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Got bunions? No insurance for you

Posted Sep 21 2009, 08:10 PM by Karen Datko
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We knew that health insurance companies refuse to sell individual policies to people who've had cancer or hypertension. But acne or bunions -- or working in a first-responder job?

Insurance company documents obtained and made public by Consumer Watchdog indicate how far some insurers will go to limit individual coverage to only the healthiest people (and those with the safest jobs). A hangnail? You'll get coverage. Toenail fungus? Perhaps not.

This is news because health care reform intends to prohibit insurance companies from denying individual coverage to those with pre-existing conditions or setting the price beyond most people's grasp.

The insurance companies whose internal documents were disclosed either wouldn't comment or observed that the documents were several years old -- and declined to say whether they'd been updated, The Washington Post said.

You can read the documents, all .pdf files, by clicking here, here, here and here.

Some examples: You could be denied coverage if you:

  • Work as a police officer, firefighter, stunt person, test pilot, logger, rodeo performer, or migrant, utility or circus worker (the big tent could come falling down, or maybe an elephant could get loose).
  • Are pregnant, are an expectant father or are going to adopt.
  • Take common prescription drugs like Allegra, Advair and Lamisil, the toenail fungus drug.
  • Have chronic tonsillitis, varicose veins, acne (Accutane-free for less than six or 12 momths), hemorrhoids, bunions, asthma, arthritis, ADD or silicone breast implants.
  • Have gotten therapy or counseling within the last six months, or "currently experiencing/experienced within the last 12 months symptoms for which a physician has not been consulted."

About that last one, Michael Santo wrote at Huliq.com:

Based on the horror stories of people who have their coverage revoked when an insurance company finds some condition they neglected to tell them about, this could be taken to the extreme: "Sorry, Mr. Johnson, you forgot to tell us about that runny nose you had in March."

What do you think? Jeff Rosenberg at MNpublius offers this opinion:

Whatever ultimately happens with health care reform, we at least need to end this nonsense. Without health insurance, millions of Americans are unable to afford proper medical treatment. So how could it make any sense to deny access to insurance just because a prospective client has heartburn?

Related reading:

Buy your own health plan

America's health insurance crisis

Your 5-minute guide to health insurance

Comments

 

From what I have read, the insurance companies are not just closing the door on perspective customers, it appears to also be a liability limiting device. The customer becomes ill with what could be an expensive treatment and the insurance company finds an excuse to terminate the customer's policy.

I can't stand insurance companies.  You're screwed with them and you're screwed without them.

Let's find out these specific insurance companies names and start recommending that future clients(and maybe current ones ) bypass them! They will either get a clue or go out of business.

markus,

Unfortunately many of this insurance companies are the only game in town.

I think there should be at least a law limiting denials due to pre-existing conditions to no more than a couple of months from the start of coverage. You cannot give a person a false sense of security for years and then bail out on them. And just as any other type of insurance if the coverage is denied after the fact, the premiums should be refunded.

For any real meaningful change to occur in healthcare reform, health insurance companies must be banned from this insane practice.  The underwriting process needs to be changed as well.  Letting these companies set rates on the individual company level allows them to effectively price out small businesses who have had an employee with a moderate claim in the prior year.  Each health company should be required to submit a rate and plan coverages to the Feds for approval and that is what everyone pays no matter the size of the company they work for. Without these items then a law requiring everyone to have insurance simply puts the Fox in charge of the hen house.

And there of course there's the ol' pre-existing condtion of being domestic violence victim: www.seiu.org/.../domestic-violence-victims-have-a-pre-existing-condition.php. Real classy, insurance companies.

If you think about it, being alive could be considered a preexisting condition by these clowns! After all, if you're alive you might be exposed to sick people, or have an accident, or have a baby and make a claim. Maybe they should only insure dead people! Meanwhile, we all need a break. Health care reform will help but I think insurance reform might be even more essential.

does that mean hookers and pimps can't get insured especially when they always have pre-existing conditions.  So I guess a person has to be purer than snow.  Or they have to be a very religious fanatic or so called Holy Roller one that goes to church daily, and is always preaching the thing called God so much that they are the chosen and gifted few.  Well I guess also they should consider blinking , breathing, associating a pre-existing condition after all it doesn't pay to exist.

My new baby and I were turned down for health insurance years ago because he was born with a clogged tear duct (it happens in like 90% of babies and goes away on its own)! and I had rosacea - NOT a life-threatening condition, and it was very mild.  I had to go back to work after three years as a SAHM just so I could get coverage.

United Health Group is one of the insurance companies this article is referring to.  See the link within the article to see what other insurance companies are crooks (click on Consumer WatchDog in the second paragraph)!  My husband was offered Cigna coverage through his employer, and the cost for a family of 4 with a huge deductible, no prescription plan, and no 'welness checkups' was $6,000 per year.  That's not too bad,  but the maximum they would pay during a hospitalized 'event' was $3,000.  So, they're willing to take your $6,000, but if you're hospitalized the maximum you can expect from them is $3,000!!!  It's cheaper for us to just bank the $6,000 and pay out of pocket negotiating a cash payment discount with the doctors.

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