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Junk InsurancePowerful Patient, 2009 Week 30Host: Joyce Graff, http://powerfulpatient.org, editor@vhl.org 800-767-4845
An estimated 49 million Americans don't have any health insurance. Frightening. But even more startling are the discoveries of a Consumer Reports investigation, which found that many people who've purchased their own insurance are not as protected as they think. Joyce talks with Nancy Metcalf, senior project editor, about Junk Insurance.
Coverage Gaps Can Leave You in Big Trouble
Consumer Reports Health has investigated numerous insurance plans, to determine just how well they protect you when you get sick.
When you are well, people’s main concern tends to be the affordability of the plan. But there are no bargains in insurance. A plan that fits your budget when you are well may break the bank when you are sick. The value of an insurance plan is how well it protects you if you should have a major illness such as cancer, diabetes, heart disease, or the attack of a particularly nasty bacterium or virus. “We think a good health-care plan should pay for necessary care without leaving you with lots of debt or high out-of-pocket costs.” While in some cases we can choose healthful behaviors that will help us avoid many major illnesses, it is not possible at this time to protect yourself completely. Everyone is at risk for major illness or accident.
Nancy Metcalf, Senior Editor at Consumer Reports, discusses with Joyce her series of reports on health insurance. Access to this information is free, and is on their website at http://consumerreports.org/health/insurance/health-insurance.htm
She has tips for how to obtain health insurance – whether you have a job or not. The primary article we are discussing begins at On this page you will find the core article, and in the menu at the left there are complementary discussions.
In particular, check out “7 signs a health plan might be junk”
And also read “7 ways to make the most of your health plan”. Once you have coverage, how you can make the most of it and use it to manage your health – not just care for you when you’re sick, but support and enhance your health.
Pre-Existing Conditions
The report includes a discussion of what to do if you have a pre-existing condition.
Getting coverage when you have a pre-existing condition is particularly hard. Even pregnancy may be considered a “pre-existing condition” if you are not covered by insurance at the time of conception.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits discriminating against pre-existing conditions, so that women like me, who switch health plans while pregnant, have it easier. But HIPAA mainly applies to those who have had prior group health coverage. If you move from an individual to a group plan, you may be subject to a pre-existing condition waiting period. Or if you move from one individual health plan to another,
Several states now have rules that disallow denial of insurance to people who have pre-existing conditions. Nonetheless, the company may “rate” you at a higher rate due to this condition.
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