Anthem Blue Cross of California Is Breaking The Law
I know a lot about the Affordable Care Act. I’m a 33 year old with a life long heart condition (that I was born with). I’ve been purchasing insurance since I was 26 and no longer eligible for Cobra coverage. I was placed into a high risk ‘pool’ by Anthem Blue Cross of California in 2007 and I’ve been paying exorbitant premiums ever since.
I know the ACA inside and out. I’ve been asking a lot of questions of both Anthem and Kaiser lately in an effort to decide with whom I will do business starting January 1, 2014.
Two week ago an Anthem Blue Cross advisor instructed me to download several packets of information for their particular plans. These packets, available on their website, contain 9 pages of details regarding the benefits and breakdowns of the specific plans they’re offering beginning January 1, 2014.
On page 8 these packets apply the plan’s benefits and uses to hypothetical hospitalizations and services.
On page 9 however, they go on to explain that these examples, and any examples about how your plan might pay for treatments, services, hospitalizations, etc - is PREDICATED UPON WHETHER OR NOT ANTHEM DETERMINES THE CONDITION FOR WHICH YOU’RE BEING TREATED, IS DETERMINED BY ANTHEM TO BE A PRE-EXISTING CONDITION.
This is illegal. They aren’t allowed to determine whether or not you had a pregnancy or diabetes prior to January 1, 2014, and therefore decide that this medical problem and its corresponding treatments, services, hospitalizations, etc is pre-existing.
When I spoke just now with another representative from Anthem Blue Cross of California I was told that these are ‘internal documents that should have never been available for me’. The representative refused to comment further.
I’ve since been unable to find anyone at Anthem who will speak to the fact that this language is in their health insurance plans. The ACA wipes everyone’s slates clean. We no longer have any pre-existing conditions. So why is Anthem ‘internally’ showing that they plan to still enforce illegal assessments and practices?
I want to know. I want to be able to share this story with as many people as possible. Perhaps if someone covers this in the media, Anthem will be forced to address/respond to this activity.