Nothing seems as unfair as when a California health insurance company (Athem Blue Cross of California, Blue Shield of California, Health Net of California, Pacificare of California) declines your application for an individual medical insurance policy. Often, the California medical insurance company sights a seemingly minor pre-existing medical condition as the basis for their decision (e.g., teenagers with acne, infants with a history of ear infections, etc.) People with AIDS, cancer or a pregnant woman usually understand the reason the health insurance company declined to offer them a California medical insurance policy. These people know that they will likely have to pay huge sums of money to obtain medical treatment. While it seems unfair for an insurance company to decline your coverage for individual health insurance, in California it is perfectly legal. The reason insurance companies refuse medical insurance coverage is to prevent people from waiting until they get sick to apply for coverage. Think about it. If there were no screening, each person would have no incentive to enroll in a California health insurance policy and only apply for coverage after they became ill or had an injury. Why would someone pay for health insurance in California before she needed it if she could obtain coverage at any time? It would make more sense to have no insurance and only sign up at the emergency room for coverage. It would be like crashing your car, then paying a small insurance premium and asking the insurance company to pay for the damage. If the only people who paid for insurance were sick or injured, the medical insurance companies would pay a huge amount of money and they would have to charge astronomically high premiums (as happens in New York) or most of the insurance companies would leave the market (as has happened in Oregon.) The only way the insurance market can function is by spreading the risk of high claims payment among many people: healthy and unhealthy. There must be many people, mostly healthy in the pool of people covered by California health insurance companies for the market to function properly. Accordingly, the rule for obtaining a California medical insurance policy is: apply while you're healthy, before you need any of the benefits. |
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California Health Insurance |
Group Health Insurance in California |
Health Savings Accounts | |
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