A question on health insurance. - Democratic Underground

plcdude

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Thu Jul-29-10 03:32 PM
Original message

A question on health insurance.

A student just came into my office with a real challenge. He was volunteering with summer program for our university and accidently tore up his knee which will now require extensive surgery and of course expense. His parents are divorced and he found out that each thought the other was covering him and neither were so he is S.O.L. Would health care refom be any assistance to him?

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DrDan

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Thu Jul-29-10 03:36 PM
Response to Original message

1. I certainly don't see how . . .

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Statistical

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Thu Jul-29-10 03:36 PM
Response to Original message

2. Sadly not that I am aware of.

Edited on Thu Jul-29-10 03:38 PM by Statistical

The only thing that even comes close is in 2013 insurance companies won't be able to put an pre-existing coverage limit on his knee injury.

Of course employer based coverage is already prohibited from having pre-existing coverage limits of more than a 12 months under HIPPA so I would hope he would be employed and with good coverage by then anyways.

You won't like this next part:
"He was volunteering with summer program for our university"

I would advise him to consult a lawyer to see if the circumstances makes the university in anyway liable and if so then sue them for medical damages.

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mdmc

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Thu Jul-29-10 03:37 PM
Response to Original message

3. he can go to the ER = an unique American solution

sure, he will be in sick ass debt, also an unique American solution.

I have full health insurance and cannot access affordable medical treatment so I really don't know if there is any help...

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dflprincess

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Thu Jul-29-10 03:42 PM
Response to Original message

4. No

and once he runs up a bill at the ER - bankruptcy "reform" might not help him either.

Maybe Mom and Dad can put the costs on credit cards. The other industry who wins big in the insurance scam as many people will still find themselves using plastic to cover out of pocket expenses.

BTW - as this was a volunteer program for the University are you sure they don't have insurance that may cover him?

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plcdude

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Thu Jul-29-10 03:45 PM
Response to Reply #4

6. I'll check

that out to see if the university can help of course but I am not holding my breath and that one. thanks

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plcdude

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Thu Jul-29-10 03:43 PM
Response to Original message

5. Thanks all

You are just confirming my perspectives and I am bound to inform the risk manager here about this so the university is prepared to deal with possible litigation.

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kdmorris

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Mon Aug-02-10 11:32 AM
Response to Original message

7. If he was volunteering, shouldn't he be covered by Workers' Comp?

Edited on Mon Aug-02-10 11:38 AM by kdmorris

Was he was "working" for the university and got hurt while "working" for the university?

Edited to add: the OP doesn't actually say he was hurt while working, so putting it in the form of a question.

Maybe not all states require that coverage...

http://www2.ed.gov/inits/americareads/resourcekit/ManageVolunteers/workers.html

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Sgent

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Mon Aug-02-10 06:01 PM
Response to Original message

8. Maybe

he should be able to get back on one parents insurance during their open enrollment period (different for every company), and the new age guidelines allow him to do it until a much later age than before.

The issue is whether he needs the surgery immediately, or if it can wait until the next open enrollment.

If he can't wait, send him to a social worker / case worker at a local FQHC (www.bphc.hrsa.gov) who should be able to alert him to options available in your area (vocational rehab fund sometimes pay for this kind of thing, etc.).

Good luck.

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TxRider

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Tue Aug-03-10 02:37 PM
Response to Original message

9. I don't see how, but

Edited on Tue Aug-03-10 02:37 PM by TxRider

But he should look into county/state/public financed hospitals.

I know if he was here here he could get care from the county/state, and afterward he would be means tested to see how much of the bill, if any, he would have to pay.

There are likely some options you and he may not be aware of.

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kjackson227

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Tue Aug-03-10 03:22 PM
Response to Original message

10. I don't see how it can IMMEDIATELY help him...

Edited on Tue Aug-03-10 03:25 PM by kjackson227

but, if he's working and able to pay, hasn't been insured for the last six months, then he can't be turned down for insurance since (I would think), this now classifies as a pre-existing condition. Also, his parents could put him back on their insurance because this is what is referred to as a "qualifying event" and he should be immediately effective for coverage. I think this would be the best option if he's under 26 years of age, unless he can get help from the county, clinic, or medicaid.

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