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Old 06-11-2010, 09:26 AM
hollyk24 hollyk24 is offline
Junior Member
 
Join Date: Feb 2010
Location: Portland, Oregon
Posts: 57
10 yr Member
hollyk24 hollyk24 is offline
Junior Member
 
Join Date: Feb 2010
Location: Portland, Oregon
Posts: 57
10 yr Member
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So, i found out the new insurance doesn't exclude rsd exactly, it just excludes coverage for any chronic pain treatment. So techinically it would cover things like pt, but it wouldn't cover any meds or pain management at all. But I've been told several different things in the last few days, so I'm waiting til I get it in writing . . . . I've been told rsd was specifically excluded (along with fibro. etc), I've been told it's just the pain managment, I've been told it's only chronic pain treatment . . . . I'm sure I've been told some other things too, but I can't remember them now.

I tried to go the preexisiting route, but the said because the new policy excludes the treatments, it didn't matter. I've tried every angle I can think of here It's not a union, it's actually an ESOP, and it spans over several states. You'd think since it's employee owned it would be easier or something, but nope

In Oregon, group policies can't have these kind of exclusions at all. I talked to the CA Insurance Commision, and they wanted me to send them a copy of the policy, which I'm doing. It does say clear as day in the exclusions "Chronic Pain Treatment", and the HR dept here is working on writing something up for me using some procedure codes I got from my doctors office (just for my normal monthly visits) saying that with the new policy they would not be covered and are specifically excluded. BOLI's office that oversee's benefit packages is also looking into the legality of this one, and I am seriously considering filing a complaint with them. But, I also have to consider the fact that if I want to hire a lawyer and pursue this I will likely lose my job - that's just how my company is. They will find a way or reason to fire me if I pursue this so I will have to tread carefully. I want to make sure my company compensates me for this, but I also want to preserve my job.

As to the survey they had us fill out, I found the email with the link, and it was still up online! So I was able to go back and print it out. And wow!!!! First off, it was not anonymous! It asked your first and last name, birth date, height and weight, as well as any dependants. Then went on to list a bunch of diseases asking if you had them or not, incuding HIV, mental illness, drug addiction, cancer, heart problems, etc. Talk about HIPPA voilation! Then it asks if you were disabled in any way, what meds you were on, how long, why, if you've been told you may need surgery in the future, what you thought your medical costs would be in the next year, and a few other questions. It ended with a paragraph about insurance fraud and about how if you intentionally lied or omitted information it could be used to deny you coverage in the future. All this was done on . . . . . SURVEY MONKEY!!!!! And according to the email, all employees, whether you were on the companies health insurance or not had to take the survey.

On a good note, I think we may have a found a workable solution We are considering getting married now, just a quickie in front of a judge thing, and then still have our real wedding later like my mom is planning, that way I can get on his insurance. He is a federal employee, so all his benefit info is online, so I was able to do all the research while he is home recovering and just bring him the info. I found a plan that would still cover everything I need, and be cheaper then what he is paying right now even when he adds me on (thankfully the feds only have individual and family plans, and he has a son, so he was already on fam, adding me on doesn't make a huge jump in price). So I was able to find a cheaper plan that still covers every single one of my meds and doctors, doesn't have a dedcutible, no waiting periods, exclusions, preexisting, decent copay, and will cover all his/his son's needs to, and save him some money. I think he feels good because he gets to be the 'hero' in the situation My mom even thinks it's a good idea, which I'm surprised at. But she realizes how important it is that I have health insurance and that if it lapses how hard it's going to be that she can over look the fact that I'll be married a few months before my wedding . . . .

I've talked to a couple other people at my work who were affected negatively by the change in insurance, but not to the extent that I was.
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