After watching his annual insurance premiums nearly double in just three years, Michael from Abingdon, Va., says he was fed up.

“It takes a lawyer to figure this stuff out, and I’d bet a lot of lawyers would still have trouble,” he says.

From a long line of coal miners, Michael is no stranger to hard work. His grandfather emigrated from Italy in 1912 and his father worked in the West Virginia mines for over 40 years. He calls himself “semi-retired” now and after working all his life as an engineer, supervisor, or government employee in the coal business; he has certainly earned this title.

As his COBRA coverage expired in 2004 and he began to look for an individual insurance policy, he found he was simply uninsurable. With a diagnosis of borderline diabetes, he was immediately disqualified for coverage. This kicked off a long series of phone calls and e-mails to the insurance commission, state legislators, and the insurance company through which Michael eventually discovered that he could not legally be disqualified from coverage in the State of Virginia.

With an already expensive policy of $785, Michael watched as his rates jumped 20% or more annually. On the three year anniversary of his plan, his monthly premium had doubled. It was time to pull back out the letters and e-mails, and get something done. Health insurance was absorbing 50% of his monthly budget and although Michael had saved up for retirement and openly states the he wants to pay for his health insurance, the cost had gotten too high.

Luckily, a helpful employee at the state insurance commission gave Michael some inside information on his insurance policy. It turned out that he was in a pool which no longer accepted new applicants. That means that the pool only gets older and sicker, allowing the insurance company to raise premiums to ridiculous levels, ridiculously fast.

Michael’s frustration mounted as he found that his diabetes automatically put him in a “Group 4” rating. With his diabetes well under control he feels like he should be viewed differently from someone that does not live a healthy lifestyle and ignores the doctor’s orders.

“The problem is the regulations,” he told us. “If the insurance company is playing by the rules and the rules are unfair, then the rules need to be changed.”

Luckily, he discovered that a new policy was available and he now pays $614 per month for insurance coverage. Still, he says, he has “no financial concern greater than affordable health insurance.” “I worked for forty years and never needed coverage under my corporate sponsored group policy. Now that I am older and might need coverage, I can't afford it. Something is wrong here.”

del.icio.us Digg It Google Windows Live Yahoo MyWeb

comments (3)

Comments

1 Posted by at 07/02/08 01:31 PM

Ditto for everything Mike says but let's go even further--What about the wage earner who cannot save enough money to pay these premiums, maybe someone who worked for low pay for many years. Don't they deserve treatment in order to have a productive life and even to live! Mike is my cousin and a harder worker there has never been! The treatment he has received is abysmal and it is indeed fortunate that he is a university educated man who can sift through this insurance mumbo-jumbo!!

2 Posted by DAVID FISTE at 07/02/08 04:38 PM

WOW! Health care surely is in crisis. I thought Georgia was high for these pools of those with "chronic condition" status -- which millions of adults now have. Pre-Medicare rates have jumped to $424+ monthly in GA with minimum out-of-pocket of $16,240+ annually, with limited 60%-70% health insurance coverage.

3 Posted by Corey Ali at 07/02/08 10:31 PM

Insurance, like almost everything else in America, is a for-profit business most of the time. Certain companies, such as Blue Cross, for example, are non-profit,but most are businesses in the business of making a profit.

Diabetes Mellitus is an extremely expensive disease, requiring daily testing with expensive blood test strips, and meters. Medications to control blood sugar are required, and even with meticulous control of the disease, people w/ diabetes usually develop complications such as blindness, heart attack, stroke, kidney failure and amputations of the extremities.

Preventing these people from joining the pool of the covered prevents expected complications from developing in your pool of insured customers, and decreases expenses for your company. I have been diabetic for 46 years, and no insurance company except Blue Cross/Blue Shield has ever willingly covered me. My insurance premium is $854 a month, not including the $400 a month on copays for meds.

Welcome to America, the home of the capitalistic model of the world.

Post a comment