HEALTH

Health Care in America: Maryland mother's insurance canceled upon dementia diagnosis

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Only months before the Affordable Care Act kicks in, a Maryland wife and mother of two teenagers was hit with frightening news.

Nancy and Mike Halwick

At the age of 49, she was diagnosed with dementia.

Then came another devastating blow. Her health insurance company suddenly canceled her coverage.

Nancy Halwick of Huntingtown was left with no insurance, a growing stack of medical bills, and a mind that was already starting to fade.

In the days ahead, Halwick's husband and two daughters will likely become strangers to her.

"Nancy's going to forget eventually who I am and who Kaley and Kelsey are. She won't remember. And things will get worse," says Mike Halwick.

The diagnosis came a year ago from doctors at Johns Hopkins: early on-set advanced dementia.

Three months later, the Halwick's insurance company, Golden Rule, sent them a letter cancelling Nancy's coverage.

And her $15,000 hospital bill?

"That's on us. We have to pay it. They're not paying it. We have to pay it," says Mike Halwick.

“I mean definitely anger, I mean I just can't believe they did it,” he says. “We paid our premiums every month, came out of the account, never late, it was automatic, and then you go to use your insurance and then it's not there? You can't use it?"

Golden Rule says the Halwicks had been with them for about seven months when those hospital claims starting coming in, raising a red flag.

The insurer started digging into Nancy's prior medical records and says it rescinded her coverage because she failed to mention in her application three visits to a doctor in the past two years and an MRI in 2011 that came back clean.

And now, with a pre-existing condition of dementia, the Halwicks say Nancy can't get anyone else to cover her.

“It's a big setback for us, with no insurance, and Nancy needs to go to the hospital quite a bit so it just hurt the family a lot," Mike Halwick says.

"That can no longer happen, in any part of the country, starting January 1," says Ron Pollack, a health care consumer advocate.

On January 1, 2014, health insurance coverage begins under the Affordable Care Act – often called Obamacare.

"An insurance company can't deny coverage due to a pre-existing condition,” Pollack says. “They can't drop you from coverage just because you get sick. They can't charge a discriminatory high premium based on your health status. And they no longer can charge women higher premiums."

And families like the Halwicks will be protected.

ABC7 spoke to representatives with Golden Rule and they maintain Nancy Halwick's application was missing "medical history that should have been reported." After dropping her, they refunded the premium payments for Nancy's coverage.

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