Fun Discoveries About Health Insurance

As the title says, I discovered lately one of the fun intricacies in the American Health Insurance Scam. Recently, I switched to my employer's policy because I was tired of paying the for the Marketplace "coverage" that required 900,000 hoops to be jumped through to cover aspirin. The policy is employer sponsered, so offeres decent prescription and medical coverage at a decent premium ($80 per pay period/a week).

I was excited because, as a Type 1 diabetic, I have a lot of very expensive prescriptions I have to fill to stay alive. As most people do now, I have regular visits with a therapist and nurse practitioner to manage my mental health and was expecting to have my insurance cover at least a portion of this. When my provider went to file a claim for my visits, they were told by the policy administrator that my policy did not have any mental health coverage. Well, I assumed that this was illegal under the ACA and after verifying that state law required parity between medical and mental health coverage, I filed a complaint with the Ohio Department of Insurance. After about a month, ODI responded saying that the policy was originated in Maryland and outside their jurisdiction.

Fine. Filed a similar complaint in the state of Maryland, where the policy was created. 2 weeks later, Maryland sends a decision back stating that because the policy is self funded by the company and only use BCBS as an administrator, the policy is not required to adhere to some of the Title XXVII protections updated by the ACA in 2010. They suggested that I file a complaint with the Company Feduciary and if I am not presented with a favorable response, to file a lawsuit in Federal Court.

Well, I know where this is going; since I have no leverage because the law is in favor of the company, my complaint will likely fall on deaf ears and because I am not hugely, independently wealthy, I can't afford to hire a lawyer who would be willing to file in Federal Court.

All that to say that American Health Insurance sucks, is a huge scam and will not change because too many people with money want the status quo to remain.

God Bless America, home of the free (if you have money), land of the brave (who were recruited to fight for the wealthy).

submitted by /u/GMorPC
[comments]