Health Care Insurance Stories

I have been paying for my own health insurance coverage since 2003. My current policy is with Blue Shield of CA. In 1994, I was diagnosed with a Stage 1 melanoma on my leg. It was small, caught early, and my markers were clear immediately. Since I was diagnosed, I have become a "reformed sun worshipper," question others who are not "sun smart," and visit my dermatologist regularly.

As a result of my diagnosis Blue Shield has rated me up to Tier 4, the highest tier for insurance premiums. I will never qualify to be rated in Tier 1 with Blue Shield because of my melanoma. Even though all dermatologists I have visited in the last 12 years have cleared me, Blue Shield is still financially penalizing me. I do not know how long Blue Shield can legally rate me up for an incident that happened 12 years ago and has been cleared by doctors.

When I applied with Nationwide, my husband's carrier, they didn't have a problem with the melanoma. They found some other small incident (ovarian cyst, Hello, I'm a woman, these happen every month during our cycle!) to use as a means to deny me coverage. I have learned that there is no consistency in the health insurance industry for approving and denying subscribers.

It would seem that the insurance companies are actually shooting themselves in the foot by rating people like me up and charging exorbitant premiums. After paying high premiums there isn't much money left over to pay for regular doctor's visits, so regular visits may not occur, which means patients may not seek help until something serious happens. At this time, the cost for medical attention is higher, deductibles are met, and the insurance company has to kick in their costs.
By keeping premiums low, people will seek basic coverage and take care of problems sooner rather than later.

Karen Lombardi
Ventura, CA

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