Californians with Anthem Blue Cross beware

Think you’re safe because you’ve got health insurance with California’s Anthem Blue Cross? Think again. They just might decide they don’t want to cover you — right after you let them know you need them to pay for your expensive procedure like they promised.

This is one of those things that makes you sad to have to talk about, but it is what it is, I suppose. This post should give you pause if you, like me, are a California Anthem Blue Cross (marketed as Tonik to Gen X, Y, and Z) individual member and are expecting Anthem to pay up should you ever have a catastrophic medical issue.

In short, Blue Cross is the worst offender in the state in terms of “rescission.” What does that mean? It means Blue Cross has been canceling people’s insurance policies when they filed claims that appeared too expensive (i.e. not profitable to Blue Cross). Imagine how you would feel if, after a $30,000 trip to the emergency room, Blue Cross told you they were no longer willing to pay as agreed in the contract despite your having paid their exorbitant premiums month after month? I know I’d be pretty angry, assuming I was healthy enough to handle such news.

There are regulatory agencies out there that are supposed to monitor this kind of insurance abuse, but Anthem Blue Cross has managed to get around ponying up to its responsibilities to its paying members. According to this article in the San Francisco Chronicle, “Anthem Blue Cross (of California) has the highest number of alleged illegal rescissions, it may face the least regulatory consequence simply because of its sheer size and its skill in legal intimidation.”

“California regulators admitted Thursday that for more than a year they didn’t even try to enforce a million-dollar fine against health insurer Anthem Blue Cross because they knew they would be outgunned in court.”

It’s one thing to pull people’s coverage when they need it most. It’s another thing to underhandedly duke it out in court with high-priced lawyers just so you can get away with such selfishness. First thing this week, I plan on getting insurance elsewhere. Right now, Kaiser Permanente seems like the best option as they have not practiced rescission since 2006 and, I’ve heard, either accept you or reject you without the pricing games that Anthem Blue Cross plays by raising your rates for every extra health issue you may have.***

For more on Anthem Blue Cross’ dirty tricks:
California Doctors and Hospitals Join Blue Cross Rescission – Cancellation Class Actions

***Update: CA’s Department of Managed Health Care has a website where you can take a look at the fines insurance companies have had to pay for their wrongdoings. Here are the links for Kaiser and Blue Cross. Most important to note is that Kaiser “reserves its right to pursue rescission of KPIF membership agreements of enrollees who enroll after May 15, 2008, in accordance with California law.” While Kaiser has publicly said they no longer pursue rescission since 2006, you should note that they have reserved their right to reinstate rescission in the future. Sorta feels like you’re gambling rather than getting peace of mind sometimes, doesn’t it?