Any tips on choosing a Duluth lawyer?

MoeSewCo May 23, 2012 9 Comments

We are having a rough time with Minnesota Care, and we need to appeal a decision they’ve made. It’s a big decision — a decision that has set a pretty bad precedent concerning Minnesota Care and PCIP — and we’d feel better making our argument with a lawyer on our side. Long story short, does anyone know a good lawyer who might have some experience dealing with medical insurance?

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9 Comments

TimK

about 12 years ago 

Orman and Nord 722-1000

InformationWanted

about 12 years ago 

If you're income-eligible, call Legal Aid Service.

emilymoesewco

about 12 years ago 

Called Legal Aid, and they might be able to help. 

PCIP is the federal Pre-Existing Condition Help Plan -- the component of 'Obamacare' that is up and running. If you can't get insurance anywhere else, you can get PCIP. What they don't tell you is that there are no in-network providers in Duluth. There's one guy in Moose Lake. 

We are the first people to try to move from PCIP to MinnesotaCare. Today, MinnesotaCare denied us because we have PCIP. They said if you're eligible for PCIP, you are not eligible for MinnesotaCare. But anyone with a pre-existing condition is eligible for PCIP. MinnesotaCare, without realizing it, just made the policy that anyone with a pre-existing condition is no longer eligible for MinnesotaCare.

jakester

about 12 years ago 

You may want to call the Health Care Access Office located at the Lake Superior Community Health Center in Duluth. They assist people in obtaining MNCare and other public health coverage programs. They may be able to advocate for you. There is no charge for their services. You can reach them at 218-722-9650.

eej003

about 12 years ago 

I am a health insurance counselor with the Iowa Insurance Division, but I am originally from Duluth and saw your question here. Although I am not familiar with Minnesota Care, I know that PCIP was created under the Affordable Care Act. In Iowa, our version of MinnesotaCare is called HIPIOWA, and the federal version of the PCIP is called HIPIOWA-FED. After a brief comparison of the programs, I can conclude that there aren't many differences between the Iowa and Minnesota high-risk state and federal programs.

One of the primary requirements for any high-risk insurance program is that the insured individual cannot have been covered by any health insurance over the required statutory period. Looking at MinnesotaCare, that requirement is 4 months, and the requirement for the PCIP is 6 months. I deal with this issue from consumers in Iowa several times a week, and unfortunately, there isn't much the government can do to get around this rule. I wouldn't recommend contacting a lawyer over this issue. Instead, try filing a complaint with the Minnesota Insurance Division. 

There is no charge for filing a complaint, and a member of the Minnesota Insurance Division should be able to provide you with a detailed answer either justifying your enrollment denial, or provide you with steps on how to file an appeal regarding your denial if they believe there is a chance it was improper. There is no need to pay a lawyer when there is a state program which provides the same service for free.

Carla

about 12 years ago 

Legal Aid really is only for people who are indigent.  If you can afford a lawyer I would heartily recommend Greg Gilbert.  He is compassionate, reasonable and well versed in most aspects of the law.

tamara

about 12 years ago 

Carla, you are incorrect. Legal Aid is for anyone who is low-income that needs legal representation. From their website:

"The law offices of Legal Aid Service of Northeastern Minnesota (LASNEM) provide free legal advice and representation to low income people who live in Northeastern Minnesota. Our goal is to provide representation and legal services to as many clients as possible consistent with the most important needs of our clients."

emilymoesewco

about 12 years ago 

We're talking with legal aid. 

But there's usually a provision in these types of insurance plans for inter-state transfer. If we've already gone through the process of waiting to get high-risk pool insurance in Illinois, Minnesota should have allowed us to simply transfer from one to the other. PCIP did. When we moved, the reason we couldn't get MinnesotaCare was that there was a 6 month residency requirement. That has since changed.

eej003

about 12 years ago 

If an inter-state transfer provision exists in the statute, I would highly recommend that you contact the Minnesota Department of Insurance to file a complaint. They should be able to provide you with a quick and accurate answer for free. You probably aren't the first person who has had this problem due to there only being two high-risk government sponsored insurance plans, so they should have a standard procedure to deal with it. Keep in mind that if the transfer provision is in the Illinois program but not the Minnesota one, Minnesota may not be bound by it.

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