Individual medical insurance

[raccoon]

Just wanted to post some things about individual health insurance plans some may not be aware of.

(1)Some people may not be able to get individual coverage at all. This happened to an in-law of mine a few years ago. Because of a health condition he had, he couldn't get coverage at all, although he could've afforded real high premiums. Fortunately for him, he turned 65 and now has Medicare.

(2)Companies can and do attach "riders" saying that they aren't going to cover some medical condition(s) you already have--NOT EVER, no way, no how. (I guess in this case you could shop around--but other companies very well might do the same thing.)

I believe lots of Americans who have been fortunate enough SO FAR to be covered by an employer-provided group plan have no idea about these things.

Yet another reason the US needs a national health plan.

Feel free to add to this list; I'm sure there are probably other things I haven't covered.

[FloridaPat]

1. I keep getting hit with the bait and switch. They come over to my

house and ask all those questions. They ask how much I weigh and I tell them. They give me a quote. Last time it was $450 a month. Then a couple of weeks later I get a call from the insurance company verifying how much I weigh. The weght is 70 pounds less then I told the agent. Then my checking account starts getting charged the monthly fee - without any notice that I even have insurance - around $300 more than the quote. And this is all legal according to the attorney general because they are giving me my money back.

Last time this happened I had insurance and was looking for cheaper insurance. The second company wrote me a letter 3 weeks after the insurance went into effect telling me I had the new insurance and what the cost was. They mailed it a month later, the day before their charge was to hit my checking account. I couldn't stop the charge. So I paid for 2 month to them without even knowing I had insurance and while I was still paying for the other $700 a month insurance! I did get my money back but I was really pissed. Now since I'm unemployed I have none at all.

Another trick I heard about. Lady got cervical cancer. They refused to cover any of it because she had pre-existing conditions - menstrual cramps! They gave her the premiums back. Big deal.

[raccoon]

7. That's disgusting what they did to that woman

who got cervival cancer. I wish she could've sued the bastards.

Many of the other things posted here are disgusting too. Disgusting that this country treats its own citizens so shabbily.

[Warpy]

2. The last time I priced Blue Cross was about 4 years ago

and for me alone, with my preexisting condition, it was $700/month. I'm sure that may not seem like a terribly steep bill to our fine congressmen, but it's half again as much as my mortgage is, and the choice would have been between shelter and an insurance plan that would cover only 80% of the health care bill once I'd reached a $2000 deductible.

This is insane.

[mpanno]

3. My husband and I can't even get coverage

My husband is a self employed CPA and has a policy with a $10,000 deductible. I have no health insurance coverage. No medical insurance company will take me because of severe back problems. Our hope is that somehow, some way, some day there will be health coverage in the U.S. for ALL.

[FloridaPat]

4. This is wierd. According to the gov't, 75% of the people are covered

by health insurance. Looks like most of the other 25% hang out here.

[bemildred]

5. I refuse to give them money any more.

Pay as you go, and if you can't afford it hope the afterlife is nice.

[Sugarbleus]

6. Wow, these stories are infuriating. ALL of us except the uberrich

NEED HEALTHCARE. Period. The stories you've told about the your insurance plans are just unacceptable.

When I worked full time with company paid insurance (that was some years ago), I rarely used it, but it did cover 98% of any medical need that would come up. Awww, those were the days. Then the company off shored and we lost our jobs. I went for 20 years without health insurance; working temp jobs. If there had been something in place that I could afford or have access to, I'd be in much better shape today! IE: Preventative healthcare.

I tried buying into a Kaiser plan that appeared affordable, during those years. Guess what? The Kaiser plan, while reasonably affordable to me, wasn't servicing my town/my address! The Kaiser hospital/clinic was just forty miles away from my home. The plan would NOT cover anyone in my county. Unfreakingbelievable!!

I've watched people like you good folks go through it with health coverage. I've watched as the plans got more expensive and then got more exclusionary etc etc. I was sickened to see the birth of HMO's and the like..that's suppose to be healthcare coverage???

So, I went along for some 20 years with no plan at all. If I could cobble together a few bucks, I go to the dentist or use it for an office visit. No way could I afford "extensive lab tests". I used my credit card for some things, but not many. At one point, my spouse (who did have medicaid) would go to his doc and get the meds I needed ...having made the case to his doc that HE needed them.

Now at 56 with a disability, I use medicare/medicaid both. Guess what? THESE programs/services/medicines are starting to be reduced and/or cut. =o/

UNIVERSAL HEALTH CARE FOR ALL NOW......

[adamd]

8. Some info about individual/small group/association insurance from inside

I've worked for one of the most prominent individual/small group insurance companies for about 4 years. I don't work in underwriting, but I work close enough I understand the basics of what they do. Once underwriting gets the application they can do a number of things:

1. Approve- no existing medical problems, good health...they will approve the application as is.

2. Rider/rate up- they will increase the premium rate for the base health policy, the additional benefits, or both. Typically this is done for minor health problems, health problems that were fixed without it showing up again after a very long time, weight problems, smoking, and even some extreme height (both too short or too tall). Obesity is the worst of all of these. I've seen extreme obesity cause the base rate to be increased 300%.

3. Partial exclusions- certain activities and health problems will be only partially covered by the insurance. For example, if you suffer from a particular health problem, they might only cover 50% of the costs of treating it.

3. Exclusions- If you have a history of certain health problems, preexisting health conditions, or you engage in really "extreme" activities they will not cover any health problems that arise from these situations. For example, if you skydive, they won't cover anything that happens as a result of a skydiving accident. Or if you have had cancer in the past, they won't cover any sort of cancer treatment in the future.

4. Decline- they decline the entire policy and refund the money paid to you.

The underwriting policy is rigged so that no matter how many claims you make against your policy, they will always make a profit. Which of the above options they take has to do with your medical history, physical health, and the state you live in, since each state has different rules that the insurance company will rate against to generate profit. Washington, for example, has some of the most expensive individual insurance because the state requires insurance companies to accept almost all preexisting conditions without exclusions or riders.

The most important advise I can offer anybody who is applying for individual insurance is to be very careful with the agent and anything you get from the insurance company. Check all of the receipts and worksheets the agent uses to calculate your premium to make sure the agent has correctly marked what is on the application and ONLY what is on the application. Agents have a history of adding benefits and ancillary products on the worksheets and receipts that you didn't select, and once you pay for it or sign off on the receipt, the insurance company will likely process those additional items even though you didn't directly know you were getting them. When you get the policy text from the insurance company, make sure you only have coverage for what you selected on the application, and do it as soon as you get it in the mail. You only have so many days (depending on the company) to review and protest anything that is in there, and after that period it is assumed you accept what you have and that is what you will be charged. And the courts accept that.