No Pre-existing Condition Clause with Medicare


by Mary Jane Stern

If you are a Medicare beneficiary the one thing you know is that Medicare has never discriminated against anyone who had a pre-existing condition.  You were accepted and had quality-affordable healthcare.

With the historic passage of Healthcare Reform in the USA on March 21, 2010, now everyone in the USA can have access to health insurance and not have to worry about a pre-existing condition or a lifetime cap.

You have to admit, it took a long time for reform to come, in particular, for those people with pre-existing conditions.  You can get insurance now and you don’t have to worry about being dropped should you become sick. Have you ever been denied coverage because you have heart disease or cancer?

I remember making phone calls in early January of 1998 after the company my husband worked for closed down and there was no COBRA.  There were two questions asked before we could continue with coverage discussions and if you answered “yes” to either of the questions, there was no coverage.  The questions were:

1.         Any history of cancer?

2.         Any history of heart disease?

For many, many years we had to worry each and every day about my husband’s pre-existing condition.  We were a family who got caught between a “rock and a hard place” during May of 1998 and my husband went in for emergency heart surgery.  Guess what, we didn’t have health insurance at that time and could not get it.

The other problem that existed is because we didn’t have health insurance we were charged over 3 times the going rate by the hospital.  At that time, the hospital would accept about $25,000 from Medicare for surgery and a 9 day recuperation stay.  Our invoice from the hospital was $70,000 for surgery and a 4 day stay with no complications (my husband discharged himself to avoid being charged anymore).  To make matters worse, the hospital wouldn’t accept any type of payments either – it was all or nothing.

The $70,000 was for the hospital only.  We had other invoices from the doctors which were approximately $20,000.

Now, no longer do you have to worry about becoming sick or facing foreclosure because you didn’t have health insurance.  AARP calls it health security for all.

If you ask any senior about Medicare, most think it’s fantastic. Although this new healthcare reform doesn’t answer everything, it’s a great start.