Health insurance that discrimates against you for being healthy?

Question by : Health insurance that discrimates against you for being healthy?
We have insurance by Health Scope benefits through my husband’s employer.

The problem is, in order for them to pay like you normally would have any insurance pay (80% them, 20% you after deductible), you HAVE to go to the doctor, have life coaching, mammograms, eye exams, etc…once every 4 months, or they will pay at 60% and stick you with a $ 3,000 deductible.

Well, other than a yearly physical, my husband and I are completely healthy. I’m too young for a mammogram, he’s too young for the prostate stuff.

Life coaching? Who DOES that?

If it ain’t broke, don’t fix it has always been our motto…so why can this company do this, and what options do we have for not so expensive insurance perhaps outside of our employer?

Of course, the company’s stand on it is that people are healthier if they are seen quarterly, but I disagree…why would I want to make a new bill every 4 months (yes, we pay out of pocket and they “reimburse” months later, and only $ 50) just so my insurance will pay what most people’s insurance pays standardly if I need to go to the ER?

Ideas and help, please? Anyone know how to submit a complaint to the powers that be (who would they be?) that makes the purchasing decision for the employee “insurance” plan?


Best answer:

Answer by mbrcatz
The insurance company does this, because this is what the EMPLOYER chose to set up. It’s the EMPLOYER making the coverage choices and options – the insurance company is only selling them what they want.

The employer is probably kicking in a good chunk of change towards the cost of the insurance, but to find out your options, you have to go to the insurance market in your state, to see what’s out there. It IS possible that, if you’re young and healthy, you CAN find private coverage cheaper. But you won’t know until you start shopping around for it.

So, contact a local broker to get quotes and see what’s available in your state.

And the “powers that be” who make the decisions, are probably the human resources department, or the board of directors, or “the boss” at the company. No one here could possibly know who that is, but I’d bet your husband has a pretty good idea.

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1 comment to Health insurance that discrimates against you for being healthy?

  • StephenWeinstein

    The “powers that be … that makes te purchasing decision” would be your husband’s employer. If you submit a complaint, it will not really do anything, except to get his employer annoyed at him, and possibly hurt his career. Even if you can convince them not to keep this insurance, they do not have to get other insruance. They can simply decide not to have there be any insurance through them, rather than deal with the complaints.

    You have the same options for getting insurance outside of the employer that you would if the employer did not offer health insurance, and getting it outside of the employer was the only option, which is the direction in which you are pushing things.

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