Thursday, July 26, 2007

Sicko Was Editedo

It seems that "Sicko" was editedo.

Yeah, I find it hard to believe too.

The Main family of Port Charlotte, Florida was supposed to be in Michael Moore's movie but somehow got left out.

Tom Main, a self-employed electrician making about $40,000 a year, had no health insurance and did not qualify for the Florida KidCare state insurance program after moving here from Colorado.

He joined the National Association for the Self-Employed, making him eligible for health coverage. In December 2005, an agent from MEGA Life and Health Insurance Company sold them a family policy at $227 a month.

That's a low price for a family of 4. No one questioned it?

The policy they bought is a limited benefit plan that caps the payout to providers.

Did they read and understand the policy limits?

According to the carrier:

"Mr. Main indicated that he understood the policy and at no point expressed that he had been told anything different about the policy by the agent who sold the policy, or express dissatisfaction with his coverage and benefit selections," Ledbetter said in an e-mail.


So Mr. Main clearly understood what he was buying, right?

An ambulance took Kenny to All Children's Hospital in St. Petersburg, where he was diagnosed with acute lymphoblastic leukemia.

When Tom Main handed over his insurance papers to the administration office he was prepared for the $5,000 deductible, but surprised when he was told the policy would not be adequate.

In all fairness, insurance policies can be written in language that might as well be in a foreign tongue to the untrained eye. That is why one should never buy a policy, even from a carrier you know, without first asking a disinterested third party to review the details.

You can start by asking your doctor if they take assignment of benefits from that carrier. If the answer is no, then go no further.

Your next call should be to the business office of your local hospital. Ask them the same question. Better to know up front than after the fact.

If Mr. Main had done this before his child became ill perhaps much of this could be avoided.

This is not casting blame, but when you buy a plan that is designed to provide you with a virtually unlimited line of credit when you need it most, it is better to find out IN ADVANCE is this is the plan you need.

In October, a film crew accompanied Hesper Main and Kenny in the family minivan on the drive to St. Petersburg, filming inside the van, at All Children's and then back at their home, where they treated the family to pizza.

When they were cut from the film, Hesper Main said that the production assistant they had been dealing with felt so bad that she offered to push their story to a companion piece running in "People" magazine.

The family's story made it into the July 23 issue, with Harry Potter on the cover.

This is a situation that even a wizard can't cure.

Do yourself a favor. Stop what you are doing right now and get your policy. Read through it paying particular attention to policy limits. Next call your doc and your local hospital. Ask them what they know about the carrier or the policy you have. It might even be worth your time to buy a cup of coffee for someone in the business office of the hospital.

Better to spend a few bucks now than losing your home later.

Drink up!
blog comments powered by Disqus