Personal Insurance Plans

[Corey Bryant]

I have a personal insurance plan thru Anthem (Blue Cross) in Colorado. My year is coming up in about 45 days and my rates will be raised. Does anyone know how much they can actually raise the rates (assuming that I have been diagnosed with a debilitating disease)? I am pretty certain they cannot terminate my plan.

[Toolman]

Corey,

I think that it depends on your state laws. I know that in Maine, insurance coverage is guarenteed (including pre-existing conditions if you have been insured for at least eighteen months), so instead of one persons rates going up for an illness, everyone's rates go up. We have about the highest rates for health "insurance" in Maine that you will find in the country, and this is part of the reason.

Sorry I can't be of more help.

[Corey Bryant]

Thanks. I know that for group plans in California, even pre-existing conditions are covered. But for personal plans, I really have no idea. I am going to probably be on a group plan next month as well. But the personal plan with Anthem, I am hoping they can only raise my rates about 10%.

[hi_from_ca]

Please don't quote me on this, it comes from 15+ years ago when I sold insurance, so it could be out of date.

The "standard" rule, at that time, was that as long as you paid your premiums, you could not be non-renewed, but you renew at their current rate. The "current rate" is based solely on risk category (smoking, age, sex, etc.) and applies to everyone in that category. Personal statistics like coverage usage, illnesses contracted/claims made since the policy was opened, etc. are not considered. That is why they employ actuaries, they pool the risk and charge everyone based on the average for their risk factors. Otherwise, the insurance companies would cancel anyone that contracts an expensive disease, like cancer, at their next renewal.

Apparently, some states now have caps on how much they can raise rates, but as recently as 4 years ago, I had a 30+% renewal increase on my personal policies here in California.

[Corey Bryant]

30% would be fine - that is about $48. I might see if I can lower that one when if I get on a group plan. I just would like to maintain the personal plan because of my diagnosis.

Now, secondary question, if I did lower my plan on the personal side, do you know if I could raise it next year? Thanks for everything!

[Corey Bryant]

To give you a quick update, I called them actually. I only had to explain it about 5 times

They said that once I a member, they cannot raise my rates based on a diagnosis while I maintain insurance with them. I can downgrade my insurance (lower monthly payment with a higher deductible / co-pay) but if I want to upgrade, then I have to re-do my application and then I will get a higher rate. Of course, they raise the rates every year, so I just need to make sure they are raising my rates according to my age and not my diagnosis

And they said I could have a group plan as long as it was not Anthem.