Health isnurance for profit is AMORAL!

So you say. Because I am compassionate, I will share this:

An ORNL isotope is saving the lives of cancer patients in medical trials, and is on its way to helping more Americans as the president prepares to sign new legislation that would allow more patients to try experimental medical treatments.

Actinium-225, an isotope of the element actinium, which is usually found in uranium ores, is proving effective in curing - not just treating - myeloid leukemia.

Myeloid leukemia is a rare and rapidly progressing blood and bone marrow cancer that interferes with the body's production of platelets and normal white and red blood cells.

The cancer is treatable in young patients, but often fatal for people over 60 years of age. That's particularly problematic because the American Cancer Society says 67 is the average age of diagnosis.

in medical trials, Actinium-225 successfully treated the disease in elderly patients. ORNL nuclear medical scientist Saed Mirzadeh said some patients went into remission after only one treatment.

The isotope, when combined with tumor-seeking antibodies, is able to target and kill cancer cells without affecting healthy cells that surround them.

"It works very well actually; everyone is surprised how well this works compared with the other isotopes," Mirzadeh said.

"With leukemia, if even one percent of the leukemic cells are not killed, then there's a possibility that they come back, but for some people, the cells are all being killed in apparently just one treatment. Some had to go and get maybe the second or third treatment."


https://www.knoxnews.com/story/news/2018/05/29/cancer-cure-used-treat-myeloid-leukemia-found-oak-ridge-national-lab/636292002/

I don't know if it will help your wife.

Gleevec stops it in its tracks. However it is actually chemo by pill. It is not a question efficacy but cost.So I say.
 
They don’t have a resconstructive surgeon in our area, the closest one it 54 miles away. They are therefore legally required to then make an exception to the “in network” requirement, but they are saying approval for such will take 6 weeks... the Oncologist says that is too long to wait. We found a reconstruction surgeon willing to accept their rates, but they still refuse to speed up the six weeks.

She is required to have a particular MRI before they will approve payment for her mastectomy but that MRI also requires pre-approval from them, that takes two weeks, for no explainable reason.

That’s just two examples.

Then pay for them out of pocket and submit the claim.
 
This is a discussion board, it’s all hearsay.

Unless you can prove it, it's hearsay anyway.

Want to address the apparent inconsistencies in your story?

Before Obamacare she was uninsurable due to a PEC.

She was only diagnosed two weeks ago. I am saying when I left my job 9 years ago, we lost that insurance and were uninstallable due to other pre-existing issues.

We had Cobra for a while, until it ran out.

So why didn't you have insurance for her, BEFORE she had the PEC??


Why didn't you mention your wife's supposed PEC back in 2014 when you sang the praises of the insurance you boasted of having?

Silly was not relevant, but I really don’t care what you think.

The ACA has helped me in three ways.

1) I was able to get insurance, previously I was excluded for a history of high Cholesterol.
2) My employees insurance, which I pay 100% of, went down about $300 a month.
3) My family's insurance went down $90 a month, and now I am covered.

Oh, and a fourth way.... Many more of my fellow Americans are now insured and that makes my nation more healthy both physically and financially. It takes the stress off the healthcare system and will lower medical care costs drastically in the long run.

1) That is true, I went without health insurance before the ACA passed. (Then I had a provisional program called the PCIP, and now I have regular health insurance)
2) I combined us all into one policy.
3) I got no subsidies.
 
Actually your honor the defendant has proven our case

The insurance company is not preventing Jarods wife from getting a mastectomy

Jarod is requesting specialized care which is not medically necessary and is cosmetic only.

A general surgeon can perform the surgery quite nicely and probably do it tomorrow.

But GayRod wants a higher level of care. That is why it is taking longer.

The prosecution rests its case your honor

All health insurance company contracts are required to cover reconstructive surgery after breast cancer, a law passed during the Clinton administration.

Two surgeries are more dangerous and the results are not as good as two separate surgeries, according to the Doctors.
 
No inconsistency.

Is that your final answer?

Before Obamacare she was uninsurable due to a PEC.

She was only diagnosed two weeks ago. I am saying when I left my job 9 years ago, we lost that insurance and were uninstallable due to other pre-existing issues.

We had Cobra for a while, until it ran out.

So why didn't you have insurance for her, BEFORE she had the PEC??


Why didn't you mention your wife's supposed PEC back in 2014 when you sang the praises of the insurance you boasted of having?

Silly was not relevant, but I really don’t care what you think.

The ACA has helped me in three ways.

1) I was able to get insurance, previously I was excluded for a history of high Cholesterol.
2) My employees insurance, which I pay 100% of, went down about $300 a month.
3) My family's insurance went down $90 a month, and now I am covered.

Oh, and a fourth way.... Many more of my fellow Americans are now insured and that makes my nation more healthy both physically and financially. It takes the stress off the healthcare system and will lower medical care costs drastically in the long run.

1) That is true, I went without health insurance before the ACA passed. (Then I had a provisional program called the PCIP, and now I have regular health insurance)
2) I combined us all into one policy.
3) I got no subsidies.
 
That was before the ACA took affect, once it took affect we got insurance.

Previously you indicated to the forum that your wife's alleged PEC was the cause of your supposed uninsurability, yet in 2014 you gave the cause as your own condition.

Isn't that right?
 
Previously you indicated to the forum that your wife's alleged PEC was the cause of your supposed uninsurability, yet in 2014 you gave the cause as your own condition.

Isn't that right?

No, we were both uninsurable due to PEC, I just did not discuss that previously.
 
Rhonda Orin is the managing partner of the Washington, D.C., law office of Anderson, Kill & Olick, P.C. and represents policyholders in disputes with health insurance companies. She is also the author of “Making Them Pay.” William Shernoff is the senior partner of Shernoff Bidart Darras, a Claremont, Calif.-based law firm that represents insurance policyholders. He’s the author of three books, including “Payment Refused.”

A surprising number of patients have been in the middle of costly treatment for a serious disease only to have their policies canceled, sometimes even retroactively, and found themselves responsible for astronomical bills. It’s called rescission.

"If they find an inconsistency in your application, even if it’s an honest mistake, your policy is rescinded,” says Shernoff.

Some insurance companies will veto a doctor’s orders if they feel the treatment isn’t necessary or consider it experimental, says Shernoff. “They do a lot of denial for newer treatments, especially cancer treatments.” What you can do, he recommends in his book “Payment Refused,” is make sure you read your policy carefully and follow exactly the steps your insurance company requires for filing a claim.

Orin emphasizes playing by the insurance company’s rules. Make sure you know what is covered, she advises in her book, so when you call for preapproval you can say with authority that you’ve checked and have met the criteria for a particular procedure.

If you’ve been denied coverage for a claim, you can appeal to the insurance company, your state’s department of insurance or you can file a lawsuit, says Shernoff.

If you appeal to the company, know that it usually goes to the medical director, who is an employee of the insurance group, he notes.

Have your doctor write a letter explaining why it was a necessary procedure. If possible, include journal articles showing the effectiveness of the treatment. The key is to get the doctor to make a stronger case than the insurance company has and make it hard for them to say it’s not medically necessary.

Many people don’t know that each state has a mandate of treatments that forces health plans to cover certain treatments, regardless of what the insurance company policy is, says Orin.

Not everyone is eligible under the mandates, but if you purchase your policy independently, you definitely are, says Orin. If you purchase it through your work, you might be. Very few policies are rescinded if people are in a group. “There’s more bargaining power,” Shernoff explains.

People are also less likely to have a claim denied if they’re part of a group. If that happens, unhappy policyholders employed at corporations can complain to human resources. And if the employer feels the employees aren’t being well taken care of, it may decide to choose a different insurance company instead.

Individuals who can’t get coverage through an employer should look for a group to join, such as the AARP or an association affiliated with your job. (Occupations ranging from fitness trainers to trial lawyers have associations that offer group insurance.)

Group insurance, such as plans signed up for through an employer, cannot drop you as long as they continue to serve the group you signed up for the policy under and you continue to meet the qualifications -- such as being employed by company that has purchased the group policy. If you lose your employment, you can continue to receive coverage -- even if you are sick -- under the COBRA program, but you must pay the full premiums. HIPAA laws offer further guarantees that cannot you be dropped from group health insurance simply for becoming sick, but you can lose coverage if you lose employment and fail to pay premiums.

Some health insurance companies advertise to attract small mom-and-pop business, Shernoff says. While at first it may look like the policy covers major medical costs, the fine print may reveal that’s not necessarily true.

“You have to be really careful to find out what the benefits really are,” he says.

That includes learning what the insurance company is willing to pay for procedures. Some policies say they cover 80 percent of “reasonable customary charges.” But if a doctor submits a bill for $20,000 worth of treatment, the company could claim that’s not a reasonable charge.


http://www.nbcnews.com/id/20186938/ns/health-health_care/t/things-insurers-dont-want-you-know/#.WxHs431EqUk
https://pocketsense.com/can-health-insurance-companies-cancel-policy-sick-after-issued-7875.html
 

No?

Before Obamacare she was uninsurable due to a PEC.

She was only diagnosed two weeks ago. I am saying when I left my job 9 years ago, we lost that insurance and were uninstallable due to other pre-existing issues.

I was able to get insurance, previously I was excluded for a history of high Cholesterol. My family's insurance went down $90 a month, and now I am covered.

I went without health insurance before the ACA passed. (Then I had a provisional program called the PCIP, and now I have regular health insurance) I combined us all into one policy.

How do you reconcile these statements, Brad?
 
They say that they will not reimburse if you do that because it requires “pre-approval”.

Are you, an experienced legal professional and member in good standing of the Florida Bar, seriously suggesting to this forum that you were unaware of the limitations and provisions of the policy you purchased, Brad?
 
Are you, an experienced legal professional and member in good standing of the Florida Bar, seriously suggesting to this forum that you were unaware of the limitations and provisions of the policy you purchased, Brad?

No I didn’t say that.
 
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