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What health reform means for the people of Illinois

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Friday, June 22, 2012

Insurance Claims - Sounds Too Good to be True?

As we await the Supreme Court decision regarding the Affordable Care Act, which has already benefited hundreds of thousands of Illinoisans, we should not get too carried away by the health insurance giants UnitedHealth Group, Aetna and Humana announcement that regardless of how the Supreme Court rules, they will voluntarily continue some important consumer protections created by the law. These include preventive health care services without co-payments, coverage of children up to age 26 and elimination of lifetime policy limits.

Sounds too good to be true? Let's be clear: the insurance companies are only talking about voluntarily extending a few of the benefits they are now required to offer. This won't cost them a nickel because the benefits were cost-efficient to begin with and are already accounted for in their premiums. And without a law to require these provisions, there is no guarantee that the insurers won't yank them whenever they want.

What the insurance companies didn't say – and what they won't do – is the real story. They aren't saying they will stop discriminating against people with pre-existing conditions as the law requires beginning in 2014. That would be a big deal, because that part of the law will stop 129 million people with chronic conditions like diabetes, high blood pressure and asthma from being overcharged or being denied coverage. They also have not offered to keep covering children with pre-existing conditions -- a provision that has already taken effect and insurers have fought.

Lynda DeLaforgue
co-director, Citizen Action/Illinois

(This post originally appeared as a Chicago Tribune Letter to the Editor on 6/22/12)

1 comment:

  1. Great information! Insurance companies don't like to pay claims and some inspectors or adjusters are invented to deny claims. With this said, if you have a legitimate claim, you should expect to be treated fairly and expect the insurance company to honor the claim. Claims Pages