Insurance Brick Wall
(AP / CBS)
For virtually all of my working life my family and I have been covered under a large health umbrella with thousands of other company employees. During that time I’ve paid thousands more in premiums than were ever been paid out, and that’s okay, because so-called “shared risk” is what large group plans are all about.
But not, it appears, individual insurance.
If you’ve been watching our reporting you’ll see how companies like to “cherry pick” only the healthiest of applicants, to the point where one expert said you have to be an “android” to get selected. I laughed until I got a good look at a “Health History Questionaire,” quickly realizing that despite the fact I’m in far better shape than most middle-aged males, I’ve got virtually no shot at ever qualifying for this kind of coverage.
Let’s begin at the beginning with this “Yes or No” question:
Has any person listed on this application, in the last 10 years (their bold), had any signs, symptoms, seen a health care provider, had treatment recommended, including prescription medications, received treatment, or been hospitalized for any of the following conditions…
Let’s see now, there’s heart disease, impotence, infertility, arthritis, diabetes, and substance abuse, which alone disqualify tens of millions of Americans. For the more common man or woman there’s allergies, infections, diarrhea, muscle pain, fractures, counseling, birthmark, acne and anxiety…
Allergies? Ah, that would be a yes. Considering I qualify for the daily double in the spring suffering and prescription medication departments given my annual trip to the doctor and pharmacy.
Infections? Yeah, as old Blue Eyes would say, I’ve had a few. (Do I dare reveal that dreaded finger nail debacle of 2003? Or the ear episode of ’01?)
Anxiety? Have I ever had any signs or symptoms of anxiety? Are you kidding me? Yeah, every damn day about 6:15 p.m. when we’re crashing a spot for the Evening News or putting the finishing touches on a major investigation. Last weekend was my 18-year-old daughter’s prom at New Canaan High School. I’d say my anxiety and blood pressure (another question) levels spiked a time or two.
By the time I got to the bottom of the 20 Questions I realized I was likely on my way to the “reject” pile, especially since insurers cleverly begin each and every one of their Brain/Nervous, Lungs/Respiratory, Nervous, Mental, Emotional, Behavioral, categories with the words “such as,” meaning even if you’re dead honest and somehow forget or omit a complaint or condition that shows up in your medical records, the company can argue you lied or committed fraud and cancel your policy, likely just at a moment you need it the most.
So welcome, one and all, to the brave new world of individual insurance. I don’t know about you but right now I’m not feeling so great.
Read the Investigative Unit's story: The "Uninsurables" 
Because I have lost so much over the past year and half financially, there is no recourse to have any reimbursement for losses. The insurance carrier cannot be sued because of a clause protecting them through ERISA. The company I worked for can't be sued because they hired the insurance carrier to handle health claims. So after 1-1/2 years later, they approve my claim based on the original diagnosis they received initially. There needs to be done about procedure. I've written a book about my experience "If You Knew How Regular I Am; You Wouldn't Be So Full Of It" because thousands of IBD sufferers are going through hell dealing with insurance carriers on a daily basis.