In my last and fourth entry about my woes and “fight” with the insurance company, Anthem Blue Cross Blue Shield, I cautiously opined that maybe, just maybe, I had won the fight because I was given a level 1 with a reasonable premium. I should have known better.
Turns out that they have set me up as being on probation, sort of. That is to say, for 12 months, I am not covered for any pre-existing conditions. So I asked the Customer Service person if they had a specific pre-existing condition outlined in my policy. ”No,” she replied. So I asked, “Then how do I know or how do they know what might be a pre-existing condition?” ”By looking through your medical records,” she informed me. ”Since the time of my birth?” I asked, incredulously. ”Pretty much,” she replied. ”Does that mean that if I had a wart on my finger when I was 12 years old and I develop a wart tomorrow, they won’t cover removal on the basis of the pre-existing clause?” ”That’s right.” ”What if I was six weeks pregnant when I applied. Does that mean they would not cover the costs of the birth?” ”That’s right. Here is a scenario that might help you understand. If you go to the doctors and he finds that you have kidney stones, the insurance company would not pay for their removal because those kidney stones were forming before the doctor found them, thus a pre-existing condition. But if you should walk out your front door and fall down the steps and break your hip, they would cover that.” ”By that logic, then, what if I go to the doctor next month and he/she finds evidence of the C word in me. Would that be considered a pre-existing condition?” “Absolutely. The insurance company’s argument would be that the cancer had developed before the doctor had found it.”
How did I get on this probationary period? It all came about because although I have been using Anthem Blue Cross Blue Shield since 1997, more than 63 days had passed between the time I began my objections for the cost of the premium on my previous insurance coverage and the present coverage, thus, erasing all previous records and causing my status to become one of a new client.
WOW! So I am once again throwing my money out of the window and I have absolutely no positioning power to fight this injustice.
I believe this is a thumbing of the nose towards President Obama’s Affordable Health Care Act, (derogatorily termed “Obama Care” by his opponents — although some day that title will become an honorific, I have no doubt), specifically the clause in which a person seeking insurance will not be penalized for having a pre-existing condition, which, unfortunately, does not become law until 2014. But the fact of the matter is that by utilizing “pre-existing condition” without definition, the insurance companies are basically avoiding their responsibility for covering any new client. This clause might well also discourage people from signing on for insurance. And the people in Congress who have put up such a fight against the Affordable Health Care Act bask in the comfort of their excellent insurance plans paid for by our tax dollars!
Well, I am grateful for this customer service person’s forthrightness and I am just kicking myself for not having thought to ask her if there were any questions I should be asking her that I had not.
I have become aware, over the past two weeks, that the danger of our society being torn apart does not just come from the major amounts of negative propaganda from the opponents, nor the major amounts of money fueling these ads and these opponents, but the choice on the part of the media to not cover what is going on. It is truly frightening to be aware of just how poorly informed we are, and I include myself, because in spite of the fact that I plan to vote for President Obama, a part of me actually has been affected by the negative campaign that has dogged him throughout his presidency and I have not actively acknowledged/recognized just how much his Administration has been doing to try and make things better in this country.
© Yvonne Behrens 2012