WarriorSpouse wrote:MissMolly, Thanks for sharing your story and the specifics with the ACA. No doubt the ACA has been helpful for those in similar positions. I would not expect those policies to change, since they are mostly covering those who need it most. The premiums and deductible appear to already be priced in for pre-existing conditions. I am not certain if what you are reading, if passed, may actually put more people on the ACA plans, and in a weird way, could lower premiums there by increasing the pool of ACA consumers. Time will tell, but clearly Congress did not have the appetite to fully eliminate the ACA, and for good reason.
NH Mike, Thanks for sharing the Dana Farber / Norwegian article. This is another example of the national plan doing cost benefit analysis and dictating what they will pay for and not. Fortunately, for the patient she has a legitimate reason to be seeking treatment at Dana Farber in Boston.
BoxHill, I am sorry to hear of the position you describe. I have provided some ideas based on my limited knowledge. I would suggest using the hospital's oncology nurse navigator to help you find additional things that we are not discussing here, that may also help if needed in your area. Good luck in your process moving forward.
Does anyone else have a story to share where a cancer drug is being denied simply due to the cost that will not be covered by Insurance or the State run program, similar to the UK and Norwegian articles linked above?
Please refer to a reputable news source to become informed of the current legal challenges being filed in federal court regarding pre-existing conditions.
The filings are contesting the constitutionally of medical insurance providers to be required to cover for pre-existing conditions, as is now mandated by the Affordable Care Act. It is a calculated attempt to have the mandates of the ACA declared unconstitutional and the provisions of the current law deemed unlawful. The federal filings, if successful, would erase coverage for pre-existing conditions and would be a seismic affront to the hard-won protections now enshrined in the law. I suspect this matter will wind its way through the federal court system to the Supreme Court.
I would include a link to a mainstream news source but I am technically naive as to how to post a link on a personal forum post such as this.
Protection for pre-existing conditions should be of vital interest to anyone and everyone. Any inkling of an infirmity on your medical record can be considered a pre-existing condition by the purveyor of an insurance adjuster. Example: A discussion of irritable bowel with your MD can be used against you in later years if there arise gastrointestinal symptoms to deny coverage. Asthma, depression, diabetes, attention deficit disorder, seizures, seasonal allergies, hypothyroidism, - the list is endless of pre-existing conditions that follow a person on their medical record. The passage of the ACA and its legal protection for pre-existing conditions is something that protects people from the very real threat of medical bankruptcy.
The Affordable Care Act affects not only individuals who purchase medical insurance on the open market but also employer based plans by specifying the legal obligations of medical insurance providers in the scope of services that must be covered. The recent federal filings challenging the pre-existing condition coverage mandate of the ACA should have everyone concerned.
Anyone can have my misfortune of falling ill and being unable to sustain employment that provides for employer-provided medical insurance benefits. Anyone.
And the truth is that everyone will be “sick” and require access to healthcare in their lifetime. Anyone who feels that they are healthy and can forego medical insurance is myoptic.
The pricing structure of healthcare in this country is in the stratosphere and beyond the ability of even the financially secrure to self-pay. And healthcare pricing does not take into account the benefit, or lack of, for the healthcare expenses incurred. For all of the healthcare services that I access, my quality of life is marginal and my state of health poor. I am barely treading water.
We are in troubled times as a nation and as a world.
WarriorSpouse wrote:Again, has anyone have evidence of being denied a drug or treatment that is known to work for the patient due to costs, similar to the UK and Norwegian examples referenced above. Thank you.