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Health coverage 'plan' was no insurance at all



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Health coverage 'plan' was no insurance at all

Oct 25, 2009 06:10 PM written by HM2VikingRN | 68 Comments
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Mary Lloyd's husband was lying in the intensive care unit of an Arizona hospital when she got a good look at their new health insurance card for the first time.

Then she got the shock of her life. The card read: "This is NOT an insurance card."

For the retired couple from East Bethel, it was the beginning of a financial nightmare that left them with at least $50,000 in unpaid medical bills. They discovered that the new "health plan," they signed up for in January, for $499 a month, wouldn't pay for any of his medical care.
http://www.startribune.com/lifestyle...oDEy3LGDiO7aiU
 
 
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68 Comments
No. 1
from Jolie
Old Oct 25, 2009, 06:22 PM

If the company or its sales person engaged in fruad, they should be prosecuted, and damages paid to the customers.

Otherwise, I fault the "policy-holders" for not knowing what they were buying and not learning the limits of their "coverage" until the husband was in the hospital.

I'm sorry, but I have little sypathy for people who fail to investigate what they are buying, whether it be a mortgage, insurance policy, auto loan, etc.

This happens far too often with people who have "real" insurance also, and assume it covers everything without reading the policy, its limits and exclusions.

May sound harsh, but I don't feel sorry for these poeple. They probably argue at the gorcery store over redeeming a $.25 coupon, but spend hundreds of dollars on "insurance", and don't know what they're buying. Stupid is what stupid buys.

This is not a reason for the taxpayers to become responsible for their health care expenses.
 
No. 2
Old Oct 25, 2009, 06:26 PM

No but we do need a transparent "plain language" insurance marketplace. If nothing else health care reform and the exchanges will improve transparency of the products.

Taxpayers will end up eating the 50K if the couple goes into bankruptcy.

She did do her homework,,,,,(From the source...)


Mary, who took meticulous notes, initially chose a plan for $588 a month. The salesman, who identified himself as Darryl Williams of Mid South Benefits, promised it would cover all preexisting conditions, Mary Lloyd recalled. After a few questions, "he said, 'Wonderful, you qualify.' "

A month later, they were still waiting for something in writing. With their old insurance expiring in two days, Mary Lloyd called Williams in late January. That's when the salesman offered to switch them to a better and cheaper plan. She admits, in retrospect, that she didn't ask a lot of questions. Running out of time, she simply agreed.
They were "bait and switched..."
 
No. 3
from Jolie
Old Oct 25, 2009, 07:36 PM

Originally Posted by HM2VikingRN View Post
No but we do need a transparent "plain language" insurance marketplace. If nothing else health care reform and the exchanges will improve transparency of the products.

Taxpayers will end up eating the 50K if the couple goes into bankruptcy.

She did do her homework,,,,,(From the source...)




They were "bait and switched..."
The "bait and switch" as you call it came about because, by her own admision, "the salesman offered to switch them to a better and cheaper plan. She admits, in retrospect, that she didn't ask a lot of questions. Running out of time, she simply agreed." Common sense would have prevented that. Doing her homework would have prevented that. Asking questions and for information in writing would have prevented that. No "better" plan is "cheaper." She wanted something for nothing. She got nothing for something because she chose to make an uninformed purchase. She was lazy and now she's in a bind of her own making. It is not the taxpayers' job to get her out of it.

I can't wait to see the "transparency" the Dems require of insurance companies. If it's anything like the transparency we've seen of the Obama administration, we're in trouble. Remember the high standards promised of Cabinet nominees, the promise to have bills available on-line 5 days for taxpayers to read prior to a vote, the proliferation of Czars who are not accountable to Congress or the electorate? Transparency is hardly the forte of this party or administration.
 
No. 4
from Jolie
Old Oct 25, 2009, 07:46 PM

Originally Posted by HM2VikingRN View Post
Taxpayers will end up eating the 50K if the couple goes into bankruptcy.
A bankruptcy that will undoubtedly be blamed on "medical expenses," instead of stupidity or laziness which would be more accurate descriptors.
 
No. 5
Old Oct 25, 2009, 08:33 PM

I don't think the timelines support that comment....The larger issue was that this couple was a victim of fraud....
 
No. 6
from GCTMT
Old Oct 25, 2009, 08:53 PM

Smart people can do some pretty stupid things.

I hope the company is prosecuted. I hope these folks are able to avoid bankruptcy.

*shrugs*

The free market at its finest.
 
No. 7
from Medic2RN
Old Oct 25, 2009, 09:33 PM

It is not the free market. It is the criminal element. You'll find that element in whatever type of system we have or will have.
 
No. 8
Old Oct 25, 2009, 10:42 PM

Originally Posted by Medic2RN View Post
It is not the free market. It is the criminal element. You'll find that element in whatever type of system we have or will have.
Yeah, and what I call criminal is paying $440 a month for health insurance through my employer that pays....for......NOTHING!!!:angryfire

That's right. I have had this insurance for a year, paid thousands of dollars into it.........and they are refusing to cover any of the expenses for my hyperparathyroidism, which have already topped a thousand bucks and continue to mount. We haven't even gotten to the DEXA scan and the renal U/S I just had a couple of weeks ago, let alone the surgery I'm going to need. Why? Well, according to them it's a "pre-existing condition", even though I have never been officially diagnosed with the condition until now.

Somebody please, tell me how in the name of all that is reasonable can an insurance company get away with ripping off consumers, month after month after month, and NOT having to provide the services we are paying for??!! And how is that moral, or right, or even good business?? My husband and I are already in so deep from having so many medical expenses over the past year for our REAL pre-existing conditions that I don't see us ever getting out from under the crushing debt load..........of course the hospitals and doctor's offices never bill us for everything all at once so we never really know just how much we owe them, but I know it's in the tens of thousands and probably will reach six figures before this particular episode of my life is over.

I feel like I'm shoveling (insert vulgar term for 'feces' here) against the tide when I pay my co-pays at the time of service and then open up the bills two months afterwards to find that my insurance company has denied yet another claim. :angryfire This is what has convinced me---a political conservative in almost every other way---that single-payer health care is the ONLY way for middle- and lower-income people to survive financially, at least if they're past 35 and have a few medical issues.

I think you all know I work hard and play by the rules; I'm not lazy, looking for handouts, or trying to cheat the system. So how is it that some folks evidently think it's perfectly OK for an insurance company to cheat ME??!!

Just venting.........I am really, really ANGRY about this and it mystifies me that anyone can possibly justify the continuation of this evil non-system in light of the fact that it's not just "the poor and lazy" who are going bankrupt here.
 
No. 9
from Moogie
Old Oct 25, 2009, 11:35 PM

Originally Posted by Jolie View Post
The "bait and switch" as you call it came about because, by her own admision, "the salesman offered to switch them to a better and cheaper plan. She admits, in retrospect, that she didn't ask a lot of questions. Running out of time, she simply agreed." Common sense would have prevented that. Doing her homework would have prevented that. Asking questions and for information in writing would have prevented that. No "better" plan is "cheaper." She wanted something for nothing. She got nothing for something because she chose to make an uninformed purchase. She was lazy and now she's in a bind of her own making. It is not the taxpayers' job to get her out of it.
I read the article in today's Star-Tribune as well. Apparently the couple could not afford the $1200/month payment for insurance through COBRA. They found this health plan at less than $500 a month; ad said everything was covered. Insurance agent called her to offer a "better but cheaper" plan and she switched. Was she being greedy? Perhaps. Should she have looked elsewhere when this seemed too good to be true? Definitely. But what is done is done.

And yes, she should have known better as she had been a clinic and hospital manager for something like 28 years. Maybe she was arrogant and thought she "knew it all". Maybe she didn't pay attention. Regardless, she and her husband were without insurance when he had his MI and those premiums she paid most surely went into some scammer's wallet.

If you get a chance, do try to read the entire article. It might give you a different impression about this story.
 
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