Anthem’s Leaving No Stone Unturned

By Karen

After getting Anthem lab results on my benign freckle they required but failed to request from my gynecologist, I thought I’d cleared the last hurdle in my 2 ½-month quest for cheaper health insurance. They said it was the last thing they needed.

Wrong! This week I couldn’t get approval without a blood pressure reading – from the family physician who hasn’t seen me in nearly a year because I’ve been feeling fine.

Naturally, the irony was lost on Anthem. Why the sudden concern about my BP just when they’ve got me about to blow a head gasket over their endless bureaucracy?

Anthem claimed they asked for the reading in January, but my doctor had no record of it. Instead, they said just last week they received a strange call from someone demanding my blood pressure numbers who wouldn’t identify themselves, so the practice refused.

I got my doctor’s assistant to give Anthem my BP reading by phone, then went home and phoned Anthem myself to double-check. Anthem assured me again that now they have everything they need.

I’ve paid the higher premium for March because Anthem sent me a late notice. I’ve soon got two routine medical appointments I’d hate to postpone again, but I doubt Anthem will have my new coverage in place. I can see them screwing up the billings and my premium credits for months to come.

Politicians are insane to think insurance providers, with their ingrained distrust and callous disregard for customers, hold the key to our healthcare mess. Anthem has now painstakingly picked over every piddling physical imperfection listed on my application. Being healthy carries no weight with them whatsoever. In so many words, they’ve said they’re dissecting my app because I might have slipped some major health crisis past them – while they’ve been insuring me for the past 5 years.

Translation: “We’re looking for any excuse to cancel you or continue making you pay through the nose, even with less coverage.”

I don’t intentionally single out Anthem, except by my experiences. They’re no more devious than the rest. Patients’ only recourse is to eliminate health insurance altogether by hounding our representatives in Washington to pass HR 676, the universal healthcare bill.

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3 Responses to Anthem’s Leaving No Stone Unturned

  1. karen says:

    I’m sorry you’re having this problem. I’ve had a policy which has been administrated by Anthem for the past 7 years and I’ve never had anything denied or even questioned. I can tell you this – Your employer (that is – if you are taking a policy your employer offers) choses your policy. They hand pick it down to the minutest detail. They look at policy packages offered by insurance companies like Anthem and Cigna, etc and they chose the one(s) that they want to offer their employees. They usually choose the most cost effective constraints that they can – to include “pre-esisting condition clauses” and the like. It sounds like your employer chose a policy with a pre-existing condition clause. This saves your employer money because these policies are offered at a cheaper rate by insurance companies for obvious reasons. At any rate, insurance companies administer plans that employers choose and hire them to administer. You might want to go to your company’s HR and complain. They may opt to buy a more flexible plan next time if they get enough complaints. People automatically assume that the insurance company is the bottom line. They don’t realize that their own employer has chosen the limitations. Best of luck to you. (P.S. – I am a nurse, but I don’t work for an insurance company. I just know these things because I have helped people maximize their benefits as a case manager in the past.)

  2. catsworking says:

    I’m self-employed and this is individual coverage, so there’s no employer involved. It’s directly between me and Anthem. If my employer was the problem, I wouldn’t be shooting my mouth off about it like this.

    Anthem’s behavior toward individuals isn’t a bit unusual. Insurance companies can “cherry-pick” customers to their heart’s content to ensure the highest premium with the least payback because individuals have virtually no rules and no rights under their policies.

    An insurer could also choose to exclude certain conditions, but it wouldn’t necessarily save me any money. They’d still charge me a fortune on the pretense that the excluded condition “might” lead to other complications.

    THIS is precisely what people with the luxury of employer-provided coverage fail to see, so they think there’s no problem with healthcare. There’s HUGE disparity in the way people are treated. Those who aren’t eligible to be in some group pay disproportionate amounts for coverage, which is why 47 million Americans have no insurance. Unless something changes soon, I’m afraid I’m going to be joining them because I’ll be paying more for insurance than for my HOUSE.

  3. karen says:

    That’s a terrible bind to be in. It certainly goes a long way in squelching entrepreneurship or other independent pursuits. (It’s just another hold that corporations have over our livelihoods as would-be independent Americans.) I would be in a similiar situation with trying to go to grad school, but I am able to receive benefits through my domestic partner’s policy because we have a few national companies here in Richmond that actually offer that option to same sex couples. This is something that you may not relate to at all, but partners in same sex couples have to carry individual policies 99% of the time. Well, however things turn out in this democratic primary the nominee will have my vote. I wish you success in securing coverage and I hope that it costs much less soon for all of us. Best regards.

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