Just got turned down for health insurance .... SLEEP APNEA

[loudsue]

Did you know that if you have sleep apnea none of the major insurance companies will cover you AT ALL?

The "high risk" insurance pool offered by the State of North Carolina is roughly $12,000 per year. You CAN'T be turned down, but who in the hell can afford that?

[sinkingfeeling]

1. I don't even understand that. If it was life insurance, I could buy the condition would be

'high risk'. But what kind of major health issues are common to people with sleep apnea?

[hobbit709]

7. Dying from stopping breathing for one

I've been on a CPAP for over 6 years now.

[nebenaube]

8. well, let's see...

Obesity, heart disease, stroke, brain damage, cognitive impairment, being accident-prone, high likelihood of unemployment, high likelihood of falling asleep at the wheel. Just to name a few...

[loudsue]

11. True. Not getting enough air is rough on the body.

[Still Blue in PDX]

37. That would be much more likely with UNDIAGNOSED sleep apnea.

If you are being treated for sleep apnea and using CPAP, then the risk of those things happening would be equal to or less than the general population.

Crazy.

[pitohui]

48. it sure would be pretty to think so that these CPAPs are a cure-all

since my friend was dx'd and put on the CPAP, he has had a stroke and multiple pneumonia, has been hospitalized many times

i'm sure the CPAP is better than nothing but to pretend that his risk is the same as the general population is bullshit of the first water

instead of pretending sick people aren't sick, we need universal health care for everyone, even SICK people, now that is what is considered "crazy" since i live in america

my friend is fortunate to be a millionaire, i have to assume a random "general population" person w. his problems would be long dead, CPAP or no CPAP device

[loudsue]

9. People w/ sleep apnea, that DON'T use a CPAP machine

will have their organs slowly break down. When you don't get air, your body doesn't work. So health problems are inevitable.

But WITH a CPAP (breathing) machine, you get plenty of air when you sleep, and you are fine.

That's why I'm so blown away by all of this.

[sinkingfeeling]

28. Thanks for the sensible reply. I knew it was life-threatening. That's why I said I could see

difficulty in getting life insurance.

[Common Sense Party]

55. The OP is about health insurance. I have sleep apnea. I have health

insurance--through my employer, I doubt I would be able to get insurance without the help of my evil corporate masters...

I also have a whopping life insurance policy. I pay a pretty penny for it, but my wife and kids are covered should I croak.

[pitohui]

50. you are not necessarily fine, see my other post

a CPAP is better than nothing, for sure, but you are sure as shit not "fine"

don't know if it's because people don't really sleep that well with a machine on their face or if it's because the sleep apnea is symptom of other problems (obesity for one) but you are not "fine"

i'm going to suggest that insurance companies know the statistics better than we do and they DON'T play to lose

in my opinion, instead of kinda fibbing about the severity of our particular issue and making up reasons why WE should be special, we should just get rid of for-profit health insurance but apparently this will not happen in my lifetime, hence the scrabble for excuses and stories

i don't blame for profit insurance for not wanting to cover someone who has to rely on a machine to BREATHE, if it's about making money for your business, that's what they SHOULD be doing...the blame is allowing for profit gambling/insurance on people's health at all in my opinion

[loudsue]

58. Well, actually, I am with you 100% on that.

We aren't necessarily "fine", but a whole helluva lot better than before the CPAP machine.

IMHO it is CRIMINAL that we have to negotiate an insurance company bureaucracy to decide whether we live or die.

The rightwing idiots keep hollering about "government bureaucracy", but there is no financial incentive for the government NOT to do their job. Insurance company employees are REQUIRED to stand between you and your health care, so they can make a profit.

[SharonAnn]

21. Heart attacks.

[superduperfarleft]

40. In addition to what everyone stated above regarding the potential risks,

there's also the fact that CPAP machines can cost anywhere from $500-$1000. So basically, the insurance company doesn't want to do what's called "buying a claim" by issuing a policy to someone who is guaranteed to need almost a thousand dollar machine.

Not saying it's right, but that's how it's done.

[Yo_Mama]

60. Cardiovascular

It can be a very serious condition.
http://www.health.harvard.edu/fhg/updates/update0905d.shtml

For severe sufferers, there is also a higher risk of accidents (from exhaustion).

[Matariki]

2. I hate this country.

I'm really sorry you have to deal with that.

[loudsue]

14. Thanks Matariki. I'm starting to hate what this country has become w/ republicans in charge

for so many years. They have taken away everything that was decent about the USA.

[dflprincess]

3. Thank God it passed!

:sarcasm:

[Deep13]

5. +1

[loudsue]

19. LOL. Not funny dfl.

They need to OUTLAW insurance companies if they're serious about bringing down costs of health care.

This week, the newly elected republican legislature in NC outlawed medical malpractice claims, for all practical purposes. If they cut off your kid's arms and legs by mistake, the most that child will EVER get is $500,000. For more than that, you have to prove PROVE that the doctor did it with malice.

If anyone in NC thinks that little piece of legislation is going to bring down the price of medical care in NC even one nickel, they are on drugs. The savings will NOT go to the consumer: the savings will go to the CEO who hired the lobbiests to buy the legislators. That is the guy who will profit from this. His already $50 million/year salary just went up. The rest of us just got screwed.

And the funny thing: if this happens to a REPUBLICAN'S child? They're going to blame it on the democrats and "obamacare", and all their buddies will believe them.

[dflprincess]

61. Dark humor

It's how I cope.

Believe me, I really don't find anything amusing about our lack of access to care and the odds that it will only get worse.

[golddigger]

32. Yep! It was "Historic!"

[HereSince1628]

4. It's just an excuse to gouge you, don't take it personally.

[Goblinmonger]

6. That sucks.

I have apnea and I don't even understand it. After you get your CPAP, I don't really even see the costs. I see my doctor for it like every other year and twice a year I need a mask replacement. It really doesn't cost that much but if you don't get the stuff you need the health concerns will just get worse which will cost the state more. I don't get it.

[Maraya1969]

10. Can't you contact the woman who is in charge of national health care now?

Katherine Sebielous I think is her name. There are supposed to be laws against this now. They can't not sell you insurance because of a pre-existing conditions.

[PA Democrat]

13. Yes they can. For adults the law doesn't kick in until 2014.

[loudsue]

15. The state WILL provide me insurance....for $12,000 per year.

I don't MAKE $12,000 per year. I'm not eligible for medicare for another 3 1/2 years. So somehow I'm supposed to get from here to age 65 without insurance...or try to find a job??? There aren't any jobs in my county of 45,000 people. But there's a helluvalot of unemployment to go around!

[Missy Vixen]

25. We have sleep apnea as well

We are lucky enough to own our CPAP machines, so it's just a case of replacing the mask and filter a couple of times a year.

I have brought up the fact that the high risk pool for us is the price of an additional primary mortgage, and would wipe us out financially.

:crickets:

I wish I had anything else to say besides I am so, so sorry this is happening to you.

:hug:

[loudsue]

30. Thank you, Missy. I mentioned that to the woman with the state on the phone

and she really acted like that just wasn't her problem.

People who don't want national health care because their "taxes would go up" don't realize that $12,000 per year per person is one helluva tax? That's even before all the deductibles and co-pays. Americans need an extra $12,000 per year bill like they need a hole in the head.

[Maraya1969]

56. If you make less than 12k you should be able to get medicaid

I just hope you don't let this outcome doesn't stop you from finding another one that may be there.

[dflprincess]

62. In Minnesota the income limit for a single, childless adult to qualify for Medicaid is $8000

and if Mark Dayton hadn't been elected governor people at that income level wouldn't be able to get the help. He was able to enact it with an executive order thanks to some language a DFL legislator inserted into a bill last session when that worm Pawlenty was still governor but refusing to expand medical care.

[Shagbark Hickory]

12. If you can't be turned down, can you just sign up for it when you absolutely need to use it?

What kind of regular proceedures and doctors visits do you have?

[loudsue]

16. There's a 60-day waiting period.

So it's not like you can just get on and off of it.

[Shagbark Hickory]

54. I was criticized for saying this before but I'm going to say it anyway...

I would suggest that if you require ongoing medical procedures, is that you reasearch the costs of having these procedures done in other countries. All other countries control cost of medical procedures and even though non-residents are not entitled to coverage for the expenses, in many countries you get exceptional quality of care, for a fraction of what it would cost here.

I don't have insurance myself, I refuse to buy it on principle alone. But you better believe if I need non-emergency medical care, I'm going shopping.

If I had an expensive medical condition, and the opportunity that I live in this country for is not enough to cover the insurance, I'd move somewhere else.

Don't take that to mean I'm a republican or libertarian that sees it as every man for him or herself. I'm just telling you that in absence of a healthcare system, these are the recommendations that others without insurance have made. I read one story of someone who had a minor injury, flew to Jamaica and got treated faster and for a lot less.

[Matariki]

17. Which brings up the question of what happens when it becomes mandatory?

will some people be forced to purchase insurance at $12,000 a year - or more?

[Missy Vixen]

26. They'll purchase health insurance they can't afford by any stretch of the imagination

or be fined via tax return.

:woohoo:

[davekriss]

49. You're forgetting the subsidy

Someone earning, say, $35,000 per year and is single will pay around $150 per month for that $12,000 policy.

[Shagbark Hickory]

53. Just just speculation tho, isn't it? Who knows what its going to cost b/c it's "free market"

insurers supposedly competing for customers.
Ordinarily competition is a good thing for consumers but as we know, the insurance cartels are aces at controlling the medical and hospital costs so that nobody can compete.

[Matariki]

64. Until next year when Congress stops the subsidy because it's a "hand out"

along with every thing else they are talking about cutting - like Social Security and Medicare.

[kenny blankenship]

18. Reminds me of another horror story involving MAGNA, one of the biggie insurance mafiosi

They won't flatly turn you down if you have cellular respiration, but you get some fine print tacked on at the bottom of the contract that says in effect that if you have cellular respiration, no claim made by you, your physician or hospital will ever be paid. Cellular respiration leads to glycolysis, they explain if asked about it, but do you know how many people have cellular respiration? Bunches. Meanwhile they're happy to take your money, year after year, while your chances to emigrate to a country with actual health care waste away and dwindle to zero.

[glinda]

20. MN. Congressman and Muslim disliker, Chip Cravaack, gets thousands of

dollars for disability each year for his sleep apnea because he will not treat it.

[Brickbat]

22. Yup. And his union pension.

[Brickbat]

23. And actually, writing to him might not be a bad idea.

[glinda]

39. Lost cause. I wrote to him opposing a Mining project and is response was totally anti-planet. Tool.

[Brickbat]

43. Well, of course. But something that he actually gives a shit about might be interesting.

Particularly if one then goes to the press with it.

[glinda]

44. I wouldn't waste my time writing to him. He is a plant for raping resources. He cares for nothing.

[loudsue]

27. How can he stand not to treat it? You feel like crap when you have

sleep apnea and don't treat it.

[glinda]

41. Money is more important in the eyes of a Dominionist. Either that or he is

a liar. Ya think?

[asjr]

24. I use my CPAP machine every night. Until

I was diagnosed with sleep apnea and got on the machine I had never had a full night's sleep. I admit I have everything else wrong with my health but I do sleep well now. I am covered by Medicare. I suppose if I didn't have medicare I would pay a very high premium for insurance.

[loudsue]

29. I'm sure your health being poor is a result of not having enough air

while you were sleeping for so many years. The change in my life after the CPAP machine was dramatically better.

[W_HAMILTON]

59. Questions.

(1) Did you have to receive a referral to get checked out for sleep apnea, or could you make an appointment with a "sleep specialist" yourself?
(2) How did it work when you had to go in for the sleep test? Do you stay there all night? Do you just go and take a nap? Do they have a bathroom in case you need to get up during the night?
(3) How restrictive is the CPAP mask?
(4) How hard is it to maintain the CPAP machine?

[asjr]

63. I had a referral from a doctor who told me

about a class being held in the city. My medicare paid for it but only the 80%. I do not have medigap insurance. It took two nights. First night was a test for sleep apnea. I thought I had not slept at all and I was correct since the test showed I had awakened 57 times during the night. The next night I slept (I use that term loosely) with the CPAP mask on. I was a little uncomfortable at first because I had never had something on my face at night before. I did sleep. So there was no doubt I had sleep apnea. Medicare pays for the machine and the masks and things that go with it. Check with your doctor to see where you might take advantage of the tests. I just wish I had it years ago. It takes some getting used to--about two weeks for me, but the first night I slept through from 9:00 pm until 7:00 am the next day I was very glad I was on the CPAP. I have had no more sleeping problems. Hope this helps. It is the difference between night and day as they say.

[sinkingfeeling]

31. Are you a member of this group: American Sleep Apnea Association?

http://www.sleepapnea.org/index.html

They have an essay about insurance here: http://www.sleepapnea.org/resources/pubs/publawyer.html

Wonder if the association couldn't get some type of group insurance.

[loudsue]

36. That's a good reference site! Thanks sink!

I don't see where they've tried to get group insurance on their own.

[spartan61]

33. OMG, I was just diagnosed with sleep apnea.

I'm waiting for my CPAP mask and instructions. At my initial sleep test I was told that I stopped breathing 137 times. What the hell do we buy insurance for if we can't use it when we need it?

[loudsue]

35. I'm sorry you have it, spartan, but I'm glad you got a CPAP machine.

It can turn your life around in such a good way. Your sleep apnea sounds very severe, so I'm sure you will enjoy breathing again. For some of us, it takes a while for the healing process to begin, even though the sleep starts getting better right away. If you've gone a long time with sleep apnea untreated, your body really starts to wear out from the strain, and it takes a while to heal all those organs that have been deprived. Good luck!! :hi:

[BobbyBoring]

34. Bummer

It's a fucking shame that even the shame of 'HCR" doesn't help with this yet and I doubt it will. One of the biggest pros of HCR was not allowing insurance Co. to discriminate against those with pre existing conditions. I guess that kicks in in 2014?

Don't despair though. Maryland has a high risk pool that I'm in. Initially, the premiums were high but they now have a program for low income people like me (musician). Maybe your state does too. Worth checking out.

Even with out insurance, you should still be able to get help with sleep apnea. The masks are pretty inexpensive and seem to work.

Best of luck!

[Still Blue in PDX]

38. That rewards people for not getting diagnosed and treated.

:scared:

[Dappleganger]

42. Single payer is the ONLY answer.

:hug:

[loudsue]

45. I'm with you. Single payer would have made this whole mess go away,

I just cannot afford to buy $12,000 worth of health insurance every year.

[Dappleganger]

46. Only the rich can do that.

The system is rigged against us, remember? That's as much as a mortgage for chrissakes, and doesn't include your co-pays, deductibles or meds no doubt.

[Jane Eyre]

47. Inclusive Health

If you have been without insurance for 6 months and you were turned down for insurance coverage due to a pre-existing condition, you can get the federal option for health insurance at a more reasonable rate. Here is the link:

http://www.inclusivehealth.org/

[loudsue]

57. Well hello, stranger! And thank you for the link

I had actually called this morning before I started this thread, and the woman on the phone told me something that was not true, according to the web site you linked: she said that the high risk insurance pool premiums would be around $800 per month w/ a $4000 deductible, and that the plan didn't pay ANYTHING until the dedeuctible was met. According to the site, that isn't what the rates are. The woman I spoke with must be new at her job and just didn't know. I hope that is what the case was, because according to the link you sent, I wouldn't be turned down, and I would qualify for a lower rate after I've been uninsured 6 months.

I'm still looking into this option, and I hope it works!

[Rex]

51. Private insurance is run by the devil.

Such an evil thing to tell someone 'no' to a life threatening condition. I have it too and if I stop breathing one day, it is still be better than living in a country that lets people die over money.

[Horse with no Name]

52. Only healthy people need health insurance silly

BUT...please let me say this. I hope you are being treated.

I had a patient in their 50's, a bit overweight, who had an elective surgery and no other problems but had undiagnosed sleep apnea.

In the middle of the night when I was making my rounds, he had a "weird" snore. It was bothersome. I woke up his wife and asked her if that was normal for him--she started laughing and carrying on.
He woke up and started laughing and said that I should hear all of the OTHER noises he made in his sleep.
BUT, it was bothersome. I had my charge nurse listen to him also after he went back to sleep--she said that as long as it was "his" normal like they said it was, not to worry about it.
BUT, it was bothersome.

My last round was a 6 am. He was still snoring and making noises.

When I gave report to the oncoming nurse, I explained to her about what I had observed. She said he would be the first patient she would look at it and she would pass it on to his doctor when he made his rounds.

She went into the patient room at about 7:30. He was still asleep. She didn't awaken him. He and his wife were still sleeping--she went to the next room.

The doctor went into his room to make his rounds at around 8:30 and give his discharge instructions. Wife was sleeping. Patient was dead. Autopsy said it was sleep apnea.

Anyway...please get it checked and I am sorry about your health insurance.

This country sucks so bad anymore.