Yet Another Example of the Fucked Up Health Insurance System

Thanks to Gawker blog The Consumerist for pointing me to the latest news about why the health insurance system, especially for self-employed individuals, is broken in so many ways.

“Cancer Patient Wins $9 Million From HealthNet in Arbitration Settlement.”

The LA Times has more details. Basically the woman was lied to while signing up for her policy, and then dropped as soon as HealthNet could cancel her “fairly” with their corrupt and unclear policies.

When HealthNet signed her up, this is apparently what happened…

“When asked about her weight, she told him her weight on her driver’s license was 185lbs. She never told Torrez to change the weight, nor was she aware that the weight had been changed.”

So… when this woman ended up getting breast cancer, they used the fact that she “gained” weight in order to bump her from the policy. Except, she hadn’t gained weight at all. The person who filled out her form while signing her up changed her weight so she would be accepted.

All of this hits close to home for me. While I (luckily) do not have breast cancer or any illness like that, I do fear my health insurance policy being canceled if I ever have to use it. That seems kind of ridiculous, doesn’t it?

As many of you remember, I had to lie on my health insurance application to get accepted.

My health insurance agent basically told me in so many words that my best option was to lie. He wouldn’t go on record about that, but he said my odds of getting health insurance while being completely honest about my pre-existing conditions (polycystic ovary sydnrome/irregular periods and major depression) were slim to none.

And he was right. The first time I applied through Pacific Care, I was entirely honest. My health insurance agent filled out the form for me as I told him my details by phone. Later, when I reviewed the information he entered before signing the form, I noticed he had taken some creative license in describing my conditions. I tweaked the language so it was 100% accurate.

A few weeks later I was declined coverage. Not for depression, which we both thought would be what held me back, but for the “irregular periods.”

As my fellow personal finance bloggers LuluGal and Escape Broklyn can attest, “irregular periods” are fairly common. And, to be fair, irregular periods often cost the insurance companies lots of money. Both those two gals are getting surgery for their problems. And, from what I understand, insurance is paying for a lot of the surgery, even though it won’t be covering everything.

For me… I don’t know if I’ll ever need surgery for my various ovarian problems. Because I know about the problems and because I’ve been diagnosed with PCOS, the cheapest way to maintain my health is to take birth control pills on a regular basis. Except my catastrophic health insurance does not cover medication. So I don’t take any.

Ultimately I was approved for health insurance. I had to lie to get approved. Well, I left off the depression and kept on the irregular periods bit. So now I can lose my coverage if they ever realize I lied about depression, and anything health problems I might have that relate to polycystic ovary syndrome won’t be covered anyway. This leaves me wondering why I bother with health insurance at all!

I really hope that Obama or Clinton get elected and then make some major progress in getting the health insurance companies in check. While I hate paying taxes, if I’m going to pay taxes I want them to be going towards keeping people in this country healthy… not fighting some trillion dollar war we can’t win.

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3 thoughts on “Yet Another Example of the Fucked Up Health Insurance System”

  1. Sadly, if they find out that you lied, you could be out your insurance premiums and the health coverage. The system really is quite broken.

  2. I so know where your coming from. I still have no health coverage. I was honest as well with my application and was flat out denied by Blue Cross Blue Shield and Kaiser. All because I have a tilted uterus. It's something some women are born with. The insurance companies stated that I was "high risk" high risk for what? Absolutley nothing. It makes me so sad sometimes. Thank goodness my fiance helps to pay for any medical bills I may incure. The next President will strongly determine where we live next year. We are seriously thinking of moving to Canada if something is not done soon with our healthcare system.Love your blog by the way ๐Ÿ™‚

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