March 14, 2006 by bob.

This has been one of those weeks . . . and it is only Tuesday.

A woman paying $800 per month for health insurance says she cannot afford to keep her policy. She has 4 different policies, one for each of her family members. Each one has a different deductible, ranging from $1000 to $2500.

She now wants everyone covered under one policy and is willing to boost her risk to $5000.

I give her a price that will cover her husbands pre-existing condition, his tobacco use, and her size 16 body.

She says that price is too high compared to one she got off the internet.

I am familiar with this carrier. They will not cover her husbands pre-existing condition, they will rate her for her weight (something my quote already considered) and the have a limit of $5,000 on prescription meds.

She doesn’t care about my observations. She already has a better price. Besides, her meds don’t run anywhere close to $5,000 per year.

I point out it doesn’t matter what you paid in the past, the reason for buying insurance is to cover things that could happen in the future. Since I have 3 clients whose Rx bill runs in excess of $2,000 per month, I feel I might know a bit about this topic.

She also says she has never heard of the carrier I have quoted. That’s OK because they probably never heard of her either.

She is 42 years old.

The carrier I quoted is over 100 years old and has always specialized in health insurance.

The carrier with the lower price has not been in the individual health insurance business for at least 15 years.

She still wants the lower price plan.

You get what you pay for. If that is her decision nothing I do is going to change her mind.

Woman number 2 tells me she doesn’t have health insurance. Her husband is covered under a plan at work but he is leaving that job and needs coverage.

They can’t afford more than $350 per month.

Her children don’t need health insurance, they are on the state welfare health plan.

This should have been my first clue things won’t turn out the way I want them to.

She has pre-existing conditions, and she cannot afford her asthma medication.

She also has Lupus but claims it has been in remission for 20 years. She also claims she has had no treatment in the last 10 years for Lupus.

I show her a plan for $360 that will cover her asthma meds. Since her Lupus is outside the boundaries of the questions on the application, she should be good to go.

She likes the plan and wants to talk it over with her husband.

I follow up the next day.

Her husband said they cannot afford a $5,000 deductible.

I quote her a $10,000 deductible for $70 less.

No, she says. They cannot afford to pay $5,000 if they had a serious illness.

How much can you afford?

Maybe $1,000.

OK, that plan is $800 per month.

We can’t afford $800.

What can you afford?

About $350.

I have a plan with a $5,000 deductible for $360. It will cover your medicine with a $35 copay.

We will just set up a savings account. The only thing we need insurance for is for a doctor visit once or twice a year and my medicine.

What if something bad happens and you run up a $40,000 bill?

We will fill bankruptcy. We have done it before and will just have to do it again.

So it is better to lose everything than cover all but $5,000 of your medical bills for a $360 per month premium?

Yes.

I just looked at the calendar.

It is a full moon.

That explains it.

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March 14, 2006 by bob.

Insurance applications are mostly based on the honor system. You are asked to put down information that you know to be correct and the carrier relies on that information to evaluate you as a risk.

Depending on the coverage applied for, there usually are additional background checks. This might include checking with M.I.B. (Medical Information Bureau), your states DMV (Department of Motor Vehicles), a credit check and a criminal history background check.

Sometimes you may be asked to submit body fluid specimens and maybe even have a physical exam.

But it still comes back to honor. The carrier EXPECTS you to honor a code of ethics and be truthful in your answers.

Speaking of honor, a former mayor of our great city was recently tried in federal court. Several wrongdoings were alleged including extortion, bribery, illegal use of campaign funds, racketeering and tax evasion.

During the trial which lasted about 2 weeks, the jury was not sequestered. Hizzoner was free to hold nightly press conferences where he would spin the events of the day in his favor. He would swagger up to the reporters, smile and stare into the camera as he talked about the lies by the prosecution that proved nothing and only served to smear his reputation.

I am sure the members of the jury adhered to their charge to avoid watching the news in an attempt to remain unbiased.

During two days of testimony former girlfriends of Hizzoner were put on the stand to testify about trips to Paris and other exotic places where gambling was a major attraction. Every one of these trips was paid for in cash. Lots of cash.

There were even some Kodak moments where the mayor posed in front of landmarks like the Eiffel Tower.

Did I mention the mayor was happily married during this time?

Hizzoner talked in his nightly spin cycle about how these allegations failed to prove any wrong-doing but only served to smear his good name and reputation.

Uh-huh.

Somehow he failed to mention that he might be incriminated, not for having a lovely accessory on his arm, but that the cash was unaccounted for in his financial records.

The mayors wife was noticeably absent from court when the girlfriends testified.

At the conclusion of the trial, many of the charges involving bribery and extortion were not proved to the satisfaction of the jury.

He was however convicted of tax evasion.

So at the end of the day, if you are to believe the jury, the mayor is not guilty of anything other than cheating on his wife, and cheating on his taxes. Other than that, he is an honorable fellow.

In fact he even proclaimed in his last press conference that his “honor had been restored”.

Really?

How did I miss that?

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