Category Archive - Individual

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Individual Health Insurance Coverage Denials Rose Since 2007

Thursday, October 14th, 2010

Image: Oldmaison under CC 3.0

Over the past two years (ending in 2009), four major health insurers’ rates of denying coverage to individual health insurance plan applicants rose by 50%.

A report from the House of Representatives Energy and Commerce Committee claims that WellPoint, Aetna, UnitedHealth, and Humana purposely refused to sell coverage to over 600,000 people with pre-existing conditions. Up to 425 health conditions could disqualify a person from coverage under one insurer, and some would not conduct further internal review before denying coverage.

On the one hand, the insurers may have seen the writing on the wall when President Obama was elected, and wanted to maximize their profits as much as possible before regulations would limit their ability to discriminate based on pre-existing conditions.

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Rate Hikes for Health Insurance Plans Requested in North Carolina

Thursday, August 19th, 2010
health insurance plans

In North Carolina, Blue Cross Blue Shield has asked to increase the monthly premiums of its health insurance plans by an average of 7 percent.

However, the rate hikes aren’t across the board. Some of the 300,000 individual health insurance customers in the state may actually end up saving money through cheaper rates, while a handful of others will experience severe premium jumps of 40 or 50 percent.

The insurer blames rising medical costs for the increase, and says that it would have been even higher without the limitations imposed by healthcare reform. It remains to be seen if the state will approve their proposal.

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Utah Individual Health Insurance Rates Go Up

Friday, July 9th, 2010

Image: debaird under CC 3.0

Similar to those in other states, Utah health insurance companies are raising their premiums. They blame the Obama administration’s healthcare reform law for forcing them to prepare for decreased profits later.

Although state law allows insurers to charge as much as they believe the market will bear, some consumer advocates are worried that filings for rate increases are considered proprietary business information and kept secret. Therefore, few health insurance buyers know what they’re getting into. Most rate changes aren’t known of unless a policyholder speaks out and complains to the media, as they did in this case.

The federal government is looking to states to strengthen their enforcement and prevent “rate creep”, which makes Democrats look bad in the mid-term election season. Humana has raised Utah individual health insurance rates by 29%, while Regence Blue Cross Blue Shield has increased some Medicare Advantage premiums by 48%.

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Will Healthcare Reform Help Part-Time Employees?

Tuesday, June 29th, 2010

Image: The Consumerist under CC 3.0

Many supporters of healthcare reform have pointed to the benefits that it can bring to part-time workers. In most cases, companies do not offer health coverage to employees who work under a certain number of hours per week. Some businesses even intentionally schedule employees just under the threshold, in order to deny them health care.

During the recession, many people have been juggling multiple part-time jobs. Although they end up working full-time hours or longer, they are eligible for health benefits from none of them.

Affordable individual health insurance is the solution in this case, but it may not be available to everyone. The exchange markets that the law establishes in 2014 are hoped to help in this regard.

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Did Group or Individual Health Insurance Premiums Rise More In ’09?

Tuesday, June 22nd, 2010

Image: TheTruthAbout under CC 3.0

According to the Kaiser Family Foundation, those buying individual health insurance have experienced far greater increases in their premiums recently.

Their findings:

  • 77% of those buying health insurance on their own were presented with a price hike
  • On average, those proposed hikes were 20%
  • 16% of those presented with proposed rate increases switched to less generous–and less expensive–health plans, either through the same or a different insurer. Many of the others didn’t switch due to pre-existing conditions that would make finding a different plan difficult.
  • Altogether, the average rate increase (including those who changed plans) was 13%.
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How Many People Have Pre-Existing Conditions?

Friday, May 28th, 2010

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A recent study from Families USA found that up to 57 million people in the United States suffer from pre-existing conditions. These issues have prevented them from buying individual health insurance on the open market.

Proponents of health insurance reform will take this statistic as proof of why comprehensive action was necessary. In 2014, health insurers will no longer be allowed to refuse any consumer, regardless of health status. In addition, the premiums charged can’t be significantly higher.

The figure excludes the elderly, whom are already covered by Medicare.

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Generation Y Most Likely To Be Uninsured

Monday, May 10th, 2010

Image: debaird™ under CC 3.0

According to a recent Pew Research Study, Millennials (generally considered those between the ages of 18 to 29) are the demographic least likely to be covered by a health insurance plan. Only 61% of them are.

What are some of the reasons that Generation Y might be uninsured?

  • After graduating from college, many young adults have been kicked off of their parents’ health plan. (This survey was taken prior to the passage of the healthcare reform law, which will soon eliminate this practice)
  • Many Generation Y-ers are unemployed, making it difficult to afford an individual health insurance policy.
  • A large percentage of those who are employed are working lower-wage entry level jobs. An increasing number of employers no longer offer health benefits.
  • Some choose to forgo health insurance, because they–falsely–believe that they are invincible and that nothing will happen to their health.
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Individual Health Insurance Rates To Increase For Young Adults?

Tuesday, March 30th, 2010

(Image: r.f.m. II under CC 3.0)

An Associated Press analysis has found that healthcare reform may result in young adults in their 20s and early 30s paying more for their health insurance plans. Starting in 2014, health insurers will no longer be allowed to deny coverage to people with pre-existing conditions, or use age rating practices to charge older consumers rates more than three times higher than those for younger ones. That cost will inadvertently end up passed onto younger policyholders, who use fewer healthcare services and are therefore more profitable.

How much will it cost them? The average individual health insurance premium for this demographic will rise by about $42; a 17% increase. Young men will be harder hit, since their rates tend to be less expensive than women of the same age.

Granted, this estimate does not take into account tax credits and subsidies to pay for insurance, which many people under 35 may be eligible for.

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Reform Would Fund Guaranteed Issue Health Insurance Pools

Wednesday, March 17th, 2010

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Many supporters of the Obama administration’s healthcare reform believe that it will significantly help uninsured individuals with pre-existing conditions. Most health insurance plans are not willing to accept them. While each state has a high-risk health insurance pool, they are often underfunded and must put a cap on the number of people they accept.

Although guaranteed issue health insurance is already available for that group, some people may be unable to afford it on their incomes. Therefore, the bill currently pending in the Senate would increase access to the states’ high-risk pools, through $5 billion in funding. Premiums are lower, since they are partially subsidized by taxpayers.

Unlike most aspects of the legislation, the boost to the state-wide pools will not take place in 2014. Instead, it is set to become effective immediately!

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Free Surgery For The Uninsured

Monday, March 8th, 2010


People who lack medical health insurance and are in need of surgery are in a major bind. Hospitals are less willing to offer charity care, due to their own budget struggles. In Kentucky, where one-third of working-age adults are uninsured, some doctors are working to change that.

Dr. Andrew Moore has launched an innovative program called SOS (Surgery on Sunday). Once a month, doctors, nurses, anesthesiologists, and others donate their time and skills to provide free outpatient surgeries to the needy. There is a waiting list, but the order is based on the urgency of patients’ needs.

Most of the people they treat earn too much to qualify for government-provided health insurance like Medicaid, but are unable to afford individual health insurance on the open market. Some have pre-existing conditions–largely exacerbated by lack of care and treatment–that would make a health insurance plan even more costly.

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