This morning I got to my office to find this gem in my inbox. I can’t say that she is wrong, and I admire her tenacity. Look for my comments at the end.
Question: I had health insurance my whole life. I have been a small LLC, member only, business for over 15 years. My health insurance rates began rising 35% annually once I turned 45. On average, in the last 10 years, I paid $5,000/year. I seldom went to the doctors and when I did I have been misdiagnosed. In the last 10 years of having health insurance I paid $50,000 getting reimbursed for less than $500. In 2009, while applying for health insurance I was denied by CareFirst. CareFirst cited high cholesterol (low ratio with 100 HDL that they do not recognized); high eye pressure that I have had for over 20 years and am monitored by an eye doctor (since the early 80s), high BMI (which I am a large boned person) and I was in my late 50s as a woman. While they denied me, they gave me a brochure to Maryland HIP program that is sponsored by CareFirst, so CareFirst takes no risks and gets the overhead/profit. The cost would be around $4000-$5000/annually with a higher deductable a nd ineligibly for any HSA. I decided not to bite.
I am angry because in my lifetime I have paid over $100,000 and maybe was reimbursed for less that $10,000 if even that. What happened? I was suckered. I was lead to believe that I would have coverage since I was paying into the system my whole life. My advice to all young people and all people is to stay out of the health insurance programs because they take your money for profit and they drop you as you age and become more risky. Health insurance only want to make high bonuses off anyone’s policies. Health insurance companies will cover you only if you are healthy and if you show signs or are statistically a risk, because of getting old, they will drop you.
My great grandparents and grandparents lived into their nineties and never needed much health care, so I will rely on my genes. I mainly wanted insurance for accidents, especially careless people that text and drive.
Another thing I went to my doctor with pains on my left side (stomach). Blood test were taken and the doctor diagnosed me with acid reflux, which I never had or have had. I received insurance statements that my doctor submitted a claim for the blood test, along with LabCorps claims, twice. The doctor and LabCorp tried billing me for the difference. The funny thing is 60% was covered by insurance the 1st time and the other 40% was cover the second submittal by Lab Corp. Then LabCorp had the audacity to try to bill me for the two balances. The total insurance reimbursement was $1000. When I contacted the insurance company to complain, they were nonchalant about it. I asked if they would honor the payee of the insurance and they stated that they only honored the provider. It turned out that I had shingles which no blood test would ever find.
Most individuals have insurance through their companies and never see the insurance statements. I am uncertain if corporations spend time reviewing or even receiving insurance claims about their employees.
The insurance companies have a fraudulent system of over compensation of claims that is one reason why they are insistent people keep getting their insurance through their employers. This over compensation of claims distorts the health care costs.
I don’t feel I need advice from you. I have resolved not to participate in such fraudulent systems as health care insurance. Believe me there are plenty of older women small business owners who have similar stories as mine. My advice to you is to get the word out that the health care and health insurance companies should not be for profit. Once this Country’s health care system is not for profit, then perhaps health care can again be an honorable profession. In the meantime, I will do everything I can to get the word out to the young not to carry health insurance, instead save their money and after 40 years they will have $200K to $300K to cover what ever health issue they have.
Well this isn’t actually a question I don’t think, and I have no idea who this woman is, much less why she wrote this on my health insurance contact form, or what her goals were in writing it. I will say it is extremely well written and she is obviously very intelligent and of course, bitter.
Where she is wrong, is her understanding of the word insurance. Insurance is a transfer of risk. Similar to auto insurance in fact. Just because you pay into a policy does not mean it should pay out unless the peril comes to fruition. I’m sure she has not recovered all of her car insurance premiums back either.
Where is she is 100% correct (and what makes her mistake above almost irrelevant), is that health insurance should be a right not a privilege. She has been paying into an insurance plan for many years faithfully and now that she can’t find a suitable plan at an affordable price she is right to scream!
Lets draw a parallel to auto insurance, had she wrecked her car several times her auto insurance would be extremely expensive. But as she said, she has not had health claims to warrant these rate ups.
Thus, she is being rated based on her age which is a factor she cannot change. Because health insurance is subject to risks you cannot avoid, it should be a government program, much like the fire department. The fire department used to a private enterprise, until obvious hazards became clear. Health insurance should be a public utility in the same way.
Sadly, its not and indeed we profit from that fact. But we are the best of the bunch who will promise to help you even if we make no money on the transaction.