Re: [MBZ] Individual health policies, was Walmart vs NAPA auto
We're way off topic now, but I will go with it- I am now happily gone from the field of medical reimbursement, but I did work in that field for nearly 20 years. For a year or so of that time I worked for a TPA which provided individual health policies to the self-employed. What an eye-opener! Such policies by their very nature are non-group and therefore the principle of shared risk, the fundamental basis of insurance, is not in play. The Insurer has to get more out of you than they pay, its that simple. Consequently, these policies look dandy if you are reasonably healthy, but if you get sick (I mean really sick, you have a heart attack, are diagnosed with cancer, or diabetes, say) your insurance company is likely to reach into its bag of dirty tricks to either rescind your coverage retroactively, increase your rates to the point that you cannot pay them, issue a rider excluding coverage for your conditon, or declare your condition to be pre-existing or otherwise excluded under the policy. Failing those things, the insurer may simply pend all of your claims for six months to a year while they investigate to FIND OUT if they can do any of those things, with the net effect that your bills don't get paid anyway until the investigation is concluded, if ever. I'm not kidding. I worked in the Medical Investigations Unit and later worked under the TPA's in-house counsel responding to Department of Insurance complaints, and this is how the thing worked. If the bill was high enough, they would even hire a PI to try and find a reason to deny the bills. Lee On Saturday 11 February 2006 5:04, David Brodbeck wrote: paul wrote: I'm self-employed, and pay for my own health insurance. I can think of 4 or 5 friends that are also self-employed, and pay for their own health insurance. There are options. Yes, it's expensive (around $400/month for the wife and I), but readily available to anyone wanting it. It's readily available if you're young and healthy. If you have any history of illness it dries up quickly. In some cases something as minor as a history of depression has caused people to be unable to get individual health insurance. Basically, they'll sell it to you as long as you don't need it. ;) $400/month is also an awful lot for someone making minimum wage. ___ http://www.striplin.net For new parts see official list sponsor: http://www.buymbparts.com/ For used parts email [EMAIL PROTECTED] To Unsubscribe or change delivery options go to: http://striplin.net/mailman/listinfo/mercedes_striplin.net
Re: [MBZ] Individual health policies, was Walmart vs NAPA auto
I know that you are right - however this is exaclty what chaps me about the insurance companies -- they should consider ALL of the policies they sell as an aggregate and spread teh risk across ALL of them, not considering each individuals policy a single instance, and all of the GM employees as another single instance! On 2/12/06, lee [EMAIL PROTECTED] wrote: We're way off topic now, but I will go with it- I am now happily gone from the field of medical reimbursement, but I did work in that field for nearly 20 years. For a year or so of that time I worked for a TPA which provided individual health policies to the self-employed. What an eye-opener! Such policies by their very nature are non-group and therefore the principle of shared risk, the fundamental basis of insurance, is not in play. The Insurer has to get more out of you than they pay, its that simple. Consequently, these policies look dandy if you are reasonably healthy, but if you get sick (I mean really sick, you have a heart attack, are diagnosed with cancer, or diabetes, say) your insurance company is likely to reach into its bag of dirty tricks to either rescind your coverage retroactively, increase your rates to the point that you cannot pay them, issue a rider excluding coverage for your conditon, or declare your condition to be pre-existing or otherwise excluded under the policy. Failing those things, the insurer may simply pend all of your claims for six months to a year while they investigate to FIND OUT if they can do any of those things, with the net effect that your bills don't get paid anyway until the investigation is concluded, if ever. I'm not kidding. I worked in the Medical Investigations Unit and later worked under the TPA's in-house counsel responding to Department of Insurance complaints, and this is how the thing worked. If the bill was high enough, they would even hire a PI to try and find a reason to deny the bills. Lee -- OK Don, KD5NRO Norman, OK '90 300D 243K, Rattled '87 300SDL 290K, Limo Lite, or blue car '81 240D 173K, Gramps, or yellow car '78 450SLC 67K, brown car '97 Ply Grand Voyager 78K Van Go
