As the Trump administration pushes less regulated health insurance plans that don't have to follow Obamacare rules, patients are at growing risk of getting duped.
Charley Butler, 36, of Sidney, Mont., bought a short-term plan in 2016 and then had to fight for more than a year to get tens of thousands of dollars in medical bills paid after he was diagnosed with cancer. After the Montana truck driver was diagnosed with testicular cancer in 2016, his insurer balked at paying tens of thousands of dollars in medical bills and then moved to cancel his coverage over a preexisting medical condition.
Nearly every company involved in Butler’s health plan has paid settlements to regulators in recent years, according to regulatory filings from around the country and a review of hundreds of pages of records inIn December, Health Insurance Innovations Inc., a Florida firm that promotes short-term plans, including the one Butler bought,to settle a 43-state investigation of the company’s sales and marketing practices.
In many cases, consumers don’t even think to ask if plans cover preexisting medical conditions, said Dania Palanker of the Georgetown University Center on Health Insurance Reforms. Such limitations make these short-term plans substantially cheaper than plans offered on the more regulated marketplaces. And Trump administration officials havewarnings from patient advocates, physician groups and state regulators
Over the next six months, Butler underwent two surgeries and aggressive chemotherapy. It was a stressful time, Butler recalled, made worse when medical bills started arriving with no indication the insurance plan was paying anything.He and his wife, Chole, were told they owed more than $3,000 to Butler’s surgeon, nearly $1,700 to the anesthesiologist and more than $20,000 to the hospital. Altogether, the bills would add up to more $43,000.
Rescission reviews were effectively eliminated by the 2010 healthcare law for more regulated plans, which cannot deny care for preexisting conditions. Customers who buy more regulated marketplace plans that must offer a network are protected from balance billing.Fortunately, Butler fared better with his medical care, and in 2017 his cancer went into remission. But as the dispute with the insurers dragged on, the Butlers were forced to hold a community fundraiser to pay off medical debt. Chole Butler was treated for stress.
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