Insurance denial can seem arbitrary

  • Article by: CHEN MAY YEE , Star Tribune
  • Updated: January 10, 2009 - 5:43 PM

Fat? Taking antidepressants? Had a C-section? You may be uninsurable in the individual market.

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dgb049Jan. 10, 09 6:22 PM

It's really anti-bankruptcy insurance. My wife and I (basically healthy) pay $1200 a month for nothing more than hoping we won't have a $250,000 hospital bill.

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julievojoJan. 10, 09 6:37 PM

That's a good comparison. We also pay nearly $1000 a month for a high deductible plan. We never saw a penny out of it, until my spouse got a bad case of pneumonia last winter and we wound up with a $90K hospital bill. Now the $1000 a month seems like a pretty good deal.

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iceicebaby46Jan. 10, 09 9:55 PM

laws against not covering pre-existing conditions. Contact the Health and Human services office. Blue Cross and Blue Shield are good for denying coverage. When my daughter was a baby, they tried to get out of covering her for pre-existing conditions as well. They had several "erroneous reasons" as they stated. My daughter's father was court ordered to put her on his insurance, and they fought it. Don't give into them, turn it over to the state. In fact, to be truthful, Medica is a much better insurance policy and you don't need a referal to see a specialist/surgeon as long as you stay within their provider network. If you need to see a chiropractor, Blue Cross and Blue Shield do not like to cover that either. Whereas Medica allows you to see one, without limitations. BYE BYE BlueCross&BlueShield, Fairview Health Systems as well(quack doctors).

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digalvinJan. 10, 0910:58 PM

But entirely legal. Insurance companies and their partners in the medical industry don't care a rat's a## about you, only your ability to pay the bills -- one way or another, if not a high insurance rate, then top tier, non discounted billing followed by rabid debt collectors. Sorry, nothing personal, it's just "business" you know. Even if you do get the coverage, it's almost guaranteed you'll be rejected another year or so down the road, especially if you file a serious $$ claim....because of some technicality or "new" requirement you suddendly don't meet. And to make matters worse, you can't self-fund or self-insure for known costs & set up your own personal H.S.A. with the money you'd otherwise send to the insurance companies --- no that's NOT legal -- some administrator needs to get his cut.

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gkrevquestJan. 11, 09 8:31 AM

Was to allow people to pool the risks involved in everyday life... property damage, injury, liability, health problems, thereby allowing everyone to bear a reasonable, predictable monthly cost and receive coverage to cover damages/losses/expenses. Today's insurance companies have long ago left that behind. The premiums they now receive provide them with a pool of money which they can then invest in other schemes in order to provide higher profit to their investors and outrageous salaries/benefits to their executives. Having to pay off on legitimate claims reduces that money pool and interferes with their main purpose - to make money for themselves and their investors. In current-day insurance, keeping the investors and the execs happy and wealthy is what matters. Those buying the coverage, paying the premiums and hoping to have their legitimate losses/expenses covered do not.

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jerryclarkJan. 11, 09 9:55 AM

What a person or their employer pays for what is labeled "Health Insurance" should be labeled "Extortion Payments" instead. This money adds to the cost of being comepetetive in this globan economy and benefits no one except those employed by the "insurance" industry and their thugs that make you pay (or if you do not these vultures will harass you until you really get ill and then you go bankrupt in trying to get them off of your back. This sounds like a racket or Ponzi scheme and what do we get - nothing but death or distrustion. We need to get a health care plan like Medicare for all that's been introduced in Congress and then just lies there until the next session,which never happens. With health care providers hiring collection agencies as their enforcers and with little protection for the victims no wonder that America has some of the worst health outcomes in the world. To get something done each person should take the responsibility to let the Obama team know their feelings and demand our share of the bail out money that has been handed out to almost bankrupt companies. In this economy if nothing is done about the health insurance problem, our society will go bankrupt for sure. (What ever is done must be peaceful or they will sick the police in riot gear on you.)

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rkleppeJan. 11, 0910:43 AM

The comments about the bad insurance companies is way off the mark. They operate within the legal framework established by the State of MN. Look at the annual reports, they are barely making money or in some cases losing money as they are paying out more in claims than they are collecting in premiums. In MN we have MCHA that will insure people who have been denied coverage. The system works pretty well, we have one of the lowest un-insured rates in the country and we are ranked as the healthiest state in the country. Our medical practicioners are high quality and insurance companies are not-for-profit if they sell fully insured products in MN. Life is Good.

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jbhall56Jan. 11, 09 4:33 PM

I've never understood why there even is individual insurance. Can't there be a group called, for lack of anything better, the 'Minnesota Group' that would include everyone in Minnesota not under an employer's group? Then the insurance companies have a group which seems to be what they need to 'feel better'. Maybe I'm just looking at this too simplistically. But it seems to me that it should be something that they could institute and would address the problem.

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upnorth85Jan. 11, 09 6:09 PM

As things stand, insurance companies negotiate treatment rates with Doctors and Hospitals. Those who are uninsured pay the top rate and invariably they declare bankruptcy when faced with enormous bills. A large number of those not having employer sponsored insurance go for high deductible plans (with "lower" premiums) just to be able to cover themselves in the event of a major illness AND also for having lower expenses for the usual sicknesses and flue etc which may be paid before the large first deductible expense is fully incurred. In some states it is illegal to charge un-insured patients higher medical/surgical fees than what the insurance companies pay. I have health insurance through my employers and am OK, but think it is morally wrong for 40 million of my fellow Americans not to have any health coverage. It is just isane for the richest country in the world to have this situation. We spend the most as a percentage of GDP but have below average health outcomes (in the west). Hopefully, we will see major changes in the health industry after 20th January.

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RipAndersonJan. 11, 09 6:46 PM

They might not have INSURANCE coverage but most have medical COVERAGE. Moreover a huge percentage of that 40 million "uninsured" are eligible for one of many medical insurance programs -- Medicaid, Medicare, MinnesotaCare, etc -- they just need to sign up.

Also, many of that 40 million "uninsured" are only counted as such on a technicality. They count anyone who was uninsured for any PART of the year. Last year I switched insurance in the middle of the year when COBRA ran out. BY LAW I couldn't sign up inbetween annual enrollment until I had LOST coverage. I couldn't sign up ahead of time; I had to wait 'till it expired THEN I could sign up for new and had 30 days to do it. Meanwhile, I was counted as one of those "uninsured" Michael Moore talks about, even though I had excellent insurance coverage the whole year.

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