(Please don't flame me) Question on the health ins

[BuffyR]

Buffy, if you or anyone else has ever been dropped from their insurance plan strictly because they got sick and filed a claim, then you have a case against them. It is illegal in all 50 states to do that. If I am wrong with that statement, then so is Attorney Richard Giller, one of the nation's leading experts on insurance coverage. I've read several articles citing him on this subject.
The troop death count just doubled in Afghanistan recently......

You are looking at at the issue of rescission incorrectly. Rescission happens when an insured gets sick and then the insurer combs through their application to find an inconsequential error i.e, an indisclosed or forgotten back strain, an abnormal pap smear etc. The insurance company will then rescind the policy even if the new illness has nothing to do with undisclosed or forgotten condition. This is extremely common. The insurance company is not rescinding the policy because the insured got sick but instead is trying to find another inconsequential excuse to rescind the policy because they don't want to pay for the new illness or injury. My understanding is that under HCR rescissions can only occur if the insured commits fraud on an insurance application and not just an error.

 

[double t]

You are looking at at the issue of rescission incorrectly. Rescission happens when an insured gets sick and then the insurer combs through their application to find an inconsequential error i.e, an indisclosed or forgotten back strain, an abnormal pap smear etc. The insurance company will then rescind the policy even if the new illness has nothing to do with undisclosed or forgotten condition. This is extremely common. The insurance company is not rescinding the policy because the insured got sick but instead is trying to find another inconsequential excuse to rescind the policy because they don't want to pay for the new illness or injury. My understanding is that under HCR rescissions can only occur if the insured commits fraud on an insurance application and not just an error.

I've never heard of that, but fair enough.

 

[BuffyR]

I've never heard of that, but fair enough.

When I first graduated from law school I worked for an insurance defense firm. One of my primary tasks was to find ways that an insurance company could deny a claim (not specifically for health insurance but for all types of insurance). Rescission for errors on an application was one of primary tools utilized. I really hated that job because I felt like it is so easy to inadvertently omit things on an insurance application. Needless to say I got the heck out of there as soon as I could.

My current health insurance is through a group plan, so there was no application required, but if I actually had to list every ailment, real or immaginery, that I ever reported to any doctor, I'm quite sure I could not remember them all. To think that an insurance company could use my lapse in memory to justify rescinding my policy when I got sick is truly frightening. I really hope that this problem will be solved by the HRC bill.

 

[dr.mel_PT]

You basically have it right. Flex spending will be capped at 2500. Before there was no cap, although employers often did cap it. I believe starting in 2011 over the counter meds will not be able to be reimbursed through flex spending.

I actually read this and did not think much of it. I use flex, but even with my kids braces, which the cost was amortized over several years, I never took out that much. They have done studies on the use of flex, and found that 1400.00 is the average amount people take out a year and the OTC option is not utilized that much. It will have an impact on a few, and if you are the few using it, it will raise your taxes.

I know many people at work don't use the flex option because they are afraid of the use it or lose it way it works. I keep pretty good records, so know how much to put in it, and always am conservative, so I have usually used it by October or November. It is a good benefit and helps lower your taxable dollar.

I don't use it much for OTC stuff either: maybe 1ce or 2ce during allergy season but other than that I just pay my co-pays and Rx refills with it. I'm also very conservative with my cash allotted. I was just curious if they were going to expand the "denied" list to anything beyond OTC drugs.

 

[dorothyrd]

So far, that is the only thing, 2500 cap and no OTC. I don't see this item being a big tax revenue producer as very few people use that high of an amount.

 

[Worknprogress]

I want to take a minute and applaud everyone who posted on this thread. This is a very controversial subject which had the potential, as in the past, to become very ugly but you all made this a worthy, very good debate/conversation.

And thanks for the oodles of info - there were a few tidbits I didn't know!