No guarantees: 3 tales of insurance disaster

http://www.msnbc.msn.com/id/33441437/ns/health-health_care/

By JoNel Aleccia
Health writer
msnbc.com
updated 10:23 a.m. ET, Mon., Oct . 26, 2009

As the mother of a toddler who survives only because of the breathing tubes up his nose, the feeding tube in his gut, and the expertise of doctors in three cities, Courtney Elliott is keenly aware of the high costs of medical care — in every sense of the word.

Until her son, Linden, 2, was born with mitochondrial disease, a rare genetic disorder, the 28-year-old Tennessee woman had no idea that a bright, energetic child could hover constantly on the edge of death.

And she certainly didn’t know that a family with good income and excellent health insurance could be devastated by out-of-pocket medical fees that top $25,000 a year.

“We were very naïve, even dumb,” said Elliott, whose husband, Isaac, also 28, is a mechanical engineer with Bechtel Jacobs Co., a government contractor in Oak Ridge, Tenn. “I didn’t even know you had medical debt if you had insurance.”

The Elliotts are not alone. They were among more than 1,200 msnbc.com readers who shared stories of medical billing disasters in response to the site’s Dose of Reality health care series. Like much of the national debate on health reform, many stories focused on the plight of the nearly 46 million Americans who face daunting bills because they have no insurance coverage at all.

‘Why do I have to suffer financially as well?’
More surprising, however, were the tales of medical debt that came from people who said they knew that health insurance was important — and took steps to make sure they had it. For three families in particular, finding out that their medical coverage wasn’t enough, that it didn’t exist when they needed it most, or that it ended with the loss of a job was as shocking as it was shattering.

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That distress is shared by Michele and Kevin Thomas, Detroit-area newlyweds who lost their jobs this year to a failing regional and national economy. Michele Thomas had health coverage through her job at a furniture store until she was laid off in April. She was searching for a policy she could afford on her unemployment compensation when she developed a severe gall bladder infection and needed emergency surgery. Now the pair, still searching for work, face $15,000 in bills they can’t pay.

Those worries are echoed by Duane Thayer, a 51-year-old Colorado man who fell off a ladder putting up Christmas lights last year and nearly severed his left foot. He thought he had coverage for nearly $500,000 in medical bills, but he says the insurance company denied his claims, in part for a single late payment and in part because they said the surgery he’d had for a club foot as a child counted as a “pre-existing condition.”

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Thayer's situation is not unique, said William Shernoff, a consumer rights lawyer in Claremont, Calif., who has written several books about insurance payment problems. Under federal COBRA law, insurance coverage may be terminated after a late payment, but it's not required to be. Often insurers will continue to accept late payments and extend coverage — until a large claim is filed.

“Once somebody has had an expensive procedure, most carriers do go back to find any loopholes to get out of paying, that’s very common,” Shernoff said.

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