In which I am confused by the health insurance industry

10/10/05

Dear Member,

The cost of health care continues to rise in Massachusetts. In order to continue providing the benefits currently available under HMO Blue® Direct, we’re jacking your rates up by the maximum amount allowed by law, for the fifth time in as many years.

The cost of health care is apparently more than double what it was five years ago. Either that, or HMO Blue® Direct is just plain raking it in.

The first thing you’ll notice is the industry’s resemblance to online poker and pornography

Seriously. Google ‘health insurance massachusetts’ and what you’ll find is hundreds of linkfarm websites, each with popup-laden, blinky, eye-watering forms inviting you to fill in your intimate personal information, which will be routed through multiple affiliate programs and clicktrackers. Out of morbid curiosity — and because, you know, I do need the health insurance — I actually fill one of these forms in. Thank you! One of our salesman will contact you soon!

The call comes in about half an hour later. It’s a nervous-sounding kid reading from a prepared script, obviously a temp worker lured by the extra three dollars an hour you get for telemarketing. You can faintly hear the cadence of the same script being read to other customers in the background. Before even asking how many people I’m looking for coverage for, he quotes the improbable rate of $150/month, and then starts reeling off a list of benefits which is peppered with phrases like “you’ll pay as low as” and “subject to availability”. The first time I interrupt the script with a question, the temp worker panics and transfers me to the boiler room manager, who is doing a perfect Glengarry Glen Ross Jack Lemmon impression; he’s got “wheedling” down to a T.

Highlights from this part of the conversation include him explaining that, though the coverage is capped at $5000, that counts as almost one hundred percent coverage. Also, that if I agree to buy right now, it’ll be $150 per month, but if I wait for even one day they’ll have filled their “preferred quota” so will have to pay “as much as” $400 per month. Meanwhile I’m googling the name of their company, and have discovered their FAQ. The first Q in this FAQ is “Is this an insurance policy?” The answer, in bold type, is “No.”

Before hanging up, I neglect to ask the salesman how, knowing that his customers are almost certainly under the mistaken impression that they have health insurance, he sleeps at night. I regret this for the rest of the day.

Meanwhile, at the legitemate firms, the salesmen are quite shy

The mass.gov website actually provides a list of all the real insurance companies that offer nongroup health coverage. Handy. Of the 21 companies listed there, fifteen do not, in fact, offer nongroup health coverage.

The remaining contenders’ websites are uniformly coy about how to actually, you know, buy their insurance, but if you dig deep enough they do list phone numbers for their sales departments. At none of these have I yet managed to talk to anyone involved in the business of sales.

Aetna: “If you are already a member, please press one now. If you are a health care provider, please press two now. [pause in confusion, while I double-check that I have in fact called the “sales” number] Please make your choice now, or be disconnected. [I try ‘0’, and ‘*’] You have made an invalid choice. [fine, let’s try ‘1’] Please enter your Aetna ID number now. […] Goodbye.”

Harvard Pilgrim: “You have reached our sales department. If you know the five digit extension of the person you are trying to reach, please press 1. If you know the name of the person you are trying to reach, please press 2.” Harvard is exclusive, after all; I guess you gotta know someone to get in.

The MEGA Health and Life Insurance Company offers no phone number, but does have a form you can fill out for more information. Undaunted by my experience with AAA Health Care, I fill in this form. This has no visible effect.

Health Care New England is closed for the holiday. Okay, this one’s my bad, I forgot it was Columbus Day.

The John Alden Life Insurance Company, despite its name, does offer health insurance. But only in Washington, Oregon, and Arizona. The very nice woman who answered the phone is as confused as I am about why they’re listed on the mass.gov website.

The last one, Blue Cross, is of course who I’m trying to get away from in the first place. I’m tempted to call them pretending to be a new customer, to see if they quote the same rate they offered when I actually was a new customer. But I don’t.

Oh, if only I still lived in California!

I could join the hip crowd at Tonik Health, the health plan “specifically designed to appeal to and service the active lifestyle needs of nineteen to twenty-nine year olds”. You see, it’s regular old Blue Cross, but the plans have names like “Thrill-Seeker” and “Part-Time Daredevil”. And the site is designed in Flash, with funky colors and animated dancing girls and snowboarders. Oh, how I miss the active lifestyle needs I had back when I was twenty-nine.