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When I went home for lunch today, I had the good fortune of receiving a letter from Blue Cross Blue Shield (BCBS) of Michigan. The letter indicated they are raising my premium rates by 28.45% effective Oct. 1. Thus, my rates will rise from $428.82 to $550.63

When I went home for lunch today, I had the good fortune of receiving a letter from Blue Cross Blue Shield (BCBS) of Michigan. The letter indicated they are raising my premium rates by 28.45% effective Oct. 1. Thus, my rates will rise from $428.82 to $550.63. By the way, this "plan" includes a $3,000 deductible.

We have paid BCBS premiums for at least 9 months, totaling over $3,852. During those 9 months, we have been restricted from using the maternity coverage that we bought, have not received one cent from BCBS in benefits coverage, and have had to fight on more than one occasion to have clearly covered benefits counted towards our deductible.

Now, in this letter, they blame a lack of health insurance regulation in Michigan and complain that other for-profit companies are allowed to deny coverage to high risk candidates. They blame the Michigan State Legislature and state law for these problems.

They do not, of course, blame themselves or their service providers.

They do not, of course, state the clear need for a public option.

So I called BCBS. I confirmed our rate increase and asked how it is that a such a large increase is dumped in the lap of the individual (not group) subscribers. I was told that group rates were also going up, but was not able to be told by how much. I was told that the economy is to blame--as more and more people lose jobs, they are "forced" into the individual plans and BCBS is "forced" by state law to cover the "unhealthiest" people in the state. (The quotation marks enclose direct quotes from this conversation.)

Finally, I was told that the service providers have increased their costs. So I asked why, instead of passing this increase on to the individual subscribers, BCBS did not negotiate with the service providers for lower fees. I was told by the rep that she didn't know why they didn't do this.

I then asked her how many subscribers they projected losing, since, like me, many likely wouldn't be able to afford this increase. The rep told me they expected to lose some, but not too many.

I finally asked why BCBS was not behind the public option, since it would seem to address the issues that were conveyed to me. The rep told me she didn't know why.

After learning that I would not be able to speak directly to a supervisor at that time, I ended the conversation.

The health insurance system is broken. We need a fix. Please, support the public option to bring about reform, true competition, and real coverage that is affordable.

[Cross-posted at my Posterous blog.]

Originally posted to didaskalos on Tue Sep 01, 2009 at 11:05 AM PDT.

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Comment Preferences

  •  that sucks! sorry to hear that. (1+ / 0-)
    Recommended by:
    cfk

    They had asked to raise their rates by over 40% (!!) so, hey, look on the bright side!
    : (

    Say "Yes" to Michigan!

    by jodygirl on Tue Sep 01, 2009 at 11:08:16 AM PDT

  •  If I were you (3+ / 0-)
    Recommended by:
    Aspe4, didaskalos, Xtatic

    I'd quit wasting my money by giving it to BCBS.  Take the money you give them every month, put it in an interest bearing account from which you can withdraw whenever you need it and save the money for any healthcare needs you might have.  If you trust in the universe, god, FSM (flying spaghetti monster or film score monthly), or whatever diety you choose to put your trust in, you'll be okay.  If you're an agnostic or athiest, just be damned careful.  But it's obvious BCBS is going to do nothing for you except relieve you of your money.  

    •  Good advice... (4+ / 0-)

      Then a couple of days later when you're driving along, within the speed limit and following all the rules, you get smacked head-on by a drunk who suddenly veers into your lane.

      The you watch your home and retirement savings disappear as you pay that $100K+ hospital bill out of pocket.

      ---

      Speaking from experience on the drunk/wreck/cost part.  And as a careful (highly-skeptical) agnostic.  

      I did have insurance, which we all really, really need.  I paid too much for it, which is why we are pushing for some competition in the market in the form of a public option.

      15 to 6. Pulled ahead as soon as the gate opened and never looked back....

      by BobTrips on Tue Sep 01, 2009 at 11:34:45 AM PDT

      [ Parent ]

      •  Personal injury insurance in your (1+ / 0-)
        Recommended by:
        ShempLugosi

        car insurance coverage will cover that.  That bogus bullshit argument always pisses me off.  When you have health insurance, it doesn't pay for car accidents anyway, until after every bit of car insurance has been sapped. Most states (Michigan is one) have a relatively generous PIP coverage.

        Beware the lollipop of mediocrity: lick it once and suck forever.

        by second gen on Tue Sep 01, 2009 at 02:14:49 PM PDT

        [ Parent ]

        •  Perhaps your state... (0+ / 0-)

          Not mine.

          So please keep your "bogus bullshit" stuff inside your own state lines....

          15 to 6. Pulled ahead as soon as the gate opened and never looked back....

          by BobTrips on Tue Sep 01, 2009 at 04:25:09 PM PDT

          [ Parent ]

          •  I worked for an insurance company that wrote (0+ / 0-)

            insurance in more than 22 states. And was licensed in 46 of them.  We wouldn't write in a state that didn't at the very least OFFER Personal Injury Protection.

            It costs FAR LESS than health insurance.  Usually about $200-$400 PER YEAR. For possibly MILLIONS in health care.  If you're gullible enough to trust your health insurance to cover a car accident, when they won't, then maybe you shouldn't give other folks advice on what they should do. (They won't cover a work accident, or any other accident that can be pushed off on someone else, read: Someone you can sue, such as a slip and fall, either, so you're not safe for anything except HEALTH)

            This diarist is in Michigan, which is what is being addressed. MICHIGAN health coverage does not pay for car accidents because it is required that all drivers have personal injury protection. YOUR health insurance and vehicle insurance isn't at issue here.

            Beware the lollipop of mediocrity: lick it once and suck forever.

            by second gen on Tue Sep 01, 2009 at 05:03:43 PM PDT

            [ Parent ]

      •  Fear, fear, fear, fear, fear, fear, fear (0+ / 0-)

        You must've missed the part of the comment about trusting that you'll be okay.  In the scenario you describe, the insurance the diarist describes wouldn't help anyway.  I've lived for the last 6 years without the insurance you claim I "really, really need".  I've had medical issues, I've had accidents which sent me to the emergency room, I've had health scares which turned out to be nothing, I've had depression and suicidal thoughts, yet I'm still here and I'm okay, all without giving any money away to an insurance company who wouldn't have covered me when the chips are down anyway.  

        Your fear is how they are controlling you.  Let it go.  To quote the sixties:  Free your mind, the rest of you will follow.  

        •  OK. so I'm left to assume that your net worth... (0+ / 0-)

          approaches zero.

          Or that you've been lucky enough to not have a large bill that you couldn't cover from your petty cash jar....

          15 to 6. Pulled ahead as soon as the gate opened and never looked back....

          by BobTrips on Tue Sep 01, 2009 at 04:27:29 PM PDT

          [ Parent ]

  •  Canada (5+ / 0-)

    Resonant Library.Info Mother Nature always has the last word.

    by Nef on Tue Sep 01, 2009 at 11:11:03 AM PDT

  •  a guy I know posted this in response to an (0+ / 0-)

    ad for healthcare I put on f.b.

    As a BCBS employee, and a democrat, I am very torn about health reform. We're increasing rates on our INDIVIDUAL product lines by 20+%, it's true. These are folks that buy insurance off the street. But, we lost $89 million dollars last year on these customers. What to do? We're one of the few remaining non-profit insurers of last resort. If ... Read Morewe don't raise rates, we run a risk of going out of business... There are websites that council hemophiliacs (very expensive to insure) to move to Michigan and take BCBSM insurance because we take everyone. It's a difficult business model...

    Say "Yes" to Michigan!

    by jodygirl on Tue Sep 01, 2009 at 11:11:31 AM PDT

  •  Our coverage costs over $600 a month (10+ / 0-)

    with a $6000 deductible, I always laugh when I say I have health insurance because nothing could be further from the truth.

    "As nightfall does not come at once, neither does oppression..." William O. Douglas

    by Patricia Bruner on Tue Sep 01, 2009 at 11:15:02 AM PDT

    •  Unbelievable (3+ / 0-)
      Recommended by:
      Aspe4, Patricia Bruner, ShempLugosi

      It seems they always pass on the costs to the end-user, not to the provider, and certainly not to themselves!

      Sorry to hear about this.

      •  I'm seriously considering dropping it (4+ / 0-)

        as Shemp Lugosi suggested above. It covers NOTHING, it's just a pass to get you through the door with no guarantee you'll get a seat.

        "As nightfall does not come at once, neither does oppression..." William O. Douglas

        by Patricia Bruner on Tue Sep 01, 2009 at 11:23:10 AM PDT

        [ Parent ]

        •  Don't. (2+ / 0-)
          Recommended by:
          Patricia Bruner, sydneyluv

          At the minimum you are protected against total financial ruin.

          Search for the best coverage and self insure as much as possible.  But cover yourself against the Great Big Hurt.

          15 to 6. Pulled ahead as soon as the gate opened and never looked back....

          by BobTrips on Tue Sep 01, 2009 at 11:36:46 AM PDT

          [ Parent ]

          •  If we were in a better financial situation, (0+ / 0-)

            I'd agree with you, but given our circumstances even with insurance we will lose everything if something terrible happens.

            "As nightfall does not come at once, neither does oppression..." William O. Douglas

            by Patricia Bruner on Tue Sep 01, 2009 at 11:39:40 AM PDT

            [ Parent ]

            •  OK, situations differ... (1+ / 0-)
              Recommended by:
              Patricia Bruner

              I've got a modest amount to loose, and would have lost a lot of it when I was hit by a drunk a few years back.  

              I would have lost enough that I would have either had to leave the US for a cheaper country or start working as a greeter at Walmart or something.  (It would take a major effort to reenter my profession.)

              If you've got little capital to loose then informing yourself on bankruptcy laws where you live might be in order.  Put money aside every month to cover the medical issues you can afford and use the courts to get a fresh start if the worst happens.

              The remaining risk is that you contact a disease that would be very costly to treat and you can't find anyone who will allow you to get treatment on credit.  Hospitals are likely to look at your financial condition and refuse to accept you for anything other than emergency care.

              --

              And, if you go the self-insured route, educate yourself about medical care in other countries.  Mexico is a good option as one can travel there for little money.

              Thailand and India are very good for more expensive procedures.  I had a root canal done in Thailand for under $100 last winter.  It would likely have cost me $1,000 - 1,500 in the US.  An exam in the US to let me know I needed a root canal cost me more than what it cost for the procedure in Thailand.

              I've seen RT airfare from SF/LA under $800, so if you're looking at something that might cost a few thousand dollars in the US then it might make a lot of sense to travel for care.

              I've a friend who is having her hip replacement surgery done in India for less than 1/10th the cost in the US.  And first class service, as well.

              15 to 6. Pulled ahead as soon as the gate opened and never looked back....

              by BobTrips on Tue Sep 01, 2009 at 11:52:29 AM PDT

              [ Parent ]

              •  Thank you, I appreciate your (0+ / 0-)

                thoughtfulness on this subject.  We have had to use almost all of our savings and reserves to get through these past two years.  I've been chronically ill through most of that time, only recently have I had the good fortune of feeling well for days at a time.  Frankly, even with insurance, I couldn't afford to go to a physician and be diagnosed, I couldn't take the chance that whatever it is I have would gobble up the rest of the little money we have left.

                "As nightfall does not come at once, neither does oppression..." William O. Douglas

                by Patricia Bruner on Tue Sep 01, 2009 at 12:43:47 PM PDT

                [ Parent ]

          •  That's only true.... (2+ / 0-)
            Recommended by:
            didaskalos, cfk

            ....if you're in an accident.  Damn near any other illness and they'll bitch about pre-existing condition, or that you didn't reasonably seek care of some other excuse to not pay the claim.  

            The pressure on self-employed people is immense.  If you're sick you can't work.  The costs are astronomical -- beyond the means of middle class people to weather over the long haul.  

            We would keep our deductible in the bank ($5,000 at the time).  I would have to pay my regular medical costs out of pocket, plus the premiums for junk insurance.  It should not cost $1,300 for an x-ray of my husband's neck and a valium, but that's what it cost us 8 years ago.  We had been to the doctor during the week, we tried to reach our doctor on Christmas Day and the answering service said to go to the ER.  He was screaming in pain.  His blood pressure was through the roof.  We had done everything right.  My goddaughter the doctor said the blood pressure alone was life-threatening.  But because he walked in on his own two feet, the claim was denied.  

            And yes, Obama is correct:  when we saw the doctor during the week he wanted additional x-rays, doubling the cost.  There was no group to negotiate reasonable prices on our behalf (since that time the Illinois law is now that they cannot overcharge individuals -- thanks Rod Blagojevich!)

            My husband couldn't work for almost two months.  At that time, he was the business -- if he couldn't work, we had no income.  It didn't take long for us to need the deductible money to pay the mortgage and the winter heating bill.  Before you know it, on a disc problem with his neck, we had no money to spare.  Our business had plummeted during the Bush years, we were trying to make it on half of what he had been making.  That loss of work, the medical bills and my medical costs hurt us.  And believe, me our problems were minor compared to so many others.  I raise the example to show how even minor health problems can hurt you.  

            How do you keep paying premiums when there's no money coming in?  

            Oh and by the way, because we filed a claim that they didn't pay, our premiums went up -- again.  

        •  Don't at least you get the contracted discounts (1+ / 0-)
          Recommended by:
          Patricia Bruner

          and usually cash charges by hospitals are 40% higher or more for cash pts.

  •  We, too, got our BC/BS bill today (5+ / 0-)

    And yes, we also live in Michigan.

    "You can never guarantee victory, but you can guarantee defeat."--Hall of Fame baseball writer Leonard Koppett.

    by Dump Terry McAuliffe on Tue Sep 01, 2009 at 11:21:06 AM PDT

  •  Wait a sec.... (0+ / 0-)

    ...this diary seems very familiar.

    Maybe I just have Deju Vu today.

  •  Unfortunately, I have to say: (7+ / 0-)

    "Welcome to the club!"

    I have "insurance" thru' my employer - Blue Shield of CA. Last year they increased the premium by a good 25-30% (was so upset, I blocked out the exact number). This year the next increase, about the same percentage...

    What do Republicans say all the time? "Health insurance is a right, not a privilege!"  :-)

    Soon, health insurance will be a "luxury good", and only the rich can afford it. (and of course...members of congress, since we are paying for it)  ;-)

    To all members of congress, who oppose a health care reform and enjoy first class health insurance, paid for with my taxes:

    FUCK YOU! FUCK YOU, YOU MOTHERFUCKING ASSHOLES!

    "When fascism comes to America it will be wrapped in the flag carrying a cross" (Sinclair Lewis)

    by Overnite on Tue Sep 01, 2009 at 11:26:23 AM PDT

  •   BCBS of Georgia - How can this be LEGAL?? (2+ / 0-)
    Recommended by:
    cfk, Patricia Bruner

    Until recently, I have always been under employer plan. I thought it would be no problem to purchase an individual plan (now unemployed). Wrong !  I have never had one claim with BCBS.  But when I applied for an individual coverage, they said due to "my injury"  I had to get a 70% increase over the normal premium. Shocked, I called customer service, and said I had never had an injury. The reply was  "We have your records madam. WE KNOW"  

    I said if you have my records then you know, I have never had a claim (I have been with them for years on the employer plan). My doctor wrote them a letter and said nothing is wrong with her.  They just ignore it.

    How can this be legal ????

    I Have to pay $600/mth. Worse thing, I fear if I ever do have to file a claim, they will deny, deny deny.

    Anybody else in Georgia have a better recommendation for an individual plan?

    •  I think Georgia has an insurance (1+ / 0-)
      Recommended by:
      cfk

      commissioner, you can file a complaint with them about your situation, I think it would be worth your time.

      "As nightfall does not come at once, neither does oppression..." William O. Douglas

      by Patricia Bruner on Tue Sep 01, 2009 at 11:44:37 AM PDT

      [ Parent ]

    •  call the state insurance commissioner and (2+ / 0-)
      Recommended by:
      cfk, Patricia Bruner

      state office of consumer affairs requesting that the insurer be required to provide documented evidence you have had an accident

    •  Most corporate HR departments will tell you (0+ / 0-)

      that if you enroll in another health insurance plan within some short time (60 days?) of leaving their group health insurance plan, you won't have to worry about pre-existing conditions or other bars to insurability.

      This is ONLY correct when going from one group plan to another. If you go from a group plan to an individual plan, you are treated as if you never had any previous insurance coverage.

      So you should consider yourself "lucky" that you could even get BCBSGA to take your money. Of course, the premiums for individual policies are far higher than premiums for group policies (and the coverage is worse, too).

      On the other hand, if your premium is 70% more than the standard premium for an individual policy, keep after them. Send them letters by certified mail. Demand a copy of their file on you. Keep copies of your letters. Then forward the copies of your letters and their responses, if any, to the Georgia Department of Insurance

      You may file a complaint with the Georgia Department of Insurance if you cannot resolve your dispute directly with your company or if you haven't been through the appraisal process.

      Our Complaint Form is located here. This form is a fillable pdf document, that can be completed, printed and submitted with copies of documents that support your complaint. This will enable us to set up a case and eliminate the need for us to request documents, and reduce the delay in providing a response. Always keep your original documents for your records.

      To help ensure that The Georgia Department of Insurance receives all necessary information to investigate your complaint, include the following information with your complaint:

         * your name, address, daytime telephone number and email address
         * the exact name of the insurance company
         * the full name of any agent or adjuster who may be involved
         * your policy number
         * your claim number and the date of your loss, if applicable
         * a copy of both sides of your insurance card
         * a concise description of your problem
         * copies of all supporting documentation, including invoices, canceled checks, advertising materials, and any letters between you and the company or agent

      Submit your completed form by mail at: Georgia Department of Insurance, 2 Martin Luther King Jr. Drive, Suite 716 West Tower, Atlanta, Georgia 30334, or by fax to: (404)-657-8542.

  •  BC of SC projects a 7% increase (1+ / 0-)
    Recommended by:
    Patricia Bruner

    in December

  •  In Michigan, BCBS in non-profit (0+ / 0-)

    which, I think, is part of the reason they have to abide by different laws than the for-profit companies. Ultimately, though, that was their choice. They made their own bed. To complain now about the color of the sheets is too much.

    I think BCBS in other states may be for-profit (Arkansas, for example?). That may account for different premiums/rate increases, etc.

    •  Part of the issue is that BCBSM is required (2+ / 0-)
      Recommended by:
      didaskalos, cfk

      to be the health insurer of last resort. Many states have no such insurer, so if you live in one of those states and you're denied coverage because of your existing or previous health problems you're SOL.

      BCBSM would dearly love to insure only healthy people, as all of its competitors do, but unless they can force a change in MI law, they're stuck.

      I don't know why BCBSM is required to insure all comers, but I strongly suspect it's due to the strength of unions in Michigan, particularly the UAW.

      Back before health insurance was a big deal, BC/BS used to be non-profit everywhere. Since the Tax Reform Act of 1986, Blue Cross Blue Shield plans lost their full Federal tax-exempt status but are entitled to "special tax benefits." Some plans (don't know how many) are still considered not-for-profit at the state level.

  •  Non-profit Blue Shield of California (3+ / 0-)
    Recommended by:
    itskevin, didaskalos, Patricia Bruner

    raised my premiums by $200 a month (a 15% increase for my family of four)...the week after I got laid off from my job in June. I sure wish I could just demand a 15% increase in my unemployment benefits as easily.


    This poster available as a PDF download: 18.5x11, 11x27, 18x24

    BushCheney Inc. - They lied to me, they lied to you, they lied to our troops.

    by jjohnjj on Tue Sep 01, 2009 at 11:56:42 AM PDT

  •  As my husband neared Medicare age..... (2+ / 0-)
    Recommended by:
    cfk, Patricia Bruner

    .... our rates doubled in two years.  This was for catastrophic coverage with a huge deductible, no major medical and of course no coverage for my asthma (or anything to do with my lungs including if I punctured a lung in a car accident) or my mild and controlled high blood pressure.  

    After paying individual insurance premiums for 20+ years, and having the three claims we submitted denied, we could no longer afford insurance.  I had to pay for asthma drugs and doctor out of pocket anyway ($6,000/year), we could no longer afford to pay in essence all of our medical expenses plus exorbitant premiums that covered nothing.  When they denied my husband's ER claim on Christmas Day (because everyone wants to spend Christmas in the ER), that was the last straw.  Even though he was screaming in pain, with a BP of 190/110 (life-threatening in itself with a chance of stroke), his pain was not "life threatening" and the claim was denied.  

    Now, because of my asthma I can't get any insurance from anyone.  Maybe I could, if put every dime we made into insurance.  But that isn't practical, is it?  I guess that makes me lazy and cheap.  

    The best thing that ever happened to us was Medicare.  The stress relief alone, just knowing that my husband has medical care, has been a blessing.  He had two minor surgeries, excellent follow-up care on everything, a primary care physician always available and a 24-hour on call nurse.  Physical therapy for his arthritic knees, and the peace of mind that he can get the medications and medical services that he needs.  

    Se we live with the ticking time bomb of unavailable health care (I'm 59 years old).  Just let me buy into Medicare, I'll pay gladly.  But we're self-employed and work hard for every dime.  There's just so much we can afford.  

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