If you’re wondering why so many people claim they liked their old health insurance, the answer is simple. Very few people with health insurance ever use it for anything other than health maintenance, like doctor visits and annual checkups and the like.
What many people seemed to be unaware of was that, under their old insurance policy, their company could simply refuse to sell them insurance, or cancel their insurance, and/or deny payment of a claim if, at any point, they decided they had a pre-existing condition.
Think of what this means. It means they and/or their employer could be paying them upwards of $1200 per month for coverage for a family. That meant they would use the $14,400 to pay for any and all doctor visits and tests and screenings, but if any of those tests or screenings actually uncovered anything, there was a very good chance the insurance company would cancel you and keep the bulk of the money you had paid them over the years.
Worse, it also meant that many of the sickest people in the country – those most likely to need health care – were not paying into the system, even though they were the most likely to incur costs under the system. It meant that, if a child or a teen was diagnosed with one of these conditions, they would either never get insurance coverage for the rest of their lives. As medical science moved forward, the number of such conditions would tend to increase, as would the number of exclusions. According to some estimates, between 30 million and 100 million insured had a pre-existing condition, and were at risk of losing coverage or not having their bills paid, if they got one or more of hundreds of illnesses. And many of them had no idea.
And if you think pre-existing conditions were limited to extremely serious conditions, think again. Here is a list of pre-existing conditions from Blue Cross and Blue Shield of Illinois, issued in 2011. Not the extremely scary line in bold:
Medical Condition Rejection List
If you have a condition, illness, or injury that is listed on the Medical Condition Rejection List below, you will most likely be declined for individual coverage with Blue Cross Blue Shield of Illinois.
These conditions include, but are not limited to:
- Alcoholism/Alcohol Abuse (within 7 years)
- Aortic Stenosis
- Arteriosclerotic Heart Disease
- Ascites (within 5 years)
- Bi-Polar Disorder
- Boecks Sarcoidosis
- By-pass surgery
- Cancer (other than skin cancer)/Malignant Melanoma²
- Cerebral Vascular Accident
- Cerebral Vascular Disease
- Chronic Obstructive Pulmonary Disease (if currently smoking)
- Chronic Pancreatitis
- Chronic Renal Failure
- Cirrhosis of Liver
- Coronary Heart Disease
- Cushing’s Syndrome
- Cystic Fibrosis
- Diabetes (managed with any type of medication)
- Drug Addiction/Abuse (within 5 years)
- Fatty Liver (hepatic steatosis) (fully recovered with normal lab results for minimum of 6 months)
- Grand Mal Epilepsy (within 5 years)
- Heart Attack
- Height and Weight (see chart)
- Hemodialysis/Peritoneal Dialysis
- Hodgkins Disease
- Huntington’s Chorea
- Immune Deficiency Syndrome
- Leukemia (within 7 years)
- Liver Atrophy
- Lupus Erythematosus (Systemic)
- Multiple Neurofibromatosis (within 7 years)
- Multiple Sclerosis
- Muscular Dystrophy
- Myasthenia Gravis
- Myocardial Infarction
- Organic Brain Disorder
- Paget’s Disease
- Parkinson’s Disease
- Pending surgery of any kind
- Peripheral Vascular Disease
- Polycystic Kidney
- Pregnancy (current)
- Psychotic Disorder
- Rheumatic Heart Disease
- Systemic Scleroderma
- Tetralogy of Fallot
- Transient Ischemic Attack (within 5 years)
- Organ Transplants
- Valve Replacement
Again, think about this: many with any of these conditions were (rather arbitrarily) actually prevented from paying into the insurance system. We are all entitled to health care at some point, such as when we’re in severe pain We know most of them weren’t paying their bills themselves, so guess who was paying them?
It was also entirely up to the insurance company; they could keep people paying premiums until an expensive treatment was needed and then deny a claim and/or cancel the policy when they decide the cost is too high.
Here’s another link to a list of pre-existing conditions by Assurant Health. It’s even longer.
Be happy for Obamacare. Your insurance is better, because it’s now actually insurance.
Copyright 2013 The PCTC Blog