Insurance Companies Avoid People With Medical Problems

The Miami Herald shows one of the problems with our health insurance system, especially for those trying to purchase individual coverage who have any medical problems:

Trying to buy health insurance on your own and have gallstones? You’ll automatically be denied coverage. Rheumatoid arthritis? Automatic denial. Severe acne? Probably denied. Do you take metformin, a popular drug for diabetes? Denied. Use the anti-clotting drug Plavix or Seroquel, prescribed for anti-psychotic or sleep problems? Forget about it.

This confidential information on some insurers’ practices is available on the Web — if you know where to look.

What’s more, you can discover that if you lie to an insurer about your medical history and drug use, you will be rejected because data-mining companies sell information to insurers about your health, including detailed usage of prescription drugs.

These issues are moving to the forefront as the Obama administration and Congress gear up for discussions about how to reform the healthcare system so that Americans won’t be rejected for insurance.

It’s especially timely because growing numbers are looking for individual health insurance after losing their jobs. On top of that, small businesses, which make up the bulk of South Florida’s economy, are frequently finding health policies too expensive and are dropping coverage, sending even more people shopping for insurance.

The problem is, material available on the Web shows that people who have specific illnesses or use certain drugs can’t buy coverage.

”This is absolutely the standard way of doing business,” said Santiago Leon, a health insurance broker in Miami. Being denied for preexisting conditions is well known, but when a person sees the usually confidential list of automatic denials for himself, “that’s a eureka moment. That shows you how harsh the system is.”

Different insurance companies will vary in their policies, and many states do have an insurance of last resort who will insure those with medical problems–often for an outrageous cost. One example of an insurance company’s underwriting policies can be found here. There is information on finding out what the data-mining companies have on you here.

These policies make it difficult for many people over 40 who are not covered by an employer’s plan to obtain individual coverage. What often happens is that such people’s chronic problems receive insufficient treatment, increasing the costs when they qualify for Medicare at age 65.

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2 Comments

  1. 1
    Eclectic Radical says:

    Tennessee had an absolutely wonderful state medical plan, TennCare. It covered the indigent, those whose jobs did not provide insurance, and people with medical conditions who were ineligible for insurance as a result. It was exceptionally good, and very well funded. Then the balance of congress changed and a new governor wanted to push his own program instead and it was gutted.

    It was excellent, it worked, and the state killed it because Republicans won the legislature and a moderate Democrat had his own pet program. Isn’t democracy wonderful?

  2. 2
    medicare supplement insurance says:

    It seems that health insurance companies are afraid to have members who already have illness or disease…why? What is the problem with that?!
    They are health insurance companies right, they are suppose to help their members once they have health problem, are they afraid of supporting a member with disease? Why then?! Are they afraid of sending out big amount of money? It’s their member’s money so what are their rights not to give it to them?
    And also why are they discriminating people?! Who do they think are they?! We are all the same here.

    medicare supplement insurance plan

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