Applied for individual health insurance through BCBS; was given a counter offer based on my medical history - can I negotiate for a better price?
April 28, 2012 2:28 PM   Subscribe

Applied for individual health insurance through BCBS; was given a counter offer based on my medical history - can I negotiate for a better price?

Located in the Northeast; Female, 28 yo soon to be 29 yo who is in professional school; but took off this semester. Therefore, I am no longer covered under the student health insurance because I am no longer a student. Filed an applied for individual health insurance at BCBS. But was given a different price quote/counter offer that is about $240 per month due to past history of being diagnosed with depression.

I did not reveal that information on my application because I don't consider myself being officially diagnosed with depression. I have taken anti-anxiety medication previously. So, I am wondering how did they find this information out? And can I refute this? I was depressed about six years and took anti-depressants/anti-anxiety medications. I have had counseling and therapy and got better.

Also my letter of termination occurred in March 1, 2012 so after a string of confusion of what my health insurance status was with the school, I finally received it and found out I had to apply to individual health insurance because the extension was too expensive. However, the application I submitted was about April 22, 2012 and now tih approximately 60 day time frame that I hear with COBRA I am wondering if I can have a gap past 60 days to find out if I can apply to another health insurance provider for a better price quote. I plan to go back to school in August 2012.

Has anyone handled this before? I have called and called the insurance company customer service and was beyond frustrated with their answers and the number of transfers I had to go through only to have someone try to sell me insurance. I basically want to pay less than what they offered but don't know how long the whole process would take for me to argue or discuss with them this since it took so long for them to get their act together and mail me the correct documents and explain to me what was going on.

posted by anonymous to Health & Fitness (6 answers total) 1 user marked this as a favorite
So, I am wondering how did they find this information out?

HIPAA regulations make it pretty easy for "covered entities" to share information . If you've ever been treated for anything ever, your next insurance provider will know about it.

Is there any reason you want to stick with BCBS? They are pricey. You might try looking at other companies. There are a lot of places online to get multiple quotes -- I'm sure someone will chime in with a link.
posted by pantarei70 at 2:58 PM on April 28, 2012

At around the same age I was was told by the BCBS customer service line based solely on my height and weight - no medical information or application filed - that I would be flat out denied individual health insurance.

So, I formed my own company as an LLC and got a small group insurance plan which is guaranteed issue under HIPAA, which cost only slightly more than COBRA did. Though I was already planning on starting a company so it wasn't anything out of the way for me; it might easily be more trouble for you than it would be worth, depending upon which state you live in, and you're at that 60/63 day limit for some of the additional benefits of HIPAA to group insurance (though I don't know if it's the same anyways with the PPACA / 2009 reforms.) An important point for me was that my Northeastern state mandates that small group insurance plans must be granted to companies with only one employee, whereas some states require at least two employees.
posted by XMLicious at 3:10 PM on April 28, 2012

If you only need this insurance over the summer, and don't have any huge health problems that will require lots of doctors/prescriptions/etc., apply for temporary/short-term insurance. The qualifications are a lot lower and it's just a catastrophic plan but it's much easier to get. Be glad that they gave you a counter-offer and didn't technically deny you coverage. Once you're denied coverage you have to list it on future applications (oh, and they'll find out). It's creepy how they find things out (they also can get a list of what prescriptions you purchased).
posted by Bunglegirl at 3:26 PM on April 28, 2012

The health insurance forms ask if you have ever been diagnosed, treated, etc. They don't ask, or care, what you think of your current medical condition. I've been through the individual plan thing several times, with multiple pre-existing conditions involved. Anything you've ever been treated for is probably on your permanent record - and they can charge accordingly if they know about it.

The 63 day coverage gap limitation is based on the day you apply for coverage. So you'll be covered retroactive to 4/22 once the policy is finally in place.

Most short term policies don't count for maintaining continuing coverage, so if that is important to you then a catastrophic / short term policy is not an option. Probably your best option is to buy the highest deductible policy BC/BS offers - which will minimize your monthly premium for the short time you may need the insurance.
posted by COD at 3:49 PM on April 28, 2012

The 63 day coverage gap limitation is based on the day you apply for coverage.

Correct me if I'm wrong, but just to be certain, you're talking about the effective date for any new coverage, not necessarily the date the application was filled out on or the application process was initiated, right? (besides which, the 4/22 application was for the expensive coverage that she doesn't want to have to accept; applications submitted while shopping around would be dated later)

But if I'm correctly remembering the research I did half-a-decade-plus ago, even at that time if you missed the 63 day window all it meant was that the new policy didn't have to pay for any treatment of your pre-existing conditions for the first twelve months. So for that specific concern missing the window might not be very serious, especially if you aren't being treated for depression now - 12 months of that doesn't cost very much anyways, it's not like it is for people who have really expensive ongoing medical costs or ones that could incur a crippling expense in the event of a hospital stay.
posted by XMLicious at 8:14 PM on April 28, 2012

That is true. However, I've had enough issues with health insurance companies to not trust them at all. If something is not covered on your policy due to pre-existing status, the insurance company will find a way to tie just about everything to that something. And it's not just big stuff that depression and chronic illness at stake here. If you sprained your ankle six months ago and them break it in a totally unrelated softball accident this summer, the insurance company very well may claim the two injuries are related and thus not cover the break to the previous treatment of a sprain.
posted by COD at 7:04 AM on April 29, 2012

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