Long-term readers may recall that I have railed against my insurance company (going so far as to write on this blog that I would dearly love to lightly stab some of its executives), one of the crappiest insurance companies I have ever had the misfortune of being insured under. Well, my insurance company is soooo crappy (how crappy is it?), so crappy that it has singlehandedly reignited the once-dead debate of national health insurance reform. Yes, my insurance company is Anthem Blue Cross of California, currently gouging California consumers with a 39% rate hike despite its literal billions raked in last year.
The insurance commissioner of California stated that he has "a healthy skepticism" about whether Anthem Blue Cross is breaking the laws requiring an insurance company to spend 70% of its income on health care. Additionally, Anthem Blue Cross is facing investigation over literally hundreds upon hundreds of incidents involving misleading its insureds to rip them off, failure to pay claims, failure to abide by rulings against it in favor of its insureds, etc.., etc...
Among its other misdeeds against me personally, Anthem Blue Cross refused to pay a cent for a doctor-ordered mammogram for me and charged me hundreds of dollars for a routine pap smear. To add insult to injury, Anthem Blue Cross sends me form letters and robocalls me to nag me to get mammograms and pap smears, services for which it refuses to pay. Their basis for refusing to pay is that those were optional tests, tests done when there was no reason to believe that I had cancer. On the one hand, they strongly believe I must get preventive screenings and nag me to do them, but on the other hand, they claim screenings are frivolous and I should do them on my own dollar. Subsequently I have not had a mammogram in a couple of years because I am on a budget and find it difficult to spare a couple hundred dollars for optional medical testing.
We were charged over two hundred dollars last year for getting Iris and Lola a routine, annual physical and the normal vaccines for their age. Again, Anthem Blue Cross displayed a rather cavalier attitude towards preventive medicine. Are they shortsightedly trying to discourage people from vaccinating? I imagine there must be many parents out there insured under Anthem Blue Cross who find it very difficult indeed to pay for routine, normal vaccines. I will pass up mammograms for myself, but I'm not going to stop getting the children vaccinated.
There was also the oh-so-amusing time when Anthem Blue Cross sent me a letter requesting that I switch to a generic antidepressant. I raised this with my psychiatrist (whom I pay completely out of my own pocket), who told me that the generic drug was not a true replication of the drug (he had a complicated explanation for that involving molecules which bind on the left side and molecules binding on the right side) but that I could save money if I tried a higher dose of the less-effective generic. When I tried to fill my prescription for the generic drug, at my crappy insurance company's own request, I found out that my insurance company was going to charge me a $225 copay. When I reported that back to my psychiatrist, he was really shocked. "That pill only costs 75 cents a pill! How on earth can they charge you $225 for that?"
Sometimes it is difficult to tell the difference between being insured under Anthem Blue Cross of California and being uninsured. Oh, wait, the difference is that if I were uninsured, I could just cut to the chase and write my big check without having to endure forms, unintelligible letters, profoundly irritating phone calls, and a massive, two hundred page booklet setting up all sorts of threatening conditions under which Anthem Blue Cross will dodge out of coverage. As a representative from Mt. Zion Hospital said to me when we were trying to work out coverage for my surgery, "I've never run across an insurance plan requiring anything like this."
Lord, I wish Doggy-o, the Sober Husband's employer, would get a decent healthcare plan. Sadly Doggy-o has gone the other way, downgrading our Anthem Blue Cross plan from the previous, extremely sucky plan to a fresh, new, unbelievably even suckier plan, done just in time for my recent surgery, which is going to bust our budget for the year. Sigh.
You can read more about Anthem Blue Cross in the San Francisco Chronicle.
p.s. For Christmas this year, I would like a mammogram.
I don't understand why Doggy-O has chosen such an obviously crappy insurance company either; it's basically a catastrophic or high deductible policy, chosen by people who don't really have or anticipate having any real need for health care. The fact that they call you to nag you about mammograms that you pay for from your own pocket--What is up with that? Insanity.
My school district insurance policy is much better, it's unbelievable to me that a company would choose that. You should be able to choose it for yourself just like your auto insurance!
My employer just dumped United Healthcare (PacifiCare) in favor of Anthem Blue Cross HMO for our group health insurance policy. I am, shall we say, not amused by the change, but somehow not surprised that this is the same insurance company that's reignited the health care debate. Egads :-O
I have United Healthcare; no complaints so far. I do at time miss having Tricare, which is what active duty military and their dependents fall under, because it was less paperwork and no co-pays at all. Anywho, I don't like where things seem to be headed with health care reform legislation, but when I hear stories like yours, I wonder how their can be people out there who are absolutely opposed to public health care, period.
I'm glad I don't have to deal with any of that...
I live in Australia and in addition to Medicare (free public healthcare) I also have MediBank Private, which means I can get free healthcare for absolutely anything that needs doing, but if I don't want to be on a public waiting list, want a private hospital room, or want to choose my own doctor, I pay $500 per hospital visit or $40 for an outpatient procedure. Thats all. Nothing more, no approval for procedures, no big bills or fees... I think Australia is the true lucky country. But that's just my bias as a hypochondriac with allergies.
I can't go out on my own to get insurance coverage, because I take an antidepressant (which is a pre-existing condition). I also could not get insured on my own in the past due to my fibroid, as no insurer wanted to be on the hook for the surgery that was going to happen one day. That's no longer an issue, as horrible old Anthem Blue Cross was left sitting in the chair when the music ran out on that fibroid, but I'd still have to lie about being on antidepressants to have any chance of any ins. co. taking me on.
DW - don't count yourself out yet. Are you still licensed or a member of any Bar association? A lot of bar associations have gotten together to purchase group health insurance plans that their members can access.
Would love to see how much Doggy-O pays for this plan each year. If they'd just give you that $ instead, you'd probably be better off!
I am licensed but an inactive member of the Calif. Bar. (If you know my real name, you can look me up at the calif. bar website). The last I looked, the only ins. I could get through any legal affiliations I have was legal malpractice ins., but that is a very good thought, Anonymous. I'll keep it in mind.
Currently the Sober Husband must maintain a job with benefits. Not all high tech start-ups offer ins., so that does limit him. He tried to get private ins. for us to open up his options, and he and the girls can get insured but not me. I'm uninsurable due to a checkered medical past (although at least the fibroid is gone... a year from that hospitalization might make me potentially insurable again if I went off antidepressants).
I'm lucky (?) enough to be with a firm, but have a lot of friends who are either SAHMs or solos right now. One SAHM reactivated herself during / after her divorce - apparently the state voluntary bar assn gives acess to pretty good blue cross blue shield (clearly we are not in CA).
It says something profound about the confidence of insurance companies (and their lobbyists) that they felt they could hike rates at a time when most people are hanging on by their nails. Clearly, they never expected repercussions, and I hope that the AG nails their asses to the wall. That doesn't help your situation, but it might be successful ammunition for SH to petition his company to change health care providers. Because if you're having these problems, then everyone ELSE at the company is having these problems too.
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