My son can't marry his true love

[pkz]

My son has been engaged for three years. They had a wedding planned for December '08. We had to cancel the wedding because of health care.
You heard me right! They can't even get married.
Sami had cancer and each of her treatments are $23,000.00
His employer's insurance will not take her because of pre-existing condition and she was forced to stay on her father's. A young couple could never handle medical bills like that.

Marriage was off the table, but now they have a baby on the way...and, her father's insurance will not pay for that.
I know, bad timing, but poor Sami finished all her radiation and wanted to "live" so much. Living for her, meant creating a new life. We aren't sure yet how to handle the financial part of this new development.

I am so happy for them and sad at the same time.

[WillParkinson]

1. I'm so sorry...

Best I can offer is a :hug:.

[PDJane]

2. And would someone tell me again why

universal health care should be off the table? Single payer 'socialized' medicine works, and saves this kind of travesty from happening.

[MADem]

3. Well, start saving for the delivery, once the kid is born, the kid can go on your son's insurance.

After all, it's his kid.

Why won't pop's insurance pay for the delivery? That's a bit different...

[pkz]

6. His insurance will pay for the baby

once it is born, but will not cover any of Sami's at-risk care, her father's will not pay for any of that either.
She is doing clinicals now and will graduate in May, but who will hire a pregnant teacher?

[MADem]

7. How much will it cost out of pocket? Can she find a doc who will take payments?

That's really the only thing to do, save show up unannounced and have the kid.

[annabanana]

4. Damn that's fucked up...

They surely don't deserve this kind of burden (the healthcare thing.. not the baby :)) We have to keep the pressure up and get some kind of solution onto the front burner & keep it there until we can get decent care that a) eliminates the "pre-existing condition" clauses . .and b) severs coverage from employment.

This can't be fixed fast enough for me. My son & his asthma just "aged out" of our family plan. . He graduates next month & the job situation isn't looking so hot right now..

[JerseygirlCT]

5. That just sucks

No one should have to be that concerned about health care. We've just got a screwed up mess of a system.

But they have each other, even without the official status - and that's something. I hope she has an uneventful and happy pregnancy, and that the cancer is long gone. Here's to the hope of a new life!

[Laelth]

8. I am simply angry.

We are the only industrialized nation on Earth without guaranteed medical care for all citizens. This shouldn't be happening to you, or your son, or Sami. It's just wrong.

:mad:

:dem:

-Laelth

[Imalittleteapot]

9. Certificate of Insurance

I had cancer and my own medical insurance policy. Like your son's fiancee, my treatments were over $20,000 each. When the insurance company raised my monthly premium from $525 to $1200 a month I started looking at other options. The one I picked was to go on my
husband's insurance, but I was worried about the "pre-existing condition" thing. Turns out that all I had to do was to get a certificate from my insurance company saying that I had been insured by them to present to my husband's company. I now pay only $410 per month.

A similar situation occurred when my daughter-in-law changed jobs and went on a new policy. When she went to have monthly prescriptions filled and her new insurance would not cover it because of pre-existing conditions. She asked her old insurer to certify that she had previous insurance. They did, and since then the new company has covered her expensive drugs.

Is your almost daughter-in-law still being treated? Have your son inquire about this certificate thing.

[pkz]

11. My son pays 42.00 a week

for insurance through his company. He is a receiving manager for a national sporting goods store. His insurance already turned her down.
I am glad that you have found coverage, but 410.00 a month is steep for a young couple. especially when only one has income now.

[Ms. Toad]

19. If his company permits spouses to be covered,

the insurance company has to accept her. (They don't have to provide coverage - but if they do, they cannot discriminate based on pre-existing conditions). What you need is a certificate of creditable coverage from her current insurer.

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

>>One of the most important protections under HIPAA is that it helps those with preexisting conditions get health coverage. In the past, some employers' group health plans limited, or even denied, coverage if a new employee had such a condition before enrolling in the plan. Under HIPAA, that is not allowed. If the plan generally provides coverage but denies benefits to you because you had a condition before your coverage began, then HIPAA applies.<<

>>Are all family members, including a spouse, covered by HIPAA?
If your group health plan permits coverage of family members ("dependents"), and if they participate in the plan, then they will have the same HIPAA protections as employees, described above.<<

[jwirr]

10. This type of situation is more common than you think. Many young

couples need to stay single in order to qualify for health care. But it does not stop there. Seniors do not get married because if they do one of them could get their Social Security cut. Again if a young couple get married while in school they must look at both of their income when qualifying for Pal Grants etc. If one of them goes to school while the other stays home to baby sit and/or support the household while the other goes to school the student will probably get quite a bit of aid BUT when it is time for the second student to go they are no longer low income because they are now in a higher income bracket.

My point is that we are looking at this kind of situation in many government programs.

[undeterred]

13. A lot of people get married to get health insurance too.

[noamnety]

12. Try calling 211

See if they have any suggestions.

[Toucano]

14. You have to fight insurance companies!

Never accept their denial letters. They try to deny every claim.

Appeal every decision and consider getting a lawyer.

Don't give up. You have to fight them. They don't make money by paying it out, so it is routine to deny procedures that often prove to be perfectly legitimate.

FWIW, they technically can get married, they just have to postpone their wedding. A marriage license is usually a nominal fee.

[Fire_Medic_Dave]

15. So why is marriage off the table now?

[SheilaT]

16. I don't understand why they can't get married.

They are committed to each other. There's a baby on the way. Her cancer will not go away if they don't get married. How old is she? She will age out of her dad's insurance eventually. What exactly is the difference between living together and being married if either way she has no health insurance? Plus, there are important benefits from marriage.

[Canuckistanian]

17. This wouldn't happen in Canada... I know, sorry, scant comfort

As a helpful suggestion, can you appeal to a service organization such as Civitan or the Rotary Club?

As a former member of Civitan, we used to help families with this sort of problem (not medical) all the time.

[Flying Dream Blues]

18. If her father's insurance is covering her, at least in my state they MUST cover

her for prenatal costs. Visit your state's insurance board website and look for mandated coverage. Insurance companies often tell people they don't cover this or that, when actually they DO (or have to), but hope you'll believe them and go away.