Getting into the much heralded PPACA High Risk Pool requires among other things that an applicant be A) uninsured for at least six months and B) produce proof of an insurer turndown--being "uninsurable", due to a pre-existing condition--a so-called denial letter.
The other day, I received a very disturbing email from fayeforcure a Kossack we all know and love about what she has encountered trying to get the all important denial letter from Blue Cross Blue Shield of Florida.
I fear Faye's story is being repeated over and over, the length and breadth of our nation.
Faye is trying to access healthcare via the PPACA and the high risk pool for her son who is a quadriplegic.
To even begin the application process, the PPACA leaves her at the tender mercies of the private insurance industry, in this case, Florida Blue Cross. She (and all Americans), first must prove citizenship, then extract from a Murder By Spreadsheet insurance company the all-important "denial of coverage" letter.
People who have been at Daily Kos for a while know Faye, in real life she's Faye Armitage and she ran for Congressin 7th CD in Florida during the 2008 cycle.
What follows is the story of one American trying to access the lifesaving High Risk pool for her severely ill son.
The process begins with obtaining a denial letter. https://www.pcip.gov/
Here's a link to the High Risk Pool application. https://www.pcip.gov/...
This is Faye's son, Jason Armitage.
In order to begin the qualification process for the PPACA High Risk Pool, Jason needs a denial letter, so Faye went to Blue Cross Blue Shield in Florida to try and obtain the lifesaving letter.
This Jason Armitage crying as he listens to his mother speak about her battle to make stem cells widely available.
This is the predatory company Faye is battling just to get a denial of coverage letter so she can try to get Jason into the PPACA high risk pool.
Here is what Faye wrote to me, she has authorized me to share it with you.
Hi Eve,
As much as I believe the healthcare reform is healthcare reform in name only, I did want to apply for the pre-existing condition coverage for my 20 year old son Jason, who is quadriplegic after colliding with another soccer player at age 7. The coverage is supposed to start Aug. 1st::
HealthCare.gov helps with finding health insurance USA Today - Sandra Block - Jul 12, 2010
You must also prove that you've been turned down for insurance because of a pre-existing condition. To do that, you'll need a denial letter from a private ...
I tried to get a denial letter from Blue Cross Blue Shield of Floridahere in Jacksonville, but although everyone in their sales office was very understanding, they told me that I couldn't even put in an application, because they wouldn't even take an application for such a severe pre-existing condition. Jason is not poor enough for Medicaid, and because he was injured as a child and never paid into social security, he also doesn't qualify for Medicare like other disabled adults.
Please help us find a way to get a denial letter so we can apply for the government pre-existing condition program that came about through the recent healthcare reform efforts.
I am sure others are having similar problems where insurance companies won't even bother writing an application for them so they can get their denial letters too.
Let me know what you find out asap.........it may already be too late to get him coverage starting Aug 1st, and he is on Plavix to keep his blood from clotting in his recently re-opened basialr artery. I'd also like to get him some physical therapy to maintain his health and prevent medical problems, and possibly even make some improvements now that his basilar artery has been re-opened.
Thank you so much for all you do to keep people from having to fight so hard for basic healthcare.
Faye
I am quickly learning that you have to run through the gates of Hell in order to figure out all the rules, regulations and curve balls of getting accepted into one of these pools.
It shouldn't be this way, but tragically it is. And you can scream until you're blue in the face, but Americans will die because healthcare continues to be a privilege not a right in this country.
Instead of creating these high-risk pools, Congress could have easily decided to provide people like Jason Armitage and millions of others just like him coverage with Medicare.
These desperately ill Americans would have started to receive benefits almost immediately. Instead, sick people are being made to jump through hoops. But we should be grateful because it is indeed, better than nothing, which is exactly what these people currently have.
Guess what, getting Medicare right away to people in need (in this case victims of asbestos contamination) was good enough for Max Baucus to slip it into the PPACA for his constituents in Libby Montana. They were enrolled lickety split in Medicare.
Here's another email from Faye, about her life. Again, those of us who've been at Daily Kos, may remember what Faye has written in the past about her struggles to get insurance for herself and Jason--not.
Hi Eve,
We've both been without insurance since Jason was 7 years old. As a caregiver and parent to 4 other children, I wasn't able to work full time to get employer based coverage. A year ago I decided to get some "junk" insurance for myself ($5,000 deductible) because I was over 50 ( so wish they had lowered the Medicare age at least to 50, so I could buy into better coverage at a more decent price.)
Here is somethingNoweasels wrote about Jason:
I have exchanged emails with kossack fayeforcure.
Her son, Jason, is paralyzed from the nose down:
Jason Armitage was 7 years old when his life changed.
He was running across a soccer field, chasing the ball, when he collided violently with another player.
At first, he appeared unharmed. He even finished the game.
Later he developed a terrible headache, so his mother took him to an emergency room. But doctors failed to correctly diagnose and treat his injuries.
Six weeks later, a blood clot triggered a massive stroke, which left Jason paralyzed from the nose down.
His last memory of life as it used to be was sitting on the front steps of his home, eating barbecue potato chips.
Source ~ Jacksonville Times-Union
Here is one of the pictures Faye has been kind enough to send me (and which she has given me permission to post):
Jason and I visited the Florida Blue center store at our Town Center mall, and Vicky told me she couldn't even take an application, because of his condition. "Some conditions don't qualify for an application." I asked her if I could get that in writing so I could use that as a "denial" to apply for the government sponsored pre-existing condition health insurance program, but she said she couldn't do that. After she went to talk to the Center Director, she said that several other people with pre-existing conditions had come in that day (July 14th) for a denial letter to meet the deadline of July 15th for applications for the federal government sponsored coverage starting Aug 1st.
I was given a 1-800 number of someone at their main office who would be in charge of sending out the denial letters, and decided to call while still at the center. I was told the letter would be sent to me the next day, but I still haven't received it. When I called today, I asked to speak with the center director but despite calling again later in the day, I never got a call back. I never thought it would be this hard to get a "denial letter"
Disabled people only qualify for Medicare if they became disabled as an adult, because Social Security disability that includes Medicare requires you to have paid SS taxes for at least 4 quarters.
If there is any other info, just let me know.
Here is another article from our stem cell advocacy days:
Here is another article from our stem cell advocacy days:
I'm trying to get some help from a local news paper health reporter
Jeremy Cox
Jeremy Cox Health Reporter Newsroom Life, Business 904-359-4083
But he's just "keeping it in mind".
Faye
This is why we need to resume the fight for Medicare for All, and why we should all stand shoulder to shoulder with Bernie Sanders, my friend and hero, John Conyers, and Dennis Kucinich, who are continuing to fight for real healthcare reform.
And there are millions of families, just like Faye and Jason Armitage, who will be waiting a very long time for anything remotely resembling affordable or guaranteed healthcare. This is why I'll be in Washington on August 4th to record the Washington DC Free Health Clinic and let you know if any U.S. Senator takes an hour to come.
There's another free clinic scheduled forNew Orleans on August 31st and September 1st if finances permit, I will try to go this this one as well.
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