United Brachial Plexus Network, Inc.

We have lost our group employer coverage and are purchasing individual insurance. Kaiser called me today regarding my 10-year old daughter to ask more questions regarding her BPI. They informed me that while they will approve insurance, it may come at a higher rate because of her risk level. I'm wondering if others have encountered this? Is there a way to fight an elevated premium? She has never had surgery nor have we been recommended toward surgery. She qualifies for CCS (state therapy) and otherwise receives aquatic therapy on a regular basis. I'm just wondering if I have any options to appeal or if we just have to suck it up. They asked me if she was disabled--I answered no--but also ask if she has restricted range of motion and if there is any affect on the skeletal part of her body. I simply told them she has an unstable shoulder joint. I don't know if that was right or wrong to say. I want to be honest but I don't know how to answer the question. She's "fine" but I pursue OT for quality of life.

And I'm having a huge mommy moment that 10 years later the actions of my doctor continue to have severe ramifications for our family. Very few people understand this part and the emotion of it all. Every once in a while I just get so angry and emotional over everything we have to face.

The insurance company is discriminating on higher premium,
Pay the premium and then deal with getting a lawyer that deals with insurance issues
I am 62 and I never payed more for my insurance because of my birth erbs , That also covering 25 yrs. of semi driving and Medicare , I also pay extra for a Insurance premiums supplemental , I have 2 mess up arms now and No one has ever even raised my arms up in a premium issue< EVER
Interesting things happen with these injuries, When I was little my mom fought so many issues because of my erbs arm with doctors trying to get help, when there really was none for me in the 50,s.
I think that I got alot of( never giving up ) attitude by how my mom tried to help I seen so many parents that are like my mom, Teaching a child how to think (out of the box )is great by so many post here to I have had a discrimination case because of my arm it, end in a gag order
I hate gray areas I got into to half to overcome some how , It a life long learning experience in life, I think we have great imagination to get threw the gray and , I know O bama care covers pre-exiting injuries , I dont think a high premium is the outcome ????
It sure is a fight or flit issue sometimes What to do???

You need insurance but you might consider a lawyer and possible issues with higher premiums and The new heath care law
Hope this help???
Tom

I suggest contacting your State Attorney General Office and inform them of this; it is discrimination and their consumer affairs person can advocate/deal with your insurance company for you.

Carolyn J
LOBPI/75

Yes, while it seems discriminatory on the surface they would/have argued that they are approving coverage at the plan I requested but I won't receive the standard rate. Because of her injury, she is in an elevated risk category with the potential for it to cost more from them. I was quoted $225 and the final number is $337.50 per month. So her injury commands a $110 per month increase in premium.

I did request an appeal so that I can talk to an actual nurse and give details regarding her injury. Seems ridiculous that if I receive state therapy for her and there is no recommendation for surgery, that they would make us pay more than $1200/year on top of expensive premiums.

I know you need to pay extra for now and go threw a appeal , but keep all your records and do contact The State I never heard of increase premium from any post I can remember Its discrimination
If you are getting state therapy is your child getting Social Security Disability. May help if not
Tom

I thought I would add this to my last post
I think kids can apply for Social Security
You know that I thought more about This question
I know my brother does, Cobra , but they jack the premium up , on things the family needs medically.
To me getting a higher premium is baseless , when it deals with possible medical needs in the future,
Here a example The question is can a insurance company jack up rates because of possible DNA results , that show you are more likely to get a disease in the future. You know they cant, by law, right

I am glad you took the first step to do a appeal Carolyn is right, To contact the state insurance regulators.
One thing about these injuries , They sure fire us up to try no matter outcome ,
Please keep us posted, Were here
Tom