As some of you know, my husband and I are both self employed. We have been without health insurance for almost a year when he lost his job with employer supplemented health insurance and even though our budget is very tight, we thought the sacrifices we would have to make to pay for health insurance would be worth it in the long run. For those of you who live in countries with National Health or who have it supplemented by your employer, consider yourselves lucky and be thankful you have coverage, even if you think its awful.
We weren't asking for a whole lot of coverage, just something for emergencies and basic wellness. Yes they had a ridiculously high deductible but we thought getting private health insurance would be the responsible thing to do.
They were willing to insure my husband, even though he smokes but when it came to me, they said I DO NOT QUALIFY!! I tried not to cry about this news but if I'm to be honest, I did cry.
They wouldn't even consider insuring me at my current weight...not even with a higher penalty premium. The answer was NO, absolutely NOT!!
I'm 5'8" and I weigh 365 pounds. To even be considered for insurance at a higher premium, I would need to weigh below 220 pounds AND prove that I've maintained that weight for at least one year. To get the non penalty rates (which are still ridiculously high per month) I would need to be below 190 pounds and have maintained it for one year.
Even if by some miracle I were able to lose enough weight to get to 220 pounds by this time next year, they still wouldn't insure me for another year!! That is at least TWO years before I could even be considered for health insurance. Honestly, I've found that many doctors won't even take you as a patient if you are uninsured. Where does that leave me?
In addition to maintaining it for one year, I can't have lost weight with the aid of any weight loss drug or weight loss surgery. They said if I had weight loss surgery they would NEVER approve me. Now I had decided weight loss surgery wasn't for me a while ago. I don't criticize or condemn in any way those who have had the surgery. Do you suppose their refusal to include those who have had weight loss surgery is because the long term effects are still not known? I wonder what their time frame on that would be?
As you all know, I was working on losing weight for many reasons, most importantly for my health. I have faced discrimination at so many levels for so many years because of my weight. I am not going to let this derail my efforts and I'm certainly not going to give the insurance industry credit for inspiring me to lose weight...the inspiration and desire to lose weight was there long before this rejection. This just feels like another form of legal discrimination and yet another kick in the face.
But still, through it all....I will persevere.
Wow, ScaleJunkie...that's a tough one!! I really feel for you! I lied on my insurance paperwork (yes, bad idea) a few years ago about my weight...I said I was 170, I think, when I was really about 215, but I was SOOOO healthy...well, I got a lovely Christmas letter from my carrier saying: you lied. You're dropped, and now YOU have to pay for every doctor visit you've been to for the last 5 months. It was around $2K because my gyno thought I had fibroids (nope, nothing wrong). I'm STILL making monthly payments. SO, I feel for you.
ReplyDeleteInsurance is such an issue in the USA. For years I went back and forth between 2 countries and needed to carry self-insurance myself (for both countries) and it was painfully expensive. It's so scary to be without it also.
ReplyDeleteI don't know about you, but I always feel so humiliated when a corporation tells me I'm not good enough (or thin enough). I DO know what you mean about not letting the insurance company take credit for your healthy changes!
Yikes ~ this whole health insurance thing is ridiculous! I got layed off from my job last June (hubby is self employed - so we counted on my job paying the premiums). Right no I'm eligible for COBRA (which means I can stay at the group rate for 18 months). Had I not been eligible for this my monthly premiums would be $1,680(that's only for me and hubby)! And now you're telling me that those damn insurers won't even cover you?? That is TOTAL discrimination! Does this mean they can drop someone if they gain weight? And how do they find this out? Spys at the Doctor's office? Perhaps one should refuse to be weighed at Dr. visits. The whole thing is infuriating.
ReplyDeleteI have experienced discrimination because of my weight on the NHS here, normally it’s been “You’re Fat” that is why you are depressed… Among other excuses given they often refuse to look past the fat. It’s annoying, it must be a whole lot worse for you when you can’t even get health insurance.
ReplyDeleteWow. That is a crock. I have insurance through my job, and they make the smokers pay a penalty and they are talking about bringing in WW for us. I can only imagine that weight could be next. They told us that if e filled out the online health assessment that we would save an additional 100 dollars on out deductible. My mom said that it was just one more thing they could use against me in the future and possibly drop me. Your story proves her theory.
ReplyDeleteI am so sorry to gear of this. I will keep good health prayers for you. You are doing this for you and not them, and we all know that!
I am so sorry Diana!
ReplyDeleteI HATE the insurance industry. I have horror stories about working that field.
After doing many years with big hospitals paying and denying claims and arguing on the phone with other carriers, I was so glad to tell the big boss where to stick it!
It was the best decision I ever made.
It was my stand for the "little guy!"
If you have not watched it yet - watch SICKO by Michael Moore- it will really show you how our health care system is!
DISGUSTING!
That totally sucks and is total discrimination. It is ridiculous that they insure smokers but not overweight Americans!!! Smoking is a definite choice, which leads to an addiction, of course. But obesity is not always a choice. (Yes, for most of us, it is a choice... or should I say day after day of the wrong choices... but there are definitely exceptions. What about those people???)
ReplyDeleteBy the way, I received my package the day before Christmas. Thank you SO much! I love everything, and look forward to trying out the DVD ASAP. :)
I just wanted to say that I am amazed at your tenacity and drive to lose weight.
ReplyDeleteGood for you to not let the insurance company get you down!
That's so upsetting to me. That would be enough to make me not even want to work with them. I mean, to put such an arbitrary number on like that.. Bleck.
ReplyDeleteIt's just appalling. I don't care- people deserve to have insurance, period. It needs to be de-privatized so that everyone can get it and companies stop worrying about how they can make money from it, because its just ridiculous. I hate it.
Good lord... I work with insurance crap all day long.. this is just horrible.. I HATE INSURANCE COMPANIES.. but on the same note I am glad BCBS insures me... I still cant believe that there is not someway u can find health insurance.. surely there has to be something... I am proud that you will not let this frustrate you to the point of saying what the hell... keep looking for some group out there .. see if there is something even a discount plan is better than nothing... much luck my dear sweet friend..
ReplyDeleteWow that is just the stupidest thing. Maybe you should sue them. ;-)
ReplyDeleteMother effing insurance companies. They deny people left and right, but their executives get wealthier and their buildings get more extravagant every day.
ReplyDeleteCan you try another insurance company? I can think of State Farm, Humana, and Blue Cross - maybe one of them can help you?!?
(And I would have cried, too.)
That's bull. I'm glad you're doing things on your own terms. Here's to hoping that the US finds a way to fix this ASAP.
ReplyDeleteI am totally blown away by your post - I can't even imagine, being in Canada we are all covered, there is zero discrimination and of course we still complain, as we think our having to pay higher taxes is a hardship, well I can't imagine not living with the security of knowing that when I get sick all I have to do is go to any hospital! Next time I complain, I will think of you, and I am totally flabbergasted at the thought - I can't believe insurance companies are able to get away with this, why doesn't the govt step in and ensure that everyone in the US is treated fairly and equally!!!! Something has to be done, you should really write your congressman, call Oprah don't take this one sitting still, this is WRONG!! You are entitled to have a doctor and not go bankrupt seeing one!! I am so angry at the very thought of this!!
ReplyDeleteMaddds
What were you willing to spend on your health insurance? Say, $100/month.
ReplyDeletePut the $100 a month in a savings acct. If you need any medical care, withdraw, otherwise, let it go.
Also, get a credit card that you promise yourself you won't use except for medical emergencies, like hospitalization or so on.
You don't need to be a victim. It is not that hard.
You'll find yourself with a healthy chunk of change in no time, and a great deal of peace of mind. Why pay the idiot insurance companies? Pay yourself! When you qualify for Medicare, cash out!
As for running towards socialized medicine, consider the following - I don't think socialized medicine is the answer for us:
ReplyDelete"The East Anglian Daily Times in Suffolk reports:
Health tourist claims back cash from NHS
A PENSIONER who borrowed more than £7,000 to pay for a hip operation abroad after being told she was too overweight to be treated on the NHS is trying to claim the money back from health chiefs. Former Bartlet Hospital canteen worker Moira Ryan, 69, from Felixstowe, flew to Malta with her son for the successful hip replacement....
The PCT had refused her treatment because of its policy of not providing surgery to most people with a body mass index of more than 35 unless they go through a weight-loss plan....Mrs Ryan said: “I had gone to Ipswich Hospital for an appointment and was told I needed a new hip but ...NHS kept putting me off, telling me to lose weight. I am obese, but I paid my taxes all my life and feel let down badly. I am very, very disappointed - I had to turn to the banks to get a loan...
Mrs. Ryan, who has three children, flew from Stansted with Operations Abroad, which arranged for her to be picked up at her home, taken to the airport, and met off the plane in Malta. She was taken to the hospital, underwent tests, and was operated on the following day.
She said: “I feel brilliant, and I am back on my feet and doing very well. I am out of pain for the first time in five years....
Mrs. Ryan is thankfully doing well now after taking matters into her own hand. She found that being on the waiting list for her hip replacement meant being perpetually put off. No doubt, Ms. Anjelica Allen, the woman denied her hip operation in May for being six pounds overweight, is hoping that won’t be the case for her. In an update on her story, the Gainsborough Standard recently reported that due to the media attention to her treatment, the Lincolnshire Primary Care Trust has agreed to put her back on a waiting list.
But don’t rejoice yet. Besides an undefined wait ahead for her, it appears they’ve loosened their ruling restrictions only for lesser fat women. Women with BMIs above 35 are still being denied routine surgeries, including hysterectomies, until they take part in weight loss programs:
Hip, hip, hurray!
A TOWN woman who made national headlines after being refused a hip operation for being just six pounds overweight has been left overjoyed after hospital chiefs performed a dramatic climb-down. Anjelica Allan, after appearing on The Standard's front page in May, made national news in The Sun, The Sunday Times and GMTV as she voiced her discontent after being refused the op.
Health bosses admitted to The Standard that people with a Body Mass Index (BMI) of greater than 30 - as in Miss Allan's case - were refused hip and knee operations to save the primary care trusts money. But health officials have now overturned the policy - and Miss Allan is back on the waiting list....
Lincolnshire Primary Care Trust (LPCT) made the ruling on funding for knee and hip replacements as part of a savings drive in May 2006 - cutting costs by £500,000 per year.
Patients with a BMI of more than 30, were denied routine surgery - including hysterectomies - under a ruling made when Lincolnshire had three separate PCTs. However, the limit has only been raised to those with a BMI of higher than 35. Patients with a higher BMI will need to take part in a weight loss programmes....
How many people will continue to be denied treatment that can return them to quality, functional living, and will be left to suffer excruciating pain, simply because they are fat? As has been well documented in the medical literature, there is no credible evidence to support claims that fat people don’t benefit just as much as anyone else from joint replacements. There is only one reason for rationing and denying them care."
Hey, be pro-active, start a health insurance company just for people with BMIs. There is money to be made.
This is ridiculous!! I can't believe it - I am definetely glad I live in Germany, let me tell you...
ReplyDeleteGrrr...this makes me so mad, I can't even think straight!
Oh wow... thats terrible news.... thats just wrong!!!!
ReplyDeleteGood luck on your weightloss journey... Its a logn hard road... but we all know how much better we will feel when we start to see light at the end of the tunnel...
Take care and have a wonderful new year...
I just wanted to empathize with you on this. My son was born with cataracts on both of his eyes and required surgery to remove them. My husband, daughter and I carry individual policies and I just assumed that I would pick up one for my son as well. Wrong. I was told flat out that he would not be covered because he had impending surgeries. WTF! Then, I was told that we would have to get the "high risk" insurance sponsored by the state and it would cost nearly $400/month. While we applied for this insurance we were told that my son would have a 12 month pre-existing condition clause meaning that he wouldn't be covered for his eye surgeries for 12 months. Here's the kicker, this pre-X clause was because he had no prior coverage for the 60 days before we applied for this policy - he was only 2 weeks old when we applied!!!! It sickens me that there are people out there manipulating the system to get health coverage, yet when we law-abiding, tax paying people need insurance we are denied. I could scream sometimes. So I know how you feel and wish you the best of luck finding some coverage.
ReplyDeleteThankfully my hubby's got family coverage. I can not imagine life without insurance. HANG IN - HANG ON. I know you want to lose weight - this issue will certainly add to your motivation I am sure! You can do it!!
ReplyDeleteoh my gosh, I am so sorry that you have to feel that kind of discrimination and hurt. That sucks because there are so many people in this world that are overweight and trying just like you are, and its like their efforts are completely ignored. Its ridiculous that you have to "prove" any type of maintenance after a year and its ridiculous that you cant have surgery if you wanted to. whatever happened to it being our bodies?
ReplyDeleteI was denied an insurance policy for taking infertility medications (which I paid for out-of-pocket anyway). I started doing the same thing as Marie. I opened a savings account with ING direct, put away a "premium" payment each month and have a credit card for emergencies. I have taken charge of my own health care - it is the only way to go!
ReplyDeleteThis makes me so mad!! After watching 'sicko' i couldnt believe your government is allowing insurance companies to run for pure profit. It's disgusting!
ReplyDeleteBeing in Canada, I can only feel lucky for our *free* health care. Not free of course, since we pay in our taxes, but I dont think it's much more than you guys. But never having to worry about being covered IS a blessing, and I dont like complaining about it. Just a month ago, my son was choking, and I called 911. I had emergency transport to the hospital, 3 hours in emergency with a chest xray, had an infant transport ambulance come and pick us up and take us to the childrens hospital, and he had surgery to remove crayon pieces from his lung.. we didn't pay a cent. That's when the system DOES work.... i couldnt imagine having to make the decision whether I could AFFORD to make my son healthy... i wonder how much all that would have cost me if i lived in the US??!!!!
I like the idea of putting money aside for yourself in case you ever need anything medically done. It totally sucks, and it must be SO frustrating, but I'm sure you'd feel good to have something put aside for your family in case something DOES happen. :)
Thank God that you don't work for an insurance company. That must be the most soul-destroying occupation to have.
ReplyDeleteLike the insurance company that denies coverage to a teenager who needed a liver transplant. The company kept putting her off until it was too late for her to have the operation. Apparently the parents are planning to sue.
Wow, I had no idea that they did that. I understand that they have to have their rules but it's almost as though they are makeing it so that you can't get insurance instead of helping you. Maybe they need to come up with a plan to help people lose weight like free tools or something instead of denying then and not offering any help.
ReplyDeleteGood for you though, you have a great attitude and I know you will come out on top!