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Old 10-02-2009, 07:14 PM
207 posts, read 494,809 times
Reputation: 169


They're all pretty bad but as a rule it's better to go with the biggest ones such as Aetna, United Health, and Blue Cross. This is because they are accepted in more places.

Individual health insurance has many very serious flaws, especially over the long term. The core problem is the way that it's structured.

Let me explain.

When you buy an individual policy you must be a in good or even great health in order to be accepted. Your policy will be sold for 2-3 years with a specific name "Plan XYZ" After a period of time, they will close the plan.

The plan's cost will start to rise as more claims come in due to aging of the people in it. The healthy people will leave the plan and get a new, cheaper one (if they have a clue.) The sicker people who are "stuck" in the plan cannot get another individual policy. Their rates will skyrocket after that point, as more people cannot afford the rates and only the sickest remain.

This is called "death spiraling" in the industry.

Since a significant number of people develop some kind of condition that makes it impossible to obtain a new plan eventually in life, many people become unable to obtain individual insurance.

Except: in Texas, there is a high risk insurance pool plan for individuals that's run by the state, but it's extremely expensive and has very limited coverage.
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Old 10-24-2009, 01:47 PM
Location: Mountains of middle TN
5,218 posts, read 11,024,026 times
Reputation: 5881
Originally Posted by FarNorthDallas View Post

Blue Cross Blue Shield is the biggest individual plan providers. Your premium will go up every year and on some of your birthdays, as well.
I have BC/BS through work, family plan. My husband is disabled. He's got tons of medical problems. Including the prescription plan we pay about $300 a month and they cover 80% of his medical bills and our 'scrips are $10 for generic and $20 for name brand.

They are good if you are vigilant at staying on them. I have never received a letter from them saying they are paying for our medical bills. Every single letter says they've not received requested paperwork from the doctors and have decided no benefit is payable. Every single time.

Pisses me off to no end. I spend a good bit of my work day when I get the letters, which is frequent, on the phone giving them hell. Low and behold within a week I get a letter saying they received the paperwork and have found the care was needed and they're paying 80%.

Before I realized they were pulling this several bills went unpaid and were placed in collections and on our credit report. Our fault, I should be opening those bills to make sure it is actually paid. Even so, it's very frustrating and wastes a good bit of my time. But for $300 a month and considering they just paid over $85,000 for his more recent surgery, and they continue to pay the balance on the 13 meds he takes daily, I can't complain.
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Old 10-27-2009, 08:29 PM
101 posts, read 301,856 times
Reputation: 87
Thank you to you all for your replies, even if there appears to be little positive sentiment towards the insurers. I guess I will just have dive in and hope and stand up for myself and my family when my chosen insurer tries to deny claims.

Now I really don't want to get political, and hijack my own thread, but please trust me when I say that a guv'ment run health system can work, I lived with it for 40 years.

I think that I'll leave it with that.

Thanks again.
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Old 10-27-2009, 10:14 PM
4,248 posts, read 8,193,621 times
Reputation: 3072
Cut out the middle man and get rid of Insurance companies.
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