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CA residents to get renewed health coverage

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About 3,400 California consumers whose individual policies were improperly revoked will soon get invitations to rejoin their health plan. The letters are being sent out as part of a batch of settlements recently announced between the state's Department of Managed Health Care and a handful of health insurers. Health plans issuing the letters include Health Net, Anthem Blue Cross of California, Blue Shield of California, Kaiser Permanente and PacifiCare, which have reached settlements over their rescission practices that included fines totaling $14 million.

The Department of Managed Health Care has ordered health plans to provide the agency with contact information for hundreds of members with rescinded policies to make sure that the members do indeed get their notices. Meanwhile, the DMHC, the state attorney general's office and health literacy experts have reviewed the noticed to make sure they'll be easily understood by consumers.

What's noteworthy, however, is that despite the fines and reinstatement of consumers, California health plans have not generally conceded that post-facto rescissions are are illegal. Most have gone into settlements screaming loudly that they'd violated no laws, despite the DMHC's firm conviction that they had. All told, it seems that even with laws on the books with arguably ban rescissions for innocent mistakes on applications, the practice is far from dead. There's more controversy to come on this issue, without a doubt.

To learn more about the reinstatements:
- read this Modern Healthcare piece

Related Articles:
WellPoint pays hospitals $11.8M to settle bills from rescissions
BC of California fined $1M for cancellations
Kaiser forced to reinstate coverage
Blue Cross of California settles plan-cancellation suits

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Comments

I think it's great these insurance companies are now re-accepting certain patients whose bills apparantly were too high.

They receive money for each person enrolled in their plans and many may only see their doctors every couple of months, and there are the few, who have been struck with conditions or complications from these conditions, who I know wish they never had.

I am permanently disabled and know my case is costly for my Medicare HMO Advantage Plan, but I would also give anything not to have the problems I do have.

I believe in the end, the bottom line does balance out, it's just insurance companies dislike paying out money for patients who develop often, severe and debilitating conditions that cost them more money than they wish to pay out, and these same people often have to write letter after letter to get the much needed care they need.

I had to fight for four years to get a Portacath implanted due to me not having venous access, but I finally got approval for it. I will have it four years this April and I baby it and get my regular four week flushes to keep it open.

I have been fighting to see a Plastic Hand Surgeon, as I have a chronic pain syndrome called RSD, Reflex Sympathetic Dystrophy, and because of it, I have severe contractures in both my hands. I live alone and am right hand dominant, and need the use of my hand, and it's taken years to make my insurance understand an Orthopedist will not do surgery on an RSD patient for fear of a pain flare up. However, if we are given adequate pain medication and blocks for the areas requiring surgery, the pain flare ups do not occur.

I am glad to hear these insurance providers are being forced to take back patients who are in my situation, although I am enrolled in an HMO and to date, knock on wood, have not been disenrolled, but certainly have the fear in the back of my mind I may get the chance to re-enroll someday.

With today's baby boomers living longer lives, many will soon drain our Medicare programs. But there are many ways they can cut back, like not providing SS Medicare to men over 65 who have children, as both the Mother, even if she is not a US citizen is eligible, along with the child both receive benefits until the child reaches 18, and it can be very costly.

I also believe that people who have come from foreign countries and obtain their citizenship, who then bring their parents or older family members SHOULD NOT RECEIVE MEDICARE BENEFITS, because they have not paid into it.

Too much money is wasted in Medicare and if they pare it down to those who have paid into it or have been housewives their whole life and raised their kids, not realizing should they get divorced, their Medicare benefits are so low, I don't know how many survive.

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