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Has your health insurer misled you?

Health Insurance Provider Anthem Blue Cross To Hike Rates

David McNew/Getty Images

In a class action lawsuit, the consumer group Consumer Watchdog alleges that Anthem Blue Cross intentionally misled customers.

Have you felt mistreated by your insurance company? We want to hear from you.

KPCC health care Correspondent Stephanie O’Neill reports that a consumer group has filed a class action lawsuit accusing Anthem Blue Cross of fraud and unfair business practices, "allegedly intended to lure customers into buying its health insurance plans."

The details

O’Neill writes:

The lawsuit, filed Tuesday in Los Angeles County Superior Court by Consumer Watchdog and Anthem customers, accuses the insurer of  "deceptive 'bait and switch' misrepresentations," among other things. (Another consumer's lawsuit filed in June makes similar accusations.)

The lawsuit alleges that Anthem:

  • Misrepresented to consumers that their physicians and hospitals were participating in Anthem health service plans;
  • Misrepresented Exclusive Provider Organization (EPO) health service plans, with no out-of-network coverage and benefits, as Preferred Provider Organization (PPO) health service plans, which provide out-of-network coverage and benefits;
  • Offered inadequate networks of physicians and hospitals, delaying and interrupting care;
  • Delayed customers' enrollment in new health service plans for months, effectively blocking access to physician and hospital services;
  • Subjected consumers to exceedingly long wait times, regularly lasting several hours, on customer service telephone lines.

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A widow's tale: How the VA helped my husband...and me

Maureen Gerwig, of Woodland Hills, holds a photo of her late husband, Vietnam veteran Michael Gerwig.

Amid the scandal about wait times at Veterans Administration medical facilities around the country (and growing concerns about patient care), we've been hearing from local vets about their experiences with the VA. There's been a mix of stories; some positive, some negative. Today we have the story of Michael Gerwig of Woodland Hills, as told by his widow, Maureen. 

Michael and Maureen met at the Perris Valley Sky Diving Center in the summer of 1980, and were married in January of 1982. He had served in the Army, doing a tour in Vietnam in 1969. Afterwards, he worked as a machinist; she worked for Los Angeles County.

Deteriorating health

In recent years, Michael's health started deteriorating.

He filed a Post Traumatic Stress Disorder claim with the VA in 2009. That year, he started going to the VA for health care.

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Are you stressed out? Tell us about it

stress

Renu Parkhi/Flickr Creative Commons

A survey by NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health found that 49 percent of respondents said they'd had a major stressful event or experience in the past year.

This morning, NPR kicked off a series of stories called "Stressed Out."

The series - based on a poll conducted this spring by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health – examines the amount of toxic stress Americans are facing.

It found that almost half of those surveyed – 49 percent – said they'd had a major stressful event or experience in the past year. Of those people, 43 percent said a health-related issue – illness and disease, or the death of a loved one – was the most stressful experience of the past year.

The survey also looked at the 26 percent of respondents who have experienced a great deal of stress in the past month. Among that group, health conditions are a major source of stress: 60 percent of those in poor health report high levels of stress, and 45 percent of people with a disability are under a lot of stress.

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What should women do about the new pelvic exam recommendation?

First-year medical student Michelle Gentile assists her classmate Abbie Harts as she performs a pelvic exam on a volunteer at Northwestern University.

Joshua Lott/Reuters /Landov

First-year medical student Michelle Gentile assists her classmate Abbie Harts as she performs a pelvic exam on a volunteer at Northwestern University.

Calling all women: What is your reaction to the new recommendation against pelvic exams for healthy women who are not pregnant and show no signs of disease?

Are you thrilled? 

Are you a little confused?

If so, Impatient is here for you. I felt those mixed emotions, too, especially as I began to read more about the American College of Physicians' recommendation, and responses to it.

Below, I'll break down for you the reasons for the recommendation, and what obstetricians and gynecologists are saying. Then, I want to hear about what you'll do, next time you get your annual well-woman exam.

The recommendation

A group of doctors wrote in the Annals of Internal Medicine:

"The current evidence shows that harms outweigh any demonstrated benefits associated with the screening pelvic examination."

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In LA, one mammogram is $60, another is $694. Why?

Mammography detects cancer, but debate rages over when and how often women should get screened.

/iStockphoto.com

Why is there a big variation in the price of mammograms in Los Angeles? Is the more expensive mammogram “better” than the cheaper one?

Last week, we asked our audience a question: What did your mammogram cost?

As part of Price Check – our collaboration with KQED in San Francisco and ClearHealthCosts.com – we’re collecting this data for the next month. The goal is to bring transparency to health costs in California, and help inform the policy debate over how to hold down these costs.

If you need a little more incentive to add your information to our database, consider this:

Before we launched this project, staff from ClearHealthCosts.com surveyed California medical centers. They found that in the Los Angeles area, the self-pay (or cash) price for a mammogram could range from $60 at H. Claude Hudson Comprehensive Health Center, to $254 at Westchester Imaging Medical Center.

Meanwhile, an audience member shared her costs: She said her Kaiser Permanente insurance paid $694 for a mammogram.

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