get the insurance, there would be no guarantee it would pay for this specific operation. Especially given the precedent Medicaid set, they could just as well refuse again, calling it "too experimental and risky" in order not to pony up half a millon bucks. I like the idea of a nud... err, rude wedding though.

10-24-2005, 06:55 AM	#7
Bright Life Veteran Member Join Date: Sep 2003 Posts: 8,345	Does Jess now have insurance?

10-24-2005, 03:19 PM	#8
WinAce Beloved Deceased Join Date: Feb 2002 Location: Carrboro, NC Posts: 1,539	Her job in Raleigh offers Blue Cross/Blue Shield health benefits. But those guidelines [PDF file] state they don't cover lung transplants in cases of “Pan-resistant Burkholderia cepacia in patients with cystic fibrosis.�? So, where Medicaid would be bitches and deny me for reasons not even in their official guidelines, Blue Cross would be similar bastards, but at least honest ones, since they state up-front they won't.

10-24-2005, 04:06 PM	#9
Not-For-Prophet Veteran Member Join Date: Jun 2005 Location: A more free place Posts: 1,272	I know this may be a long shot, but Jess may want to look into companies in your area that offer domestic partner benefits. It is becoming much more common, in fact two of the last three companies I've worked for offer domestic partner benefits to unmarried couples and same sex couples. I haven't looked for info, but I would think you may be able to find resources online on who has these benefits. The first thing that comes to my mind would be gay and lesbian advocacy groups.

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