While employed for 17 years in the family business, I never had to worry about having health insurance. About 5 years ago, when the company could no longer support three families (my parents, brother and his family, and my wife and me), I stayed on part-time while starting my own business as web developer. I remained on the company policy for about two years as a part-time employee, however, when I left completely, I could no longer stay on the company policy. I did have the opportunity to get into a BC/BS of PA plan within six months, but even the cheapest monthly premium was too expensive for both my wife and myself (around $1100 per month).
Eventually, my wife got Medicare due to her disability and we got her into a Medicare Advantage plan, which, come January 1, 2010, will no longer exist. I am assuming that Aetna is dropping the plan because they no longer find it profitable.
I am a relatively healthy 43-year-old that usually saw my family doctor four times a year for regular check-ups and to have my cholesterol checked. Over the past two years, I have had no health insurance because when I did apply for the Blue Cross HMO plan, I was turned down due to pre-existing conditions (high cholesterol that is under control, a neck surgery I had 8 years ago, and a kidney stone I had a little over two years ago). After that I thought my only option would be to apply for the Pennsylvania run health insurance for adults. I was accepted into the plan but the waiting period was two years.
Soon after, I got a call from an insurance agent looking to sell me a group policy through my business. Since I am the sole employee, the group option wouldn't work but he told me he could get me into an individual policy at a fairly reasonable monthly premium. The plan was an Aetna PPO plan with a $2500 deductible, $30 office visit co-pay, and dental for only $180 per month. I asked the agent what might happen during the medical review process due to my pre-existing conditions and I was told that the premium might go up a few dollars if they find anything significant. I wrote him a check and he submitted the application.
Three weeks later my $180 check was cashed and a few days later I received my health insurance cards. "WOW," I thought, "I have health insurance! I can feel like a human being again!"
Today, I received my first bill...for $442.
They raised my premium to $311 without telling me. The bill was for the $131 difference for November plus December's premium of $311.
I did not receive any notice of my acceptance until I received my cards on November 16th, nor was there notice of the rate hike. On the statement, the line for November indicates coverage between 11/1/09-11/30/09 and in the description, "Retroactive Enrollment Change."
In my mind, Aetna pulled a bait-and-switch with me by quoting me $180 monthly premium then charging me $311 with absolutely no notification or the option to decline the plan. So, basically, even if I cancel the policy, I would still owe them $131 for the November coverage I never used or even knew I had. I had not even submitted a claim and they raised my rate 73%.
I have not had the chance to speak with anyone at Aetna to try to get an answer as they were closed for the holiday today. I am very curious as to what their answer will be.
To paraphrase J. Walter Weatherman, "And that's why we NEED a public option."