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MineralMan

(146,248 posts)
Tue May 2, 2017, 10:08 AM May 2017

Pre-Existing Conditions - If You're over 50, You Haz 'Em.

If you're taking a statin drug to lower cholesterol, you have a pre-existing condition. If you're on even a low dose of blood pressure medication, you have a pre-existing condition. If your doctor has told you that you might be pre-diabetic, it's the same story. If you're taking an anti-depressant medication or any other psychiatric meds, you have a pre-existing condition. If you're a woman of any age, odds are high that you have some pre-existing condition, even something like mild osteoporosis. As far as the insurance companies are concerned, just about everyone past 50 is almost certain to have some pre-existing condition.

Health insurance companies have used that pre-existing condition excuse to raise health insurance rates for a very long time. ACA stopped them from refusing coverage, but any repeal is likely to remove that very important factor.

So, if you're talking to someone over 50 who wants Obamacare to be repealed and replaced by some Republican healthcare bill, remind them that they almost certainly have a pre-existing condition. Help them to understand that they may be at risk from an ACA repeal.

84 replies = new reply since forum marked as read
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Pre-Existing Conditions - If You're over 50, You Haz 'Em. (Original Post) MineralMan May 2017 OP
If you are female of any age you have them. nt DURHAM D May 2017 #1
So it seems to me. MineralMan May 2017 #8
Women have always been rated up. DURHAM D May 2017 #14
Yes, and very unfairly so. MineralMan May 2017 #15
Simply being female... 2naSalit May 2017 #35
I have a number of pre-existing conditions. Gothmog May 2017 #2
So do I, but I'm on Medicare now, and the MineralMan May 2017 #4
Medicare Supplemental Plans (Medigap) - do they raise premiums based on age? progree May 2017 #28
I chose a Medicare (Cost) supplement MineralMan May 2017 #33
Thanks much for the info! I fear surprise medical bills from a surprise out-of-network provider progree May 2017 #41
You definitely need to confirm that everyone's in system if MineralMan May 2017 #47
Thanks! progree May 2017 #51
One thing that most people miss about the 80/20 split ... hedda_foil May 2017 #61
The danger is to people over 55 who have been laid off by their companies. redstatebluegirl May 2017 #58
AND to people of any age who went ahead and had Hortensis May 2017 #83
Exactly! redstatebluegirl May 2017 #84
I'm a female over 50. cwydro May 2017 #3
I hate you MFM008 May 2017 #5
I love exercise. cwydro May 2017 #65
You're fortunate, then. MineralMan May 2017 #7
Well then I HAVE to assume Brainstormy May 2017 #9
Um yeah, it sure isn't what I'd like it to be lol. cwydro May 2017 #70
68 and no pre existing conditions HockeyMom May 2017 #36
Just the fact mercuryblues May 2017 #38
Yup, in many states, women paid more. MineralMan May 2017 #39
I'm over 60 and all I take are vitamins. calimary May 2017 #46
Good for you IronLionZion May 2017 #57
Certainly true. cwydro May 2017 #72
I'm 55, and I don't have any either...thankfully. Knock wood, etc. adigal May 2017 #62
Unfortunately, the insurance companies don't see it that way ecstatic May 2017 #68
I'm on Medicare, but take no meds either womanofthehills May 2017 #71
+1000 smirkymonkey May 2017 #6
Truth... Wounded Bear May 2017 #10
Yes. Sadly, the insurance companies consistently raised MineralMan May 2017 #12
"reduce the Medicare age to 50" was one of the ACA provisions in 2008. was dropped so the Act passed Sunlei May 2017 #22
Yeah, several progressive measures were briefly considered and then dropped... Wounded Bear May 2017 #23
If Republicans stopped pushing all the stuff to benefit 'for profit' Corps & dropped medicare to age Sunlei May 2017 #26
If they're over 50 and supporting Trump, I want them to suffer horribly. My KingCharlemagne May 2017 #11
I don't want anyone to suffer. What I want is for people to get MineralMan May 2017 #13
Well to be perfectly cynical malaise May 2017 #16
Yes, of course. MineralMan May 2017 #17
Isn't that the truth malaise May 2017 #24
You know, it's a wonder we survived our childhood at all... MineralMan May 2017 #34
Well they let us hurt ourselves malaise May 2017 #40
But at least we rode bikes Ron Obvious May 2017 #54
Very true malaise May 2017 #55
My husband (73) hasn't ever smoked, drank and always ate sensibly. sarge43 May 2017 #25
Yep - old is a pre-existing condition if you're lucky enough to grown old : malaise May 2017 #27
Age affects us all, healthcare-wise. The Insurance companies MineralMan May 2017 #43
Free single payer for all is the only decent solution HoneyBadger May 2017 #52
45 is America's pre-existing condition. forgotmylogin May 2017 #18
I see what you did there... Wounded Bear May 2017 #20
Yes! Exactly! Lyricalinklines May 2017 #59
+1 uponit7771 May 2017 #66
Yep. 50+ year old with mild to moderate psoriasis, otherwise healthy Freethinker65 May 2017 #19
Yes. Although you're otherwise healthy, MineralMan May 2017 #21
My daughter has psoriasis. However, the Doc diagnosed it as seborrhea dermatitis. progressoid May 2017 #31
Atopic dermatitis HockeyMom May 2017 #44
Over 50 LittleGirl May 2017 #29
Life as far as I'm concerned is a "pre-existing condition". mwooldri May 2017 #30
I remember being afraid to see a doctor cilla4progress May 2017 #32
If the Republicans get their way on health care PA Democrat May 2017 #37
Another example: arthritis--many people over 50 have at least spooky3 May 2017 #42
Another: prostrate cancer sarge43 May 2017 #45
Typically, though, that occurs after Medicare age. MineralMan May 2017 #48
A review of your medical records marybourg May 2017 #81
Yes. The list is long. spooky3 May 2017 #82
anyone who supports any kind of GOP plan Locrian May 2017 #49
At least being eaten by lions and tigers would be relatively quick. The Velveteen Ocelot May 2017 #53
The GOP is America's pre-existing condition. And Trump is another fistula. C Moon May 2017 #50
Chances are, if they support "repeal-and-replace"... benpollard May 2017 #56
And that's only part of it. Amimnoch May 2017 #60
Charging more for coverage for people with pre-existing conditions is nuts, too. Vinca May 2017 #63
i couldnt get life insurance because i have fibro. mopinko May 2017 #64
Help them understand? Can someone help ME understand how ecstatic May 2017 #67
More people know nothing about healthcare MineralMan May 2017 #69
Uggh. Fair enough. ecstatic May 2017 #73
If they're allowed to force genetic testing on us all- everyone will have them. bettyellen May 2017 #74
Raising Hand ProfessorGAC May 2017 #75
Yup, and five years to go before Medicare kicks in. MineralMan May 2017 #77
Then BLOTUS has a pre-existing condition MFM008 May 2017 #76
Yabbut, he can afford to be insured. MineralMan May 2017 #78
18 months from Medicare Dan May 2017 #79
Actually studies have shown plaque on vessel walls starts are early as the 20's--or even younger ismnotwasm May 2017 #80

MineralMan

(146,248 posts)
8. So it seems to me.
Tue May 2, 2017, 10:26 AM
May 2017

For the insurance companies, even being of child-bearing age looks like a pre-existing condition to them. Then, there is menopause, which raises the risk of other conditions. A note on a mammogram report of fibrous breast tissue alarms insurance companies, too.

Those companies would like to be able to charge women more for health insurance from the very beginning, I'm sure.

MineralMan

(146,248 posts)
15. Yes, and very unfairly so.
Tue May 2, 2017, 10:44 AM
May 2017

It's just another bit of evidence of systemic misogyny in this country. We need far more women in legislative offices, and have needed that for decades. The current situation remains abysmal, in that regard.

I was so hoping that Hillary Clinton would be our President. That she is not is a result of a disastrous failing on our parts in 2016.

MineralMan

(146,248 posts)
4. So do I, but I'm on Medicare now, and the
Tue May 2, 2017, 10:18 AM
May 2017

supplements sold by the insurance companies don't seem to care about them. The danger zone is largest among people who have not reached the age of Medicare eligibility, but who have any sort of condition that is considered by the insurance company to be a risk, and that's a long, long list of conditions.

progree

(10,889 posts)
28. Medicare Supplemental Plans (Medigap) - do they raise premiums based on age?
Tue May 2, 2017, 11:14 AM
May 2017

Like you, I'm in the Twin Cities (Golden Valley in my case)

I just got on basic Medicare, but as you probably know, Part A (Hospital Insurance) has some serious limitations and Part B (doctor visits, out-patient procedures etc.) pay only 80% -- the 20% that the person has to pay would bankrupt many seniors with a 6-figure set of medical bills. To overcome that I have the choice of (a) Medicare Advantage or Medicare Cost or (b) a Medicare Supplement policy (Medigap)

I've gravitated towards Medigap because of the no-networks thing. But now I look at the premiums in the "Heath Care Choices for Minnesotans on Medicare" book ... and then I read in the Medicare publication, "Choosing A Medigap Policy: A Guide", it says

Each insurance company decides how it’ll set the price, or premium, for its Medigap policies. It’s important to ask how an insurance company prices its policies. The way they set the price affects how much you pay now and in the future. Medigap policies can be priced or “rated” in 3 ways:
1. Community-rated (also called “no-age-rated”)
2. Issue-age-rated (also called “entry-age-rated”)
3. Attained-age-rated


And they go on to explain that community-rated don't raise the premiums based on your age -- everyone pays the same rate no matter how young or old. Whereas in the attained-age-rated, they raise the premiums based on your age. And that book says to call each insurance company you are interested in and find out..

Really crucial information because one can't switch Medigap policies (e.g. from "K" to "N&quot or providers later on and still retain the federal guarantees of guaranteed - issue and no medical conditions discrimination in premiums .... So I see my "job" as picking one that I can stick with for as many years as possible.... Meaning the plan with the higher premium in the book might be the cheaper one in the long-run if they use community-rated (don't charge older people more), compared to one that does charge older people more.

I talked to someone at the Senior Linkage Line, and it wasn't a helpful conversation, on the one hand she said the premiums listed in the "Health Care Choices" book were "flat rate" but on the other hand said it was up to the insurance company whether they raised premiums based on one's age. (Sigh)

Sorry about the wonky question, but maybe you plowed this furrow already... since you mentioned "supplements sold by the insurance companies" and that you are on Medicare, I'm guessing you have a Medigap policy or at least looked into them.

Maybe off-topic too, but age is a "pre-exising condition" that is guaranteed to get worse...

Thanks

MineralMan

(146,248 posts)
33. I chose a Medicare (Cost) supplement
Tue May 2, 2017, 11:31 AM
May 2017

back when I first got on Medicare. Mine's with Blue Cross/Blue Shield of MN. It's their Platinum Blue plan. It has a network, but in Minnesota, that network covers about all of the major healthcare systems and Hospitals. I'm paying $114 per month, and there's no pre-existing conditions or age related limitations on it. It has gone up only $5 over the six years I've had it. I don't have Part D coverage, since my meds are cheap and because I can sign up with the VA for pharmaceuticals if necessary. However, if you don't add the Part D the first year, the cost goes up if you add it later. It's a planned risk sort of thing, really.

I'm not a big fan of Advantage plans, since people I know who have been on them get frustrated by their pre-approval requirements for surgeries and specialist referrals.

While it all seems complicated that first year, I'm glad I chose the Blue Cross plan I picked. I haven't paid a cent for any healthcare needs since I turned 65. My mother-in-law, who recently died at 88, never paid a cent for her healthcare, either, with the same plan I chose, and she had some serious issues and hospitalizations.

Once you pick a plan, if you like it, you can just let it roll over from year to year. They send out premium notices each year about the time the open enrollment period comes around, so you can check and switch at that time if you feel the need to do so.

From what I could tell, all of the (cost) plans had about the same premiums, so I chose the one with the widest network. In Minnesota, we have excellent levels from the major healthcare systems, like Allina (my choice), Healtheast and others. The Blue Shield network pretty much includes all of the major systems. My Allina multi-specialty clinic covers almost all specialties, and has a good group of primary care docs, too.

Do your research, but don't fret too much over the choice. That's my advice. Opt for one of the higher-level plans and you'll be covered for just about everything 100%. If you travel, make sure that coverage is good, as well.

I think many people overthink this. In Minnesota, at least, there's enough competition to keep the playing field fairly level.

progree

(10,889 posts)
41. Thanks much for the info! I fear surprise medical bills from a surprise out-of-network provider
Tue May 2, 2017, 11:47 AM
May 2017

I worry a lot about all the horror stories I read (including in Minnesota) where someone has a major surgery. They were careful in advance to verify that the hospital is in the network, the surgeon is in network, maybe the radiologist and the lab and the anesthesiologist and on and on. Or they relied on the health insurer's listing. And then voila', somebodies is not in network and sends a bill and the insurance company won't pay a dime.

Google "surprise medical bills"

Oh, here's a Minnesota story:

Blue Cross Blue Shield pays back $328K over misleading website, Kare11, 4/24/17

http://www.kare11.com/news/bcbs-to-pay-back-328k-over-misleading-website/433847257

When we met Jay Craswell months ago, he was frustrated with his health insurance
company ( http://www.kare11.com/news/minn-man-wins-battle-over-surprise-medical-bills/385353845 )

... Doctors and hospitals listed as "in-network" when he signed up for the Blue Cross Blue Shield Consumer Value Network were actually out of network when he visited them.

... And KARE 11 found others, like Joel and Julie Smith, billed thousands of dollars in "out-of-network" costs for doctors who thee Blue Cross website listed "in-network" when consumers signed up. And according to the Minnesota Commerce Department, BCBSMN knew those providers would drop out of network before consumers could use them.

.... But the Commerce Department held Blue Cross Blue Shield of Minnesota accountable, fining the insurer $45,000 with the agreement BCBS voluntarily pays back nearly $328,000 in surprise medical bills to at least 400 Minnesotans fooled by the misleading website.

A BCBS spokesperson said the insurer reprocessed the claims and paid back the money in 2016.

MineralMan

(146,248 posts)
47. You definitely need to confirm that everyone's in system if
Tue May 2, 2017, 12:09 PM
May 2017

you're going to have surgery. My wife recently had a hip replacement. To avoid the risk of a non-network problem, she had to have it done in an Allina hospital (United in St. Paul) where it was guaranteed that no non-network people would be involved. If you need immediate surgery, that could be more difficult, but you can make certain that everyone's in network beforehand and get that in writing.

Prior planning for where to go if you have an emergency should be job one, long before any such emergency occurs. Then, you tell the ambulance what hospital to take you too. Once you're covered, you should call the supplement insurer which hospitals are in their system and ask whether anyone who might be involved in an emergency is out of network. The major health system hospitals generally only work with in-system people, even on an emergency basis.

Fortunately in Minnesota, we're blessed with a great range of major networks that own their own hospitals. Get started by switching to one of the networks multi-specialty clinics for regular healthcare needs, and use the network's hospital and you'll be OK.

It's not too difficult to do, but you have to have that information in advance of an emergency need. Then, when you have to call 911, you tell the ambulance which hospital is your choice or have your significant other do it if you can't. That will prevent almost all issues. In Minnesota, the healthcare network you choose should be one of the major ones. That way, you can access any specialist needs and any hospital or surgery issues within that covered network.

Choosing your healthcare network before choosing a supplement coverage is really the most important issue. BS/BC of Minnesota has arrangement with more networks that the others, simply because of their size. I like Allina, but HealthEast is also very good, based on my discussions with friends.

progree

(10,889 posts)
51. Thanks!
Tue May 2, 2017, 12:27 PM
May 2017

BTW I did get a prescription drug plan -- only $31/mo, $0 deductible (SilverScript). Even though I don't take any drugs, but blood pressure and cholesterol have been creeping up, so I expect to in the not-too-distant future.

The penalty for not signing up within the initial enrollment period window looked pretty hefty: For example to delay 1 year, would be $51/year added to one's premium for the entirety of one's life (for a 20-year life expectancy, that's $1020). And actually that $51/year figure goes up as the "national base premium" goes up, and who knows how fast that will rise in the future. It rose from $34.10 in 2016 to $35.63 in 2017, a 4.5% increase.

[font color = red]On Edit[/font]: revised above for the 2017 national base premium

hedda_foil

(16,371 posts)
61. One thing that most people miss about the 80/20 split ...
Tue May 2, 2017, 01:37 PM
May 2017

You don't get charged 20% of your actual part B medical bills. Medicare pays a much, much smaller amount fixed per contract with all providers. Say your bill is $500. Medicare's formula reduces that to, say, $130. They pay 80% of the $130 and you pay the remaining 20% of that amount.

Same goes for Part A, but there are a couple of copays.

So even if your bill is in the six figure range, the amount you're left with is much less. That's what Medigap policies(Medicare Supplement Insurance) pay.

BTW, I can't believe the difference in premiums is between Minnesota and Illinois, where I live. The type of insurance MineralMan is talking about, where everything is paid for, is Plan F. It's the exact same plan wherever you live. In Illinois, the premium for Plan F has risen to nearly $200/month. I shop plans every year to find the least expensive premium and couldn't find Plan F offered by any company for less than around $170/month. That's ridiculous. I've had to switch to Plan N, where I have to pay $20 for doctor's visits and the relatively small Part B B deductible. Otherwise, it pays for everything. A few companies offer it for around $105.

redstatebluegirl

(12,265 posts)
58. The danger is to people over 55 who have been laid off by their companies.
Tue May 2, 2017, 01:06 PM
May 2017

Try getting any kind of insurance after 55, I did, it was horrible. They want those of us over 55 who are not wealthy to die quickly. They are going to get their wish. I was lucky, I landed a job at 58 with benefits which was shocking. It is soft money (grant money), I pray I can keep it until I am old enough for medicare but due to budget cuts I may not. Scares the crap out of me.

Hortensis

(58,785 posts)
83. AND to people of any age who went ahead and had
Wed May 3, 2017, 06:27 PM
May 2017

that little thing that was concerning them checked out, knowing if it was something that all would be covered under the ACA.

There was a time when I specifically did not to go the doctor because I couldn't risk getting diagnosed before I had new coverage in place. And for the first three months it was, when I went in for a physical I made no mention of the twinges in my left axilla--because cancer wouldn't be covered. It wasn't and only cost me some worry in the middle of the night.

How many millions did that, and would again? And how many paid a dreadful price for it?

 

cwydro

(51,308 posts)
3. I'm a female over 50.
Tue May 2, 2017, 10:16 AM
May 2017

I take no medications.

I run, swim, row, and work out daily.

No pre-existing conditions, but 100% in favor of the ACA.

Brainstormy

(2,380 posts)
9. Well then I HAVE to assume
Tue May 2, 2017, 10:26 AM
May 2017

that your house is a mess!

Just kidding! Good for you. You're an inspiration.

 

cwydro

(51,308 posts)
70. Um yeah, it sure isn't what I'd like it to be lol.
Wed May 3, 2017, 11:41 AM
May 2017


I can ALWAYS find something to do outside, rather than doing what I SHOULD be doing inside. Sigh, now I've got laundry to fold...

mercuryblues

(14,521 posts)
38. Just the fact
Tue May 2, 2017, 11:40 AM
May 2017

that you have a uterus is a pre-existing condition in the health insurance world. No matter your age.

price gap pre ACA


?resize=620%2C413

MineralMan

(146,248 posts)
39. Yup, in many states, women paid more.
Tue May 2, 2017, 11:46 AM
May 2017

I've always lived in a state that didn't allow gender adjustments.

calimary

(81,085 posts)
46. I'm over 60 and all I take are vitamins.
Tue May 2, 2017, 12:02 PM
May 2017

I am VERY grateful for my health. My back bothers me after an hour or so of bending over to pull weeds or do other gardening or collecting pine cones for crafting when they've been blown off the trees and into the street. But that's about it. One-too-many attempts at a cobra pose in a yoga class kinda killed going to yoga for me. But that's really about it.

To say I'm grateful is an understatement.

IronLionZion

(45,380 posts)
57. Good for you
Tue May 2, 2017, 01:00 PM
May 2017

but lifestyle is only one part of it. Many folks have conditions that diet and exercise can't fix.

 

cwydro

(51,308 posts)
72. Certainly true.
Wed May 3, 2017, 12:43 PM
May 2017

I've been very fortunate.

Great genes. Also, I thank my parents for never allowing soda in my childhood. A coke was a rare treat.

 

adigal

(7,581 posts)
62. I'm 55, and I don't have any either...thankfully. Knock wood, etc.
Tue May 2, 2017, 01:50 PM
May 2017

I have higher cholesterol, but statins are horrible for you. I just watch what I eat. I quit smoking 12 years ago, quit drinking 7 years ago, gained 30 pounds and finally lost it last year. I gained about 7 back, so I am going to start running again. I did a Olympic distance triathlon about 5 years ago when I was 185 pounds (I am 5ft5in, and muscular, but I was fat!) I came in second to last, but did it. It is a mile swim, 25 mile bike (hate the bike part!!) and 6 mile run.
My point is that anyone can get into better shape and healthier - which doesn't mean people don't have pre-existing conditions. My husband never smoked, rarely drank, but was a NYC firefighter and stood on that pile looking for body parts for a year so he has Asthma/reactive airways.
Most of us have something.

ecstatic

(32,641 posts)
68. Unfortunately, the insurance companies don't see it that way
Tue May 2, 2017, 10:31 PM
May 2017

Your age and gender are automatically considered pre-existing conditions.

Wounded Bear

(58,584 posts)
10. Truth...
Tue May 2, 2017, 10:29 AM
May 2017

and one partial "fix" to the system would be to reduce the Medicare age to 50. That would cover all of those situations.

The reason Medicare was started in the first place was that insurance co's would not cover the elderly an anything like a reasonable rate.

MineralMan

(146,248 posts)
12. Yes. Sadly, the insurance companies consistently raised
Tue May 2, 2017, 10:39 AM
May 2017

rates through the roof for people aged 55 or older. Before ACA, my wife, for example, saw her premiums go up almost 200% in just four years, once she hit 50. In Minnesota, the insurance company could not drop her coverage, but they could, and did, jack up her rates, due to pre-existing conditions. Others in her situation couldn't get insurance at all. ACA leveled the playing field somewhat, and her premiums were cut in half after it took effect.

She's still a few years from Medicare eligibility. We're crossing our fingers, here.

If the ACA is repealed, we're going to be in financial difficulty, I can guarantee. Since we're self-employed, we're part of a group that has always had real problems with health insurance.

Like you, I'm hoping for a drop in Medicare eligibility age, for her sake. It's a real concern.

Sunlei

(22,651 posts)
22. "reduce the Medicare age to 50" was one of the ACA provisions in 2008. was dropped so the Act passed
Tue May 2, 2017, 11:04 AM
May 2017

Wounded Bear

(58,584 posts)
23. Yeah, several progressive measures were briefly considered and then dropped...
Tue May 2, 2017, 11:06 AM
May 2017

Hopefully, we can get majorities in Congress and start pushing real fixes to the law instead of all this "soft kill" shit the Repubs are pushing.

Sunlei

(22,651 posts)
26. If Republicans stopped pushing all the stuff to benefit 'for profit' Corps & dropped medicare to age
Tue May 2, 2017, 11:12 AM
May 2017

to age 50 with premium payments on bell curve by age & income, America would save multi-billions in state & federal healthcare costs.

 

KingCharlemagne

(7,908 posts)
11. If they're over 50 and supporting Trump, I want them to suffer horribly. My
Tue May 2, 2017, 10:30 AM
May 2017

compassion reserves are running on empty. They were more than willing that others suffer and die, so long as it wasn't them. Fuck that. I want them to come to the brink of death because of the consequences of the choices they made.

Flame away, I guess.

MineralMan

(146,248 posts)
13. I don't want anyone to suffer. What I want is for people to get
Tue May 2, 2017, 10:40 AM
May 2017

educated, so they understand what their risks really are if ACA is repealed. Vindictiveness is not an answer. It's never an answer. We need to work hard to avoid this issue, not threaten people.

That's my opinion, anyhow.

malaise

(268,668 posts)
16. Well to be perfectly cynical
Tue May 2, 2017, 10:47 AM
May 2017

from you're born you have a pre-existing condition because you're going to die of something,
Every one should support Obamacare or go further and support single payer.

MineralMan

(146,248 posts)
17. Yes, of course.
Tue May 2, 2017, 10:54 AM
May 2017

Lots of people, however, don't seem to realize that. Young people, especially, seem to think they're immortal. Comes with the territory, I suppose. I know that I felt that way until I was in my 40s. It's not true, of course, and young people die, too. The illusion of immortality is strong in most people under 40, though. Always has been, I guess.

malaise

(268,668 posts)
24. Isn't that the truth
Tue May 2, 2017, 11:09 AM
May 2017

Last edited Tue May 2, 2017, 11:40 AM - Edit history (1)

On the other hand parents don't think they should change the diet for their kids given their own genetic predisposition to certain diseases.

malaise

(268,668 posts)
40. Well they let us hurt ourselves
Tue May 2, 2017, 11:47 AM
May 2017

and have fun. We were less protected and given way more space to play and roam - we climbed fruit trees, rode bikes without helmets. We used to do gymnastics on a tree and a fence below - outside the fence was a concrete gutter - we were raving mad.
Only one person ever fell - my younger sister landed on the fence and broke two teeth. The rest of us continued right through the long holidays.

It's also true that most of our parents knew very little about diet change in those days. That said, parents from the 60s and 70s could have changed some of the crap they gave their kids.

 

Ron Obvious

(6,261 posts)
54. But at least we rode bikes
Tue May 2, 2017, 12:43 PM
May 2017

Studies show that the health benefits of cycling vastly outweigh the relatively small risks inherent in the activity.

It's the sedentary life that kills.

malaise

(268,668 posts)
55. Very true
Tue May 2, 2017, 12:57 PM
May 2017

We ran or road all over the neighborhood -there was always someone keeping an eye on us even if we didn't know that.
I don't remember anyone getting hurt on a bike but there were fewer cars back then.

sarge43

(28,940 posts)
25. My husband (73) hasn't ever smoked, drank and always ate sensibly.
Tue May 2, 2017, 11:11 AM
May 2017

Last edited Tue May 2, 2017, 11:54 AM - Edit history (1)

He also jogs minimum 2 miles every day. This August he had to have a triple bypass - 90% blockage in one artery. I ran this list by his doctor, then asked "Why? He's done everything right." Doc's answer, "He got old."

Fortunately, we both have Tricare and Medicare; otherwise, I'd be a widow now. The operation cost o/a 80K.

Damn right I support single payer.

malaise

(268,668 posts)
27. Yep - old is a pre-existing condition if you're lucky enough to grown old :
Tue May 2, 2017, 11:14 AM
May 2017

There are way too many folks who died young because they could not afford healthcare

MineralMan

(146,248 posts)
43. Age affects us all, healthcare-wise. The Insurance companies
Tue May 2, 2017, 11:56 AM
May 2017

definitely know that. Personally, my prime choice for healthcare coverage would be a tax-funded single-payer system with one price for the entire pool of people. Everyone would pay the same premium. Period. That would lower lifetime costs for everyone, even though it would raise premiums for the young. They'd stay stable, though, throughout life.

I'd make it a lot like Medicare, with insurance companies able to sell supplements to cover a 20% copay on 80% coverage, just like Medicare does now. For older Americans at retirement age, it would work as it does now with Medicare, although the age should be lowered to 50 or 55, with premiums lowered appropriately, depending on age. The Insurance companies love those Medicare supplemental policies like you wouldn't believe, so that would probably work out for them, as well.

I don't see such a thing as being possible, though, without majorities in both houses and a Democratic President. Not before 2020 at the earliest.

I get the most argument about the single pool factor. Younger people would see a rise in their premiums, so they wouldn't like it on an immediate basis. Over time, though, it would save everyone money through their lives. It would take some selling.

Freethinker65

(9,998 posts)
19. Yep. 50+ year old with mild to moderate psoriasis, otherwise healthy
Tue May 2, 2017, 10:55 AM
May 2017

Treatment is affordable and has been for the last 35 years. But about 10 years ago I contracted c. diff (misdiagnosed by incompetent pathologist as IBS) no recurrence and a bout of psoriatic arthritis in early forties which has been non-existent (I credit diet and lifestyle change) for about 8 years and still in remission. So I look like a candidate for an autoimmune pre-existing condition surcharge of about an EXTRA $25K/year according to reports I have seen on GOPs proposed plan.

My insurance portion for healthcare for the past 10 years has been well under the premiums paid and I am ok with that (it is insurance after all, and does get me reduced rates for my deductibles and out of pocket copays, and will be there should I need it for a major health issue). I am fine with a substantial portion of my premiums now being used to provide care to other members that have medical issues. I am currently on my spouse's work policy and he will be retiring before I reach Medicare age. I planned on buying non-subsidized coverage on the exchange to bridge the gap to Medicare. I knew it would be costly, but not costly plus $25K/year, that is if my state even decides to offer it under the proposed plan.

MineralMan

(146,248 posts)
21. Yes. Although you're otherwise healthy,
Tue May 2, 2017, 11:03 AM
May 2017

your medical history puts you in what insurance companies think of as a high-risk group. Most people over 50 have at least one condition that puts them in that category. Standard treatments for auto-immune disorders are getting more and more costly. While new medications are available, they are hugely expensive and have really, really serious potential side effects.

Few individuals in the middle class can afford insurance that costs them $25K per year. That's completely untenable for almost everyone.

progressoid

(49,933 posts)
31. My daughter has psoriasis. However, the Doc diagnosed it as seborrhea dermatitis.
Tue May 2, 2017, 11:27 AM
May 2017

She didn't misdiagnose it. But seborrhea dermatitis wasn't considered a pre-existing condition, so she called it that so we wouldn't have to worry about insurance problems in the future.

 

HockeyMom

(14,337 posts)
44. Atopic dermatitis
Tue May 2, 2017, 11:59 AM
May 2017

Eliminate what is coming into contact with skin and it goes away. This was 10 years ago. My employer self insured but I paid it myself since it didn't come close to a $3,500 deductible. Same with when I had food poisoning 7 years ago. Same employer and paid entire bill from urgent care center. Pre existing conditions? What records from a health insurance company?

LittleGirl

(8,277 posts)
29. Over 50
Tue May 2, 2017, 11:24 AM
May 2017

and have always paid more than the guys for insurance at work.

ALWAYS.

When I was 20, it was because I was child bearing age.
When I was 30, it was because I had endometriosis.
When I was 40, it was because I had poly cystic ovary syndrome.
When I was 50, it was because I had surgical menopause and Hashimoto's.
I can only wonder what the excuse will be when I hit 60 in 2.5 yrs.

Being a woman is a pre-existing condition for the insurance companies.

Single payer for all.

mwooldri

(10,299 posts)
30. Life as far as I'm concerned is a "pre-existing condition".
Tue May 2, 2017, 11:27 AM
May 2017

That, and the Republican Party. Though health insurance shouldn't cover Republicanism specifically.

cilla4progress

(24,714 posts)
32. I remember being afraid to see a doctor
Tue May 2, 2017, 11:28 AM
May 2017

and getting a diagnosis because of this exclusion. One of the best things about Ocare - getting rid of it.

It s how insurance companies game the risk and it's patently unfair.


PA Democrat

(13,225 posts)
37. If the Republicans get their way on health care
Tue May 2, 2017, 11:36 AM
May 2017

I predict that Medicare costs will increase disproportionately since many people will put off preventative care and screenings until they are on Medicare. Early diagnosis and early treatment are well-proven to reduce long-term costs.

spooky3

(34,401 posts)
42. Another example: arthritis--many people over 50 have at least
Tue May 2, 2017, 11:52 AM
May 2017

A touch of it. Many don't yet know it, but if they have to undergo a full physical, it might be detected. No cure, and it worsens. And people can't beat it by staying active--in fact many types of exercise over the course of your life (e.g., high impact sports or aerobics) can worsen it. So people have to view it as bad luck rather than entirely under their control.

http://www.arthritis.org/about-arthritis/

MineralMan

(146,248 posts)
48. Typically, though, that occurs after Medicare age.
Tue May 2, 2017, 12:12 PM
May 2017

If you have a good supplement, you'll be OK. It's covered, and you're unlikely to have any out of pocket costs, regardless of treatment if you have Medicare and a good supplemental policy.

marybourg

(12,584 posts)
81. A review of your medical records
Wed May 3, 2017, 04:49 PM
May 2017

may show something as innocuous as respiratory or food or drug allergies. Pre-existing condition.

Locrian

(4,522 posts)
49. anyone who supports any kind of GOP plan
Tue May 2, 2017, 12:15 PM
May 2017

Is nothing more than a sucker.

People need to understand that while our natural predators (lions, tigers, etc) went away, we are STILL being preyed upon by the wealthy. They want your $$$ - and with medical it's tied to you and your families health / life.

Unless you are rich (ie more than a millionaire) AND heartless - if you don't support some kind of healthcare reform and coverage, you're a sucker and being mined for $$.

The Velveteen Ocelot

(115,576 posts)
53. At least being eaten by lions and tigers would be relatively quick.
Tue May 2, 2017, 12:34 PM
May 2017

Being preyed upon by the wealthy means a slow death.

benpollard

(199 posts)
56. Chances are, if they support "repeal-and-replace"...
Tue May 2, 2017, 12:59 PM
May 2017

Chances are, if they support "repeal-and-replace," they're a conservative sheep who would support anything Republicans proposed -- even if they were hurt by it.

There may be a silver lining, though. If enough people over 50 lose their health care, there might be enough outrage to force the government to lower the Medicare eligibility age.

We can only hope.

 

Amimnoch

(4,558 posts)
60. And that's only part of it.
Tue May 2, 2017, 01:26 PM
May 2017

Bankruptcy due to medical bills accounts.

In 2007, 62.1% of bankruptcies were caused by medical bills.

One car accident..
One fall..
One cancer..
Any illness that takes you out of work for more than a few months, and just about anyone.. at any age.. is looking at bankruptcy.. anyone other than the most wealthy. That's anyone at any age or demographic.

cite: http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf

Vinca

(50,236 posts)
63. Charging more for coverage for people with pre-existing conditions is nuts, too.
Tue May 2, 2017, 01:59 PM
May 2017

Often they are footing the bill for expensive meds or can't work full-time. The whole concept of insurance is based on well people sharing the burden with unwell people. None of us stays healthy forever. We need Medicare for all.

mopinko

(69,983 posts)
64. i couldnt get life insurance because i have fibro.
Tue May 2, 2017, 06:40 PM
May 2017

it has zero impact of life expectancy.
i also have an autoimmune abnormality that is indicative of exactly nothing as far as anyone knows.
i intend to live to me 100. most of my female relatives lived to 90 w/o much benefit of modern medicine.
and this was not even about paying for my medical care. it was about how long i would live.

i shudder to think about health ins w/o the aca. i have cobra until 9 month before medicare age. at this point is expect the bite my nails for 9 months.

ecstatic

(32,641 posts)
67. Help them understand? Can someone help ME understand how
Tue May 2, 2017, 10:29 PM
May 2017

a person makes it to 50+ years old in this country without having a fucking clue? If anyone out there can help me understand that, then maybe I'll try to spoon feed random deplorables on how the ACA works.

MineralMan

(146,248 posts)
69. More people know nothing about healthcare
Wed May 3, 2017, 09:25 AM
May 2017

and insurance than know something. Most people receive health insurance coverage through their employer. The employer typically pays part of the premium, with the rest showing up as a deduction from every paycheck. That means that most people don't actually know how much their health insurance costs.

Further, most people don't bother following the details of the news. They don't know what's going on in the world or even locally that affects them. When the ACA was passed and signed, most people had no idea what it really meant and how it would affect them. People who are Republicans tend to watch Fox News, which maligned "Obamacare" constantly.

People don't pay attention. They don't even try to understand. They know more about their healthcare coverage than the fact that they have a card they have to show at the doctor's office, and that their employer takes some money out of their pay. They know they have to pay a co-pay. That's it.

So, the bottom line is that most people don't know bupkes about healthcare, and have no interest in knowing more. They think that everyone has coverage like they do and have no concept of how premiums are set up.

That's how they make it to 50+ without knowing anything, really. We should try to educate them, but they probably won't pay any attention to us.

ecstatic

(32,641 posts)
73. Uggh. Fair enough.
Wed May 3, 2017, 02:11 PM
May 2017

I'm on an employer sponsored group plan now, but I spent most of my life without insurance/healthcare. Before my group plan, I had an individual plan for about 5 years (which didn't include maternity in the event of an unexpected pregnancy).

ProfessorGAC

(64,827 posts)
75. Raising Hand
Wed May 3, 2017, 03:32 PM
May 2017

MS for 21 years.
RA for 6
Hypertensive (moderate) since around 2005.
Family history of blood disorders, kidney and liver (not alcohol related) dysfunction.

Turned 60 around 7 months ago.

MineralMan

(146,248 posts)
77. Yup, and five years to go before Medicare kicks in.
Wed May 3, 2017, 03:53 PM
May 2017

I was in that spot a few years ago. At that time, between my wife and I, our health insurance bills were over $17K per year.

It was almost impossible, but we paid them. I was overjoyed when I turned 65.

Dan

(3,537 posts)
79. 18 months from Medicare
Wed May 3, 2017, 04:14 PM
May 2017

and every time that I see my doctor, I feel that I should be carrying a body bag...

ismnotwasm

(41,956 posts)
80. Actually studies have shown plaque on vessel walls starts are early as the 20's--or even younger
Wed May 3, 2017, 04:21 PM
May 2017

Atherosclerosis, Leading to CAD, increasing the danger of heart attack or stroke. The "pre-existing condition" clause is deadly serious

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