by sdchargersfan » Tue Dec 09, 2008 11:52 am
I have a question. I work with a 'client' who had Diabeties ( not sure how to spell it..) and ALOT of Health problems. He has had one of his legs ( from the knee down) amputated BECAUSE of this. He is a VERY large man...overweight. He's in a wheelchair. There is ALOT of things that he needs (a NEW wheelchair because his is wearing out, a Nebulizer, etc.)however, his 'insurance' says they won't cover alot of it. he is on Medicare. His health problems ARE getting worse because he drinks QUITE ABIT!!..'Self-Infliction..I guess you can say. He's looked at OTHER insurances.....because of Pre-Existing problems, the insurance companies he has looked into are 'dening' him or the payments would be SOOO high, he wouldn;t beable to afford it. Any advice?
Posted: Wed Dec 10, 2008 07:59 pm Post Subject: uninsurable
I would check into your state high risk pool. I know in Indiana and Illinois there is one. Check out Indiana's at ICHA.COM or google Indiana Comprehensive Health Care Association.
Hope it helps
Posted: Thu Dec 11, 2008 04:57 am Post Subject:
Nearly forty six states in USA require some or the other form of mandatory coverage for diabetes. It'll cover both treatments for diabetes and associated complications.
Sd, your client may receive coverage from the Blue Cross Blue Shield, since its suggested that they are required to offer coverage to the residents of PA regardless of their health status, but this information requires confirmation. Please, check out with the state insurance department for more information.
Posted: Thu Dec 11, 2008 05:07 am Post Subject:
Hey, some of the states follow the policy of guaranteed issue of health coverage, which implies, that an individual can't be turned-down for health coverage because of his health condition. Some states may also ensure that one is not charged extraordinary rates for health coverage, it's called community rating. The cost of the coverage gets shared between the customers of the same risk group and therefore doesn't strain one's pocket too much.
You really need to find out the state laws regarding insuring individuals with high health risks and/or uninsured.
Posted: Thu Dec 11, 2008 11:45 am Post Subject: insurance
I appricaite everyone's advice and coments on this. I'm just trying to figure out where my 'client' can go, to get the coverage he needs. Thanks, again. It's heatbreaking to see people struggle because they can't get what they Medically need.
Posted: Sun Mar 15, 2009 11:04 pm Post Subject:
I was reading your post...do you still have dealings with this client? You stated he was on Medicare...He would qualify for most of the programs out there because Medicare Part C Programs are guaranteed issue. If he is on Medicaid, there is a really good program that would pay for durable medical equipment, all of his diabetic supplies, OTC drugs, and a whole lot more...and it will cost him NOTHING! There are some other programs available depending on the state as well.
It is sad to see how many older clients are not able to get what they need! Send me a message if you need any more specific information!
Posted: Mon Mar 16, 2009 12:41 am Post Subject: insurance
Hi, CHRIS. No, I no longer take care of this 'Client'. As a matter of fact, 'our' agency cancelled his services. I'm not sure why, however. Thanks for the help, though.
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