Tuesday, November 05, 2013

Obamacare Might Not Cover Your Preexisting Condition - Just when you think you’ve heard it all

From Forbes, by Fox..it’s utterly incredible
By Robert Book, Contributor to Forbes.com
How many times have we heard, over the last three and a half years, that one of the primary and most popular features of Obamacare is that no one could be denied coverage for a preexisting condition? It turns out that this is just another one of the false claims used to sell the public on a health care reform that seems to move every aspect of health care in the wrong direction.
The Affordable Care Act does indeed specify, in Section 1201, that “a health insurance issuer offering group or individual health insurance coverage may not impose any preexisting condition exclusion with respect to such plan or coverage.” In other words, a health plan cannot deny enrollment, or the plan’s benefits, to someone based on that person’s preexisting.
However, that is not the same as saying that a plan has to include coverage for any particular preexisting condition, and it certainly does not mean a plan has to include coverage for ongoing treatment that a patient started before obtain coverage in an exchange plan on January 1, 2014.
Key to understanding this distinction is that having “health coverage” is not the same as actually obtaining “health care.” The insurance plan has to take anyone who wants to enroll, regardless of their health status or health history – but they don’t have to provide the same treatments, the same doctors, or the same medications that a patient has been receiving.
Last year I could have joined my wife’s cadillac plan as an individual for just a tad less than $1,000/month. BUT… any appt, treatment or Rx for my heart would have to be self pay for 12 months. Now I can do the same thing for $3700 - 6000/month?
Awesome
Apparently, while I cannot be turned away (as indeed I could not, here in Maine BEFORE), that’s not the same as coverage of what ails you. Broken arm, but not what you are sick with.
Is another basic premise of Ocare another piece of bologna?
Do the Ocare team know the answer?
What’s the over/under on that?

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