Medical insurance practices: is this legal??

MrsGabbs4Ed

My friend was telling me that her job has annual biometric screenings (held by the insurance company).  If you do not show up for it, then they drop you off the plan.  The screenings don't apply to spouse or any kids on the plan, just the employee.  My friend also said that this year at her screening they compared her weight to last year's screening (weight went up a little bit...10 lbs she says).  They also compared blood sugar test results too. She said she got a "lecture" about the gain and was warned to watch it/be careful, etc.  Is this something new or is it just dependent on what the insurance company chooses to do?  Are they actually allowed to do that?  I thought that was only for life insurance policies.  I realize this probably sounds naive and stupid but I really thought that was not legal to do, at least for medical insurance anyway.  Thoughts?

UsedToBeGoldie

sure it's legal... just as it's legal for insurance companies to say they won't cover you if you have certain conditions... it SUCKS, but it's legal.

junebug1

I'm not sure it's legal, but I think its brilliant and wish more companies would do it.  I'm overweight, Why shouldn't I have to pay a larger share of the premium when most of the ailments I'll probably deal with in the future are directly related to my lifestyle?  Japan is very strict about weight and size.  It may not be the best plan, but they've got like a 5% obesity rate compared to our, what, like 40%?   

debfife

Yes, it's becomming very common. They can't not cover you but they will make you pay more.

MrsDB

i'm sure it's legal. the plan probably offers very low premiums as well.  just like you can get no-exam life insurance, but you'll be paying higher premiums. 

MrsGabbs4Ed

I just find it weird that the health screening only applied to my friend and not her kid or husband.  If they're going to do it, shouldn't the rules be the same for everyone on the health plan including spouse/kids?  I mean that affects the utilization too.  I just find it amusing that they lecture my friend with a slight weight gain yet yet she covers her husband on the plan.  Ironically he is the one who's much heavier and not in good health at all.

debfife

my company told us that this is coming for 2012. If you smoke, are overweight, and there were other "risk" factors, you will have a higher premium. I"m not sure how they are handling kids/husbands yet.

oct11bride03

I agree that it's odd that the screenings don't at least apply to the spouse. I feel like kids are different somehow.

Anyway, like the others have said it's totally legal and I think the point is to focus on preventative care like healthy diet, exercise, regular exams, etc. to avoid costly medications and procedures down the road. But with that I'd assume her spouse should be examined as well if he's covered under the plan. 

I've seen health insurance plans where you get "points" for being a non-smoker and having a good metabolic screening and those "points" = lower premiums. 

UsedToBeGoldie

maybe it's just how they worked the plan... to start with screening employees... and eventually they'll add in spouses, etc.

with life insurance through my company they only ask for medical history of my spouse- not me...   so yeah- it might seem odd that they only screened her- but it's also much easier to screen her in the office... than it is to send someone around to screen spouses = more cost, etc.

mrs.marie.g

does her company cover the employees medical costs or does she pay it out 100%. if the  company pays for it i can easily see a company implementing it. do i think it sucks but i can totally see it being legal. i could ALMOST see my company doing it. because our ceo's are very health conscious and they pay 100% medical for all employees and dependents. so its a way to cut cost. keep people healthier ect. 

laurenpetro

DH's company requires us all to get a yearly physical (i should say, they require the adults.  i assume they require the kids too but they go anyway so it's never been tested.)  they aren't charging us for being overwieght/smokers or anything but if you don't get a physical they charge you something like 25% more.

DH said in the first year they did it they found 5 guys with heart disease, 1 had a triple bypass.  2 more found out they have cancer.

i'm totally fine with this on every single level.

Liz051405

laurenpetro:

DH's company requires us all to get a yearly physical (i should say, they require the adults.  i assume they require the kids too but they go anyway so it's never been tested.)  they aren't charging us for being overwieght/smokers or anything but if you don't get a physical they charge you something like 25% more.

DH said in the first year they did it they found 5 guys with heart disease, 1 had a triple bypass.  2 more found out they have cancer.

i'm totally fine with this on every single level.

And ironically my insurance doesn't even cover physicals for adults.

I have no issue with insurance attempting to move to more preventive measures. I also think smokers should pay more.

laurenpetro

i should add that i think it's shyte to make someone who is overweight or a smoker to pay more when they START the program. 

my friend works for the state of NC and they did something brilliant.  you went in for your baseline.  you were told about whatever health issues (weight and smoking, specifically) that you had to deal with.  you had 6 months to show improvement.  you didn't have to lose ALL the weight but you did have to show that you lost some.  if you did it, your premiums remained the same provided you continued to improve.  if you didn't, they would go up.

i have always had serious problems with someone changing the terms of a contract, be it written or unwritten, midway through a term and without notice.  this kind of change makes me very happy.

wed2506

MH's company is requiring every employee to go thru a health screeningths April. If you don't, you will pay an additional $40 a month for benefits. The is for employees now but letter he received states that spouses & dependants will be included over th next few years.