<p>GP, giving up a policy voluntarily and then complaining you cant have it anymore is a little lame. </p>
<p>When I called Anthem, the recorded message talked about grandfathered plans. I was a little surprised. And I guess policyholders can keep them. I didnt pay that much attention. You can listen yourself. You dont have to talk to a live person.</p>
<p>GP: here’s the article</p>
<p><a href=“http://www.latimes.com/business/healthcare/la-fi-mo-health-insurance-cancellations-20131104,0,3987[/url]”>http://www.latimes.com/business/healthcare/la-fi-mo-health-insurance-cancellations-20131104,0,3987</a></p>
<p>"LA Times is reporting that Blue Shield of California individual plan customers can ‘keep their plan, if they like their plan’ until March 31, 2014. "</p>
<p>I saw a story couple of days ago about Governor of Vermont invoking some clause to delay until March 31st. This is not what I read but it is the gist.</p>
<p>[Health</a> care exchange contingency plan outlined <em>:</em>Times Argus Online](<a href=“http://www.timesargus.com/article/20131101/THISJUSTIN/711019997/0/NEWS08]Health”>http://www.timesargus.com/article/20131101/THISJUSTIN/711019997/0/NEWS08)</p>
<p>“The Department of Financial Regulation has issued a rule — permitted under Act 171 — to allow both individuals and employers to maintain current health care plans through March 31, even if they do not meet the new coverage requirements under ACA, said Shumlin, who was flanked by Republican Lt. Gov. Phil Scot, his senior health care team, Democratic legislative leaders and insurance company executives.”</p>
<p>But wouldn’t the maximum OOP be reached even if it’s out of network?</p>
<p>Yeah, it looks like they extended the date to March 31. So now you don’t have to feel rushed to make a decision by Dec 15. However, I don’t consider that to be much of a concession. </p>
<p>I understand Anthem is being sued to allow everyone who got the cancellation notices to keep their plans. I just called the attorney and asked him to include Blue Shield. He is one of the best attorneys in the state and has successfully sued the insurance companies on a variety of issues in the past. He is going to call me back and let me know about including Blue Shield</p>
<p>^ I hope you are not waiting for the case get a resolution before buying insurance. You might end up paying fines for a couple of years if you do. :D</p>
<p>[Two</a> California Residents Sue Anthem Blue Cross Over Health Policy Cancellations - California Healthline](<a href=“http://www.californiahealthline.org/articles/2013/11/5/two-california-residents-sue-anthem-blue-cross-over-health-policy-cancellations]Two”>Two California Residents Sue Anthem Blue Cross Over Health Policy Cancellations | California Healthline)</p>
<p>It is not just the cancellations… It is the misrepresentations. It is amazing. It is an addiction. These companies can not stop misleading their policyholders and the public.</p>
<p>“On Monday, two California residents filed separate lawsuits against Anthem Blue Cross, alleging that the insurer misled them into giving up their health policies that were grandfathered under the Affordable Care Act.”</p>
<p>Yeah, that could be a drawn-out process</p>
<p>I explained my situation to the attorney and he thinks I got a good case.</p>
<p>The telling point is that many people do not want to lose their pre-ACA plans. They do not consider the new plans a better deal.</p>
<p>What is your case?</p>
<p>You dont have a grandfathered plan.</p>
<p>“My Blue Shield plan before 2010 had a $6 million lifetime cap for each person and no annual cap. College students were allowed to stay on the plan. According to the administration, this was a substandard plan. How many people spend more than $6 million on their care?”</p>
<p>Very few people do, but those who are so unlucky, oh my gosh, how wretchedly difficult it is for them, having to scrape and beg for medical care with conditions such that they have spent so much and now they are out of gas. There are those born with chronic conditions that require all sorts of care, and those who have something that make them susceptible to all sorts of things that involve a lot of medical care. Fortunately, there are very few in that situation so that to squeeze savings out of those so unfortunate by ending their care at $6 million is not saving as much money as it may seem. </p>
<p>Yes, college students and all children up to age 26 have to be allowed to stay on health care plans under ACA. Makes no sense that if the kid is in college, he can stay on the plan, but if he’s not, he can’t. What does college have to do with health insurance. In fact, those who were in college before all of this often had college health insurance as an alternative to the parents’ plans or going independent on the market. A kid at loose ends who equally or more likely needed insurance did not have that option. So it’s now age 26 for all children.</p>
<p>"The telling point is that many people do not want to lose their pre-ACA plans. They do not consider the new plans a better deal. "</p>
<p>Of course many people do not want to lose what is familiar to them if it suits them just fine. I hate, hate, hate having to learn the new rules and have to get to know new systems. Each time our health care plans had to change, it was a pain in the neck for me Heck, I don’t like getting a new cell phone even. So, yes, many peopld do not want change of any sort, and it makes sense. Also many people could not care less if anyone else is suffering, dying or having issues. So what? The big question is whether all of this will be an improvement for more people in the the most significant ways. Time will only tell. I expect there will be a lot of confusion until things settle down with this and it won’t be till then that we can judge the overall change. There will be those who end up on a shorter end of the stick for this. So bringing up those examples is no news. Yes, it’s change and sometimes for the worse.</p>
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<p>It’s obvious that many people don’t want to lose their pre-ACA plans. I doubt if anyone here disputes that the new plans available to you are a worse deal than your old one. How is that a basis for a lawsuit?</p>
<p>If you are losing your plan, you are not grandfathered.</p>
<p>All I can say is that I told him the specifics of my case about changing plans in 2012 because of a premium increase, and this seems to meet his criteria for the lawsuit.</p>
<p>cpt, I am not going to respond to your post. You can take my no response as to what I think of your arguments.</p>
<p>Well GP, </p>
<p>Make sure your attorney takes your case on a contingency basis. :)</p>
<p>Is the lawyer going for some sort of injunctive relief? That would be necessary given that the policies are running out soon. Is it going to be a class action?</p>
<p>Tatin and dstark, I think the lawsuit against Anthem is a class action and the lawyer is now considering bringing another class action against Blue Shield. We didn’t get into the details, just that they would call me back this week.</p>
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<p>It does – it is in the LAW. The insurance companies have to cover that whether they want to or not. Emergency care + medically necessary care that cannot be provided in-network.</p>
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<p>In a way, you have it backward. “Before”, there was no national standard in place that would require all insurance companies to provide specified benefits-- so there was nothing to protect people against unscrupulous companies that sold cut-rate insurance with so many limits and exclusions that the policies were meaningless. Now, you can choose a plan with the assurance that a long list of basics are in the plan, simply because it is legally required.</p>
<p>Back in the day, I remember having to dig deep down in reading a schedule of benefits to determine whether maternity benefits were covered. That was important to me, and confusing because of course all the plans with maternity cost more, but the fact that the plan cost more was not a guarantee that maternity was covered. Now, that’s got to be in all plans – although it is no longer something that concerns me. However, as the mother of a daughter who is at peak reproductive age, I am glad to know that her policy will cover that – plus so much more. </p>
<p>So now you can just read the essential benefits list and then not worry about whether or not a policy covers specific items. </p>
<p>I think that one reason that there is so much focus on the scope of the networks is that is about the only thing left to distinguish one company’s plan from another.</p>