anthem_logoEleven months ago, my weight — which has grown steadily over the past few years — hit a knee-staggering 280 pounds. My doctor warned me that my blood sugar had reached the bottom threshold to signal a threat for diabetes. She recommended I deal with the problem immediately.

I listened and went on a weight loss program that involved a complete change in lifestyle. Since then, I have dropped 55 pounds and my blood suger is well within normal range. I also feel a lot better.

At least I did until Anthem Blue Cross in Roanoke decided to lie about my medical history and use those lies as an excuse to try and cancel my health insurance.

In September, Amy and I applied for a new Blue Cross plan designed to lower our rates — a move prompted in part by my decision to retire early and go on Social Security. I’m not eligible for Medicare for another three years and Amy is still a long way from either Social Security or Medicare.

Anthem approved Amy for the new plan but rejected me, saying my “height to weight” ratio was beyond their norms. They based their decision not on what I weighed in September but used my weight in January — nine months earlier.

My doctor sent in a letter verifying that my weight in September was 40 pounds below what I weighed in January (I’ve lost 15 more pounds since then).

So Anthem came back with another denial, this time claiming that my doctor had diagnosed me as diabetic in January.

That was a lie. The medical record in January stated that my blood sugar in January was 127 — one point above the bottom level of 126 to signal a “danger of developing” diabetes.

Anthem refused to alter their stance, saying their “interpretation” of the medical record indicated that I was diabetic.

So my doctor ran a new blood sugar test and also a glucose test — an indicator of diabetes. The blood sugar came back normal and the glucose test was negative for diabetes. She sent a new report to Anthem.

That was 10 days ago. As of today, Anthem has not altered their position. I still am not eligible for the new plan. I recently passed a full physical for a new life insurance policy with another insurance company. They found no problems with my medical history or condition. In the past three months, I have passed a stress test, a heart test, x-rays of vital organs and a colonoscopy.

But Anthem makes up excuses to deny coverage. Even when you catch them in a lie they ignore the truth. My insurance agent says Anthem has denied other applicants with claims of non-existent medical conditions.

Translation: Anthem wants to cancel my health insurance because I turn 62 next month and they are willing to lie and distort my medical record to justify their immoral and illegal actions.

In the past five years, Amy and I have paid Anthem premiums that exceed what they have paid out in our behalf by 735 percent.

I continue to appeal their decision. I’m not giving in without a fight.

It won’t be easy. Anthem is a company that lies and cheats. They have the business ethics of a street whore.

No, that’s too harsh. At least a street whore gives you service for your money.

10 COMMENTS

  1. Carl, I used to work for UHC. They are just one rung beneath Anthem on the dung heap ladder. They’re all crooks, using the legal system to force people to buy their shoddy products. I wouldn’t give you a nickel for any of them. I wish insurance companies would become just a dark memory of history.

    • I’m so sorry to hear about your experience with Anthem. My family is now on COBRA with Anthem so I’ll be keeping a close eye. Besides fighting them head on we can all keep talking online to help drive change.

  2. …I was hoping to see a “Good News” follow-up to this post telling us that you had battled the evil BC and won… sadly, I see less and less of those sorts of follow-ups and more and more people I know losing their coverage. Anyone for a Floyd County Medical Co-Op?

  3. Lauren: The flaw in the discussion about health care reform is the concept that health care should be in the hands of private companies. Private companies operate on a for-profit basis, which is perfectly understandable. They have stockholders to whom they are accountable. They MUST make a profit, and that profit comes out of our wallets. I urge you to read the book entitled “The United States of Europe” to learn how well universal, government-provided health care has worked in European countries and in the United Kingdom.

    • Yvonne: You are right, every private company is motivated by earning a profit. What keeps them in check is the possibility that other companies can enter the market and provide competition. However, the government restricts entry to markets by requiring licenses or imposing regulations. Monopolies are nearly impossible to enforce without using government laws backed by the threat of violence.

      Examine the FDA, AMA, and medical insurance industries and see if you don’t see government licensing restricting the supply of health care.

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