And a Happy Ho, Ho, Ho! to you Too, Blue Shield

In My Humble Opinion
1

Just got a real heartwarming note from my beloved Blue Shield of California.
In relevant part:
"Effective January 1, 2010 Blue Shield will no longer reinstate policies…
This means if your premiums are not paid in full and received by the due date, your policy will be cancelled and you will need to re-apply for coverage"
I have an individual PPO - and more pre-existings than I care to think about. They are probably payying out more for my drugs (I get the good stuff -4 controlled substances, one of which is a sch II) than they get in premiums.
Yes, loving Blue Shield, I know you want me gone. Too bad.

Somebody tell me again how much better off I am with good all-American Private Enterprise attending to my medical needs…

2

So…you’re upset cause they’ll cancel your policy if you don’t pay them? I don’t see the problem with that. They’re a business, and if people don’t pay by the due set set upon in advance, then what’s the issue?

Maybe I’m missing something here, but so far it doesn’t seem like that absurd of a policy.

3

I think the point that the OP is making is that Blue Shield is counting on the fact that things happen and some people are going to be late on their payment, and when that happens it gives Blue Shield a perfect opportunity to drop, and then not renew anybody who’s sick because they can count it as a pre-existing condition.

In other words, this isn’t about responsibility, it’s about Blue Shield trying to drop the people who they have to pay out on, and keep the ones they don’t.

4

Yes - the point is their downright eagerness - one day late - even if it’s the Postal Sevice’s fault, and you’re out. And good luck getting anybody to touch your incurable-progressive-going-to-need-bunches-of-surgery ass.

By comparson - they used to give you 2 occurances in any 12 months, and I don’t think they cancelled the next friggin’ day.

5

I have a hard time respecting a business that uses its customers errors/oversights/mistakes as a part of their business practice.

Yes, it’s your own fault as a customer, but then away goes any pretense of the business caring about me as anything more than a revenue stream.

6

I agree that stuff happens, and sometimes it’s your fault, but still as long as it’s not an issue.

Like with credit cards, they change due dates. I thought they weren’t allowed to do this anymore without telling you.

OK in the last ten years I’ve been late about three times and I always paid them and the payment would post a day or two after. I would call the credit card company and they said “Sure, you always paid fine before, we’ll let it slide this one time.”

Sure enough this month, Walmart (which I pay off in full) changed my date from the 10th of the month to the 8th. And so did Bank Of America. I have had both credit cards for over 7 years and my payment has always been on the 10th. OK so I missed, my fault I screwed up, I didn’t check close enough.

I asked them to waive the late charge. Both said “No,we won’t do that.”

OK fine I accept it, my error," but the fact that cracks me up is how many business are trying to screw you over, just waiting for you to make an error.

I’m not saying in my case I was right but come on, you can give a bit, especially when you have a perfect record in the past.

The thing that bugs me about the OP is the number of people that for some reason won’t read that and will get busted because of it.

I can see the company’s point of view, but hopefully Blue Sheild isn’t the only game in town for this poster and customer service at another place will be better enough to make a switch possible. Unfortunately sometimes a company has a lock on you, then you’re screwed.

Like once I had an electric bill for something like $20.41 and I sent them a check for $20.14. They cashed it and sent me a late charge. OK obviously I transposed a number, so I tried to get the late charge waived and Commenwealth Edison, said “If you don’t like it, don’t use us.” Well that was real helpful.

7

This is one of those cases in the “then you’re screwed” catagory - nobody will touch me with my pre-existings - one company I called put it bluntly: “you’re lucky you have insurance - don’t let anything happen to that policy”.

I will have them do the automatic deduct thing - that should make the timing their problem, but I don’t have the money to sue them if they do screw up.

And, I’m guessing none of you have ever tried to make an appointment with a new Dr. and, when asked what kind of insurance you have, you say “none”. This is when you will here the word “elsewhere” - as in “you ain’t welcome here, and there is no place we know of where you WILL be welcome”.
Oh yes - saying “medicare” in place of “none” gets you EXACTLY the same response (there may be Dr.'s who will work for what medicare pays, but even the UC clinic I use (not noted for wealthy clientele) turned away at least one person (I was standing behind her in line) for saying “medicare”.
My diabetic in-law just got laid off from his 30+ year job - a few more folks run into the reality of what medical care for the uninsurable (like me, and the diabetic) is like, and we just might get some real action in Washington.

8

The situation where this policy really sucks is if someone finds themself seriously ill and hospitalized. Particularly if you’re single, this could easily result in bills getting behind, and all of a sudden the person has no insurance and no way to get any. Meanwhile, the insurance company is just saying “whew, just dodged all of those claims for the rest of her coma.”

9

As a piggyback, why is this? I have insurance, but it has a $1000 deductible, so I just pay everything up front. Well, after the doctor’s visit, but before I leave. Why can’t they just demand up-front payment from uninsured people?

(My last visit was $300 worth of labs paid up-front. I can’t wait for next year’s $500 deductible $3000 max out of pocket. I’m going to have that maxed out by July at the latest.)

10

You got it!

I’m single, live alone, know no neighbors.
Their first big notice of me was a $54K hospital bill - and I can be expected to run up a couple of $100K worth of surgeries in the coming years.
They are praying I either have the common courtesy to die, or least get off their books.
Just noticed: they also will now cancel if I move out of California.

Why the hostility to un- and under-insured? Have no idea, but the situation is this - If the mailman gets run over, I will never again be welcome at any medical facility in the US.
Kids - get insurance while you are healthy - they will not write policies for people with “pre-existing medical conditions” - like diabetes, osteoarthritis, breast cancer or Parkinsons. Thats my brother-in-law, me, sister-in-law, sister.

11

FWIW, North Carolina and some other states have begun creating high-risk pools. You do have to be a legal resident of the state, and the rates aren’t exactly low, but it does mean that even those with pre-existing conditions can get insurance. If things don’t change on the federal level, more states will explore innovations like this: http://www.nchirp.org/

12

Edison has some of the worst customer service out there. They were busted a few years ago rigging their satisfaction reports they are required to send to the state public utilities omission, by channeling all the surveys to contractors who they had pretty much under their thumb: “Give us a positive review or we will delay the shit out of your hookups.” I have had dealings with them, and they are eeevil. Our local city utility here is much better.

13

I had HealthNet cancel my coverage for “nonpayment of premiums.” Except that I had automatic deductions set up with a valid credit card. They later claimed the payment was “denied” by the credit company. My credit card company had no record of that. The card was always valid. Furthermore, they never bothered to tell me at the time that they had canceled my coverage. I only found out about it about three months later when I noticed I had more money in my bank account than I expected. I called them immediately, outraged, and they did reinstate my coverage, but only after retroactively charging me premiums for the three months I was uninsured, and charging me an additional “re-activation fee” and generally treating me like a deadbeat who could not possibly be right. (I should have fought them on that, but I was tired, busy, and just wanted my coverage back.) At that point I had never even used my insurance yet, nor did they have any history of preexisting conditions for me. If I had had a history of preexisting conditions and/or claims, I’m sure they would have refused reinstatement altogether, in which case I probably would have had to go to court, or at least threaten to go to court, to get my coverage back.

14

That’s not really their fault. Health insurance policies are written according to state laws, and specific policy terms may not be legal in other states.

15

Update:
They allegedly accepted checking account payment over the phone.
Also said I was now in their auto-pay system.
Of course, I have no way of confiming this.
The nice woman in customer service (bad, but it will eventually let you speak to a real person) said the “next day” thing was “just a form letter”, and they still do the grace period thing.
Which is why I want confirmation - a customer service’s oral representation v. a lawyer’s written one. Guess which controls.

And, YES there IS a difference between “verbal” and “oral”. I can’t wait for somebody to cut and paste a dictionary entry which actually reads: illiterate people use it to mean:" and claim this PROVES it means…

16

I was really glad to drop my Blue Shield for my Medicare Advantage insurance. The last 2 years I had Blue Shield, pretty near every claim was denied until I would call and speak with a representative…sometimes 2 or 3 calls were needed. I suspect that they routinely deny coverage to more folks than just me.