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Re: [IP] I am having problems getting individual pay insurance

Memories of experiences I had during 1995/96.

At 06/24/2003   04:56 PM, you wrote:
>I have been rejected by Kaiser Permanente because of diabetes (perfectly
>legal is DC) for self pay insurance.  I can appeal with a letter outlining
>        1.   My reasons for requesting the appeal
>        2.   Additional documentation from a licensed health care provider to
>support my appeal
>Does anyone have any ideas about what I can say or what would pursuade them
>to cover me?
>Has anyone else found a carrier that does not reject on the basis of a
>pre-existing, chronic condition?  What can I do to get insurance?
>Any comments/suggestions would be welcome.  You can also reply to
>email @ redacted

Wish I had advice to give you, but I don't.  Being philosophical, I 
recognize confusing health/ethical/moral issues with contractual issues.

For the personal health plans, they are offering a (contractural) service 
if you meet their requirements.   Though it may not be RIGHT, they are not 
required to enter a  contract with any individual......   (OR for that 
matter to continue coverage for a specific Company or Employer.)

Extracted from California Medical Review Questionaire

22      Have you ever been hospitalized, diagnosed or treated for any of 
the tollowlngq Please Place a check (0 m the Yes or No column EVEF?Y ITEM 
Yes No  Yea No
Alcoholism      o Heart attack or other hearf trouble
Serious anemia or other blood dmeases   0 Heart murmur
Arthrltls, gout, or painful joints      0 Hypertension or h!gh blood pressure
Asthma , wheezing       c1 Herma (rupture) ~ Yes ~ No Surgically repa[red
Chronic cough emphysema or other chronic lung dweases   immunological 
deflclency, such as Acqumct Immune Dehclency
Back ache or back m)ury Syndrome (AIDS), Aids-related complex (ARC)
Serious bodily Injury or dmabdlty       Ulcers of stomach or duodenum
Cancer, leukemia or tumors      Venereal Disease
Convulsions, seizures or epdepsy        Persstent Indtgestlon or peptic 
symptoms Diabetes or sugar In urine Medicafron " ~ Oral ~ 
Injection     Kidney condmon, kidney StOfleS
Dtarrhea or colms (chrome) Rectal bleeding or other rectal 
adment       Loss of urine control, bladder problems, or dlfflcult unnatlon 
Ear problems or loss of haanng   prostate problems Tubes now present In 
ears for otltfs meda     Liver conditions ~ Clrrhosm~ Jaundice ~ Hepatttls 
Eye condmon (cataract, Irltm, etc )   Paralysls Strokes 
Glaucoma      serious skin disease, melanoma, psonasls Gallbladder stones ~ 
Yes ~ No Surgically removed       Female organ abnormality Goiter or 
thyroid condltlon    Irregular vaginal bleeding Hay fever or 
allergles       Mental ! ernouonal disorders
Currently on allergy mpctlons   Psychlatnc counsehng
Headaches ~dlsabling) or mlgrame        Drug addctlon or abuse (Please sp6cIfy)

copyright KP.org

My experience was yes answers would result in no availability of 
coverage.  (2  very specific, one time exceptions, were made over 6 years ago)

Extracted from Maryland/W. DC site

Summary: If you permanently move to another Kaiser Permanente or Group 
Health Cooperative service area, your coverage will be terminated unless 
you are covered under live and work service agreement provisions. Kaiser 
Permanente The Kaiser Permanente Medical Care P

copyright KP.org


Through conversations, I have been told that if I leave my current 
"coverage area" I will no longer be eligible for a personal health plan.

Jim S.

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         copyright: 2003, James W. Sandberg; All rights reserved.

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