Bradley M. Kuhn

For-Profit Health Insurance Is a Scam

Bradley M. Kuhn at

Here's yet another scam that the Health Insurance Company is pulling on Conservancy's employees. I've written before about how the company claimed that our "existing plans" including the one that's one of the best plans available in NYS, is no longer compliant with the Affordable Care Act. So, they forced us to switch mid-calendar-year to a new plan.

Then, they sneakily reset the deductibles, which meant under our old plan, we got only nine-months of coverage for a 12 month period. Here's why: for out-of-network coverage, you're required to meet your the deductible of $1,000. That means if your doctor isn't "in their plan", you pay the doctor directly the first $1,000, and thereafter you get reimbursed.

By resetting the plan, they're claiming that we all have to meet the deductible again, which means they're effectively stealing up to $1,000 from each of Conservancy's employees.

Of course, Conservancy's staff (myself included) is all over this and fighting the insurance company — we try our best to take care of our employees. But, this is just another example when you pick the obvious best provider in your state, they are still constantly trying to screw you. That's what healthcare in the USA is, because it's primarily for-profit.

(This problem is almost wholly unrelated to the recent issue I described with their website, BTW.)

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> almost

Did their website accidentally reset the deductibles?

All right, who clicked the "screw everyone over" button?

Mark Holmquist at 2014-12-30T17:16:54Z

@bkuhn@identi.ca its related in that healthcare here in the US is a money grubbing scam.

x1101 at 2014-12-30T18:26:05Z

On a side note, I discovered that claiming a lower expected income gets dramatically lower-deductible from some plans through healthcare.gov regardless of being the same premium, same name of plan, etc. This is not related to subsidy from feds which is a tax detail. Literally saying you will earn $23k gets you a $500 deductible and saying you'll earn $40k gets you a $10,000 deductible for the otherwise identical plan at identical price.

Insurance is a screwy scam. We should just do Medicare for all.

Aaron Wolf at 2014-12-30T20:39:51Z

Olivier Mehani likes this.

>> Aaron Wolf:

“On a side note, I discovered that claiming a lower expected income gets dramatically lower-deductible from some plans through healthcare.gov regardless of being the same premium, same name of plan, etc. This is not related to subsidy from feds which is a tax detail. Literally saying you will earn $23k gets you a $500 deductible and saying you'll earn $40k gets you a $10,000 deductible for the otherwise identical plan at identical price.

Insurance is a screwy scam. We should just do Medicare for all.”

The problem with that is that mess over expected income is that you're supposed to do reconciliation on a month by month basis with the exchange as to your income amount. Failure to do so may result in Penalties & Interest being assessed in interesting ways for material misstatement of your income and, if somebody is feeling particularly nasty, violating 18 USC 1001. Everything will change because it is expected to change.


I am still left wondering how anybody thought PPACA was going to actually be functional. It certainly has increased the size of Medicaid enrollment if nothing else...

Stephen Michael Kellat at 2014-12-30T21:15:55Z