Video: The Non-Existing Condition

Valerie Scaglione’s story is almost comical:

Monthly premiums for Blue Cross coverage for them and their three daughters have soared over the years to almost $2,000, Scaglione says.

She estimates that in the past six years, the family has spent more than $140,000 on premiums and co-payments.

Yet when she tried to switch from the family’s expensive individual insurance to a Blue Shield group plan that’s more affordable, she said, she and her oldest daughter were denied coverage. She said neither of them has the medical conditions that were listed as reasons for being denied – bronchitis and a skin ailment.

“I have three children,” said Scaglione, 47. “We have to have insurance. Stitches may be required. A broken bone may have to be set. We have no chronic diseases. We’re a normal family. This is crazy.”

Consumer advocates consider their story emblematic in many ways of complaints that plague the entire health insurance industry.

“We’ve seen people denied for things as minor as heartburn,” said Anthony Wright, executive director of Health Access California, a statewide health advocacy coalition. “It gets to the point where living is a pre-existing condition.

Mrs. Scaglione’s health insurance coverage costs three times as much as the family’s MORTGAGE. And she can’t get out of it and into a group plan, because Blue Shield flat-out invented reasons to deny the coverage. She has demanded to see the medical records that show her daughter having bronchitis and her having a skin condition called rosacea, but the health insurer refused the request.

As the debate continues, the Scagliones remain among California’s 3 million consumers in the pricey individual insurance market.

“I wonder how many other families are like ours,” Scaglione said. “What’s the option, to be uninsured? This forces me to stay with our same plan. Premiums will go up and up and up. What, do we not feed the kids? It gets to the point of being absurd.”

Blue Shield of California can be reached at (866) 256-7703. You might want to ask them what health care ailments they think you have of which you’re unaware.

ej_or

New Slogan for Blue Shield:

"Health Insurance for Everyone- who would never need it!"

ej_or

New slogan for Blue Shield: "Health insurance for people who would never need it!"

Craig_Sipple1

I recon you guys could still get a robust public option, but you have to start fighting now.

Everybody together now... and push!

Jamie Sanderson

Thanks for sharing truth to the masses.

Bonnie Crawford

The greed of these insurance companies is totally unacceptable! With over 45 million people unable to afford health insurance, and those whose exorbitant premiums will force them out of the market, we have GOT to have a national healthcare plan and preferably a public option. That's all that will force insurance companies to be honest and lower their excessively astronomical premium prices. Greed has overtaken this country; we've seen what has happened with healthcare and Wall Street, and people are going to have to be vigilant against being abused. It's sad that greedy politicians can manipulate people into believing that the U.S. system is "the best in the world." What a joke! This country is way behind all other industrialized nations regarding healthcare and will continue to be until a universal coverage plan is put into place.

karenmugan

Our two children were both denied individual coverage from Blue Cross Blue Shield and also have no chronic illnesses. Our son was diagnosed as having ADHD and both children had therapy sessions with family therapists when they were teens struggling with the normal teenage stuff. That's it, no cancer, no diabetes, no heart disease, no previous surgeries and no other serious illness other than the usual childhood stuff, i.e., ear infections, colds and flu, etc. We eventually got coverage throught a state mandated program where coverage could not be denied. We were given no reason from Blue Cross/Blue Shield for the denial.

janet burdine

well after your nutrition deteriorates because you have paid all your high premiums,insted of being able to buy food, and you start to get sick from malnutrition, maybe the insurance coompany will come up with another bogus reason for denial..maybe they should consider having insurance as a pre existing conditioon..lol

Robert F.

This is criminal, wrong, and unless we have a public option for competition, nothing will change.

ColoradoBob

My wife has respiratory problems, and we pay $630 a month for two of us to have a catastrophic $5000 EACH deductible policy via Blue Cross Anthem. So The Anthem people get to put over$7500 of our dollars into the "In" box each year. This year a possible public health menice, "Swine Flu" (H1N1) comes along and she gets a flu shot at the local clinic for $85, all of which was "denied" as good sense preventive care. Time for a public option health plan that takes care of health, fights death, not poverty.