Off Topic: I Have Swine Flu & Blue Shield Is Evil

If you’re a regular reader of Credit Card Forum blog, you may have noticed there have not been any posts for over a week. The reason being I’ve had [and still have] swine flu and haven’t had the energy to be on the computer. So despite it being only September, be warned if you are in Southern California. I am a healthy younger individual that washes my hands and uses hand sanitizer religiously, but apparently it didn’t do any good.

However the problem is not that I have swine flu… the problem is that I don’t have insurance.

And no, it’s not because I haven’t tried to get insurance. In fact, I can’t even tell you how much time I spent in 2008 trying to purchase insurance once I became self-employed. However, I was repeatedly denied underwriting for ridiculous reasons. The endless phone calls, faxes, and letters to dispute their decision did no good, and you won’t believe just how unethical Blue Shield was during the process, which started with their rejection letter…

Hmm… so what do you think this unacceptable “criteria” could be? It must be something really awful, right?

Well getting to the bottom of this was almost impossible. You see, they list no phone numbers on this letter… once they reject you they don’t want to hear from you. Whether their reason is valid or not apparently doesn’t matter. In fact, they don’t even put their actual physical address on the letter!

Instead they put this obscure post office box address at the very bottom corner…

…and yeah that’s right, they even have to put this little P.O. box in a hard-to-read light gray font. Imagine if I was older and had vision problems?

And you may be wondering who the wonderful individual is there that is making decisions like this which are virtually life and death for some people? Well, they’re not exactly transparent in telling you that either…

Don’t ya just love that signature… a squiggly line resembling an “n” that took a whole 10 nanoseconds to scribble down. I wonder if my buddy David was as thorough going through my medical records as he was signing his name?

After a bit of legwork, I located their phone number through Google and gave them a call…

Operator: Blue Shield
Me: Hi can I please speak to David L. in underwriting?
Operator: I need a last name to connect you.
Me: Your letter didn’t mention his last name.
Operator: Then I can’t connect you. [CLICK]

Like I said, they really don’t want to talk to you! So I turned back to Google and started doing queries like “David L”+ “Blue Shield of California” hoping to track down who this guy was so I could talk to him. No luck.

So I hit the phones again and again, trying to get through to either David himself or just the underwriting department. You would think it would be a right – not a privilege – to at least speak to them, right? Nope! Time after time, the operators gave me the same rude answer, which in a nutshell was “You’re denied. Your problem, not ours. Tough luck. Don’t contact us.”

Then it finally dawned on me… if this guy is an insurance underwriter, he has to be (1) licensed by the state, and (2) possibly a member of one or more of the insurance underwriters associations.

By searching for his first name and last initial, I was able to locate who he was through the National Association of Health Underwriters website. However I got extremely lucky here, because this is an optional organization that he just happened to be a member of. You aren’t going to find everyone in this profession listed.

Once I had his last name, I now had the ability to call! So I gave them a ring, dropped his full name, and they patched me through. The first few times I got his voicemail, but eventually I finally got to to talk to him.

First he claimed I was denied because of an auto accident I was in long ago. However, that excuse didn’t quite work. You see that accident happened in Michigan years ago, the only state which gives unlimited medical coverage to auto accident victims insured in their state (and of course, the accident has to occur there, too). They pay 100% of all medical care – anywhere, any doctor, any time – for treatment resulting from accident injuries… for your entire life!

During my application process with Blue Shield, I even submitted an official document certifying this exclusion. Well, David the underwriter apparently must have not gotten that memo during his decision. But either way, he stood firm. He cited other medical history as a cause for denial…

That’s right folks. Pimples.

But it gets worse…

This is not even referencing a current acne problem. I haven’t had a zit in years! Rather, they’re talking about normal teen acne from many years ago. So attention parents: if your child has a pimple, do NOT tell the doctor or take him to the dermatologist to get a prescription for face wash. Because if you do, your son or daughter will “exceed underwriting acceptance criteria” when they’re an adult!

If you support health care reform and agree that having pimples as a teen shouldn’t disqualify you for insurance as an adult, please link to my story in your blog and help spread the word!

Thanks,
Mike

Written Sept. 2009

 
Comments
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I just started paying for insurance again, (finally had enough money to get started) and I am amazed that what I have is called insurance. I was surprised to receive a bill from the company that analyzed my pap test. I thought that preventative procedures were supposed to be covered but I’m sure that I missed some fine or hazy print that states differently. I’m a little nervous even writing this because I fear that I could be cancelled for being out spoken. These people who are afraid of a government run insurance probably have never been denied anything and are living in a dream world, like Congress.

This is why we need a public option. You can’t trust the insurance companies. They are out to make the most money possible. It’s sad to think that profiting so excessively off others medical misfortunes has become the American way.

Blue Shield is one of the most corrupt companies in America. The worst part is they claim to be a non-profit so they don’t have to pay taxes, either!

Sometimes professional organizations that you belong to can facilitate the purchase of medical insurance. For instance, a friend was able to purchase insurance because of membership in the International Documentary Association(IDA). The IDA is a great organization largely made up of independent creative people like you, worthy of your support, and documentary film is an effective way communicating problems like the one you illustrate here.(For example, to be eligible through the IDA one would need to be self-employed in the arts and entertainment industry, and living in the required geographic area). http://www.documentary.org/

Of course you are making a good case for reform of our current healthcare system, but perhaps a group can accomplish what is difficult for an individual to accomplish in the meantime.

Best wishes