Public Enemy No. 1 is America’s health insurance firms
I have no health insurance, but have a son in high school who wanted to play sports. He couldn’t participate without health insurance, so I called my agent for a policy. I wanted major medical coverage with a high deductible. He recommended Blue Shield of California.
I received the 12page application. It requested exact dates of every doctor visit, the reason, diagnosis, any prescriptions and exact dosages over the last 10 years. I didn’t have all the information and no way to get it. It said any errors or omissions would lead to cancellation of the policy.
I’d have to enclose the first payment for three months coverage. They promised a refund if my son wasn’t accepted. I wasn’t allowed to see the policy until I was accepted. I completed the application as best I could and sent everything to my agent, who faxed it in.
Three weeks later, when I hadn’t heard anything, I contacted my agent, who tried for two days to contact Blue Shield. When someone finally answered, they said they had no record of my application, even though my agent had a receipt number. The information was re-faxed, and, ultimately, my son was approved, and I received the 78-page policy.
As I read it, I noted things that weren’t covered, how much they’d pay for each problem and all the steps that I’d face and in what order to get reimbursed.
Particularly disturbing was the “Critical Condition Protection” section. It stated that if the insured had a stroke, myocardial infarction or life-threatening cancer, they’d pay a lump sum of $10,000 per insured per lifetime. “The insured must survive for a minimum of 30 days after the date of the initial verifiable diagnosis of a Critical Condition, in order for the condition to qualify under this benefit,” it said and “Only one Critical Condition payment will be paid for each Subscriber or Dependent per Lifetime regardless of the number of Critical Conditions experienced.”
This is called a major medical policy.
I can’t wait for government insurance and will be first in line to get it if it’s approved. Tom Graves Newbury Park


