Aetna reinstates customer who made $64 error
I haven’t followed the pending health care legislation. Not closely anyway. But from personal experience, I know something needs to give. Health care is broken: pre-existing conditions, reliance on employers, incomprehensible coverage. You know what I’m saying.
Here’s a horror story I just read. According to The Los Angeles Times, Aetna cancelled a woman’s health care for paying $64 too little. Stacey Owens, the customer, paid on time. But her premiums increased, and she either missed the notices or never received them. Guess what my bet is.
My family relies heavily on health insurance, and Owen’s experience is our worst nightmare. I’ve authorized automatic debits for coverage, even though I’d prefer to write checks. Automatic debits, it seems to me, flip responsibility back to the insurance company. I think. I hope. Some families are not even able to get any type of health insurance because they are on a low-income salary, luckily there is coverage like Medi-cal from places like https://www.iehp.org/en/members/medical-benefits-and-services so they can be covered, but this just goes to show how scary it can be with health insurance.
Insurance-medical, property and casualty, life-is a paper nightmare. The industry, IMHO, may explain the loss of half the rain forest in Brazil. Medical insurance is the worst. The piles start when coverage is denied, and a notice comes in the mail explaining why. Usually, a box is checked next to a paragraph of insurance inscruta-speak, the kind of language that makes my teeth hurt.
Insurance inscruta-speak is not an allowable claim.
Years ago, John Grisham wrote a novel about an insurance company that routinely denied claims. His work was fiction, but I can’t help but wonder if the premise was more fact than fiction. The interest-rate float during arguments must be a huge windfall to the industry.
The New York Times describes my novels as “money porn,” “a red-hot franchise,” and “glittery thrillers about fiscal malfeasance.” Through fiction I explore the dark side of money and the motivations of those who have it, want more, and will steamroll anybody who gets in their way.
You’re right to wonder about the premise in the Grisham novel. Insurance companies figure that if they deny a majority of claims and only 50% of claimants challenge the decision (or sue), the insurer is still ahead on the numbers. So cynical.
Anita, that’s really scary.
Wouldn’t it be great to tax their executive bonuses according to some kind of aggravation scale, the more claims denied, the greater the number of days to dispute resolution, the higher the tax.
🙂
I wonder what happens post the MA election.
In 2006 I went to the emergency room with a 103Âş fever, abdominal pain and chills (It was 4th of July in Miami and I was wearing full sweats yet shivering with cold). I was there for four hours, most of which was spent waiting for tests. They gave me intravenous antibiotics, and two Tylenol. I had a chest x-ray and a sonogram. At the time my health coverage was with United American Insurance and I paid about $265 a month. The bill from the emergency room – the part that I was responsible for – was over $6,000. Turns out my insurer had a ceiling of $300 on emergency room visits (no, I am not missing a zero there – it was in the very, very fine print on about page 25 of the policy) . If the doctors had admitted me, rather than sending me home after four hours, it would have cost me less. If I didn’t have health insurance the hospital would have charged me at a lower rate. The bill was over four pages long for the above noted treatment. Because I did pay regularly for coverage, the rate at which I was charged was higher than for those who don’t carry coverage. . ‘Splain me that!
BTW most hospital bills, it turns out, are negotiable. I’ve learned a lot since that 4th of July.
Dorothy,
Yikes. I can’t splain that. It sounds like a story made for investigative journalism.
This article is really fantastic. thank you.
Health Care Makes Me Sick | ACRIMONEY, The Wild Wild World of Wealth
Many thanks. We’ll see what happens in 2014 when the provisions of the new bill take effect.
thanks very much, I have to say your blog is excellent!