Name:   Lifer - Subject:   100% WRONG Date:   4/25/2016 12:39:59 PM (updated 4/25/2016 12:42:00 PM)

When I posted this I noticed it went in reponse to myslef but was meant for Copper.....so I guess I use the new @Copperline.

Several times in my working career I changed jobs and always kept coverage without any problem save one time.  I changed from BC\BS to some other ( can't remember right now, United maybe ) and went straight in with no waiting or exclusions.  When I changed again and was back on BC/BS and they denied coverage for pre-exixting condition.  I appealled showing group coverage for the same diagnoses and the claim was paid promptly and never denied again

You may can win this argument with some folks, but not me.  I know the laws that were in place before ACA.  I have been a consumer of more health care in my lifetime unfortunately, than most.  I have had 19 MAJOR operations in my life time with maybe a dozen or so hospitalizations that didnt require surgery starting with Rhuematic (sp?) fever when I was 5.  So dont try to convince me the options I have stated weren't there.  They absoulutely were.  

As for your 'client' being refuse emergency care because the hospital wasn't in network is bovine shinola.  EVERYONE knows true emergency care is given in every emergency room in the country.  Your client may have considered it an emergency, but obviuosly the doctors didn't.  No insured, even out of network, would be turned away in a life and death situation, and you and everone else knows it.  That was one if the major rationales of the ACA, that hopsitals had to treat everyone that walked into the ER.  Maybe you "client" had been sick all week but decided to wait till the weekend and use the ER like so many do.  Nothing irks me more than being in an ER needing medical attention and there is someone in the next room that has been sick all week but goes to an ER rather than go to the doctors office.  So give us all the details of your 'cleint' getting turned away.  The whole truth, not your watered down BS.

Don't blame the system if you were an ill informed advocate and couldn't get results for your "client". It is the consumers responsibillity to know their policy.  It is not the companies problem if you don't.  They don't have to explain every option to consumers.  They give you a written policy.  Try reading it.

I know one retired insurance executive that frequents this forum.  He is called many names, none flatering, but aside from being a liberal he is an intelligent and thoughtful person ( I know contradictory statements there...lol). I am pretty sure he and I had a conversation about this in one our discusions.  I know we spoke about diabillity insurance and its rules and regs.  He also has a son that is a prominent doctor in and impoverished area who developed a better system of health maintenanace in the area based on "hot spots" the same as the LEO's in the area operate.

I repect you Copper because you post thoughtful and reasonable essays, mostly wrong IMHO, but you think things through and try to posit solutions to problems,  But on this issue you are DEAD WRONG.  I would say research it, but that didn't work for you when advocating for your "client" so I doubt it will work now.  Given time I will find some relevant info and post or send it to you.  Many folks knew of these solutions and that is why healthcare NEVER polled in the top ten issues Americans were worried about, but folks such as yourself listened to politcal rhetoric rather look at facts.