Sex, Lies and Consumer Alerts

You pay more than men to dry clean your clothes. You pay more than men for a haircut.  And, because of your sex, you are most likely paying more than men for individual health insurance. Health insurers have long held that women of child-bearing age use the health system more, have higher health care costs and, therefore, are charged higher premiums when purchasing coverage. Only if you're insured through an employer's health plan can you be sure you aren't paying more. Federal anti-discrimination laws prohibit employers from charging women covered under employee group plans more than men for the same coverage.  But the woman who is single and self-employed or employed at a low-paying job that does not offer health insurance benefits is vulnerable to the practice if she buys individual coverage.

The health reform law includes a provision to stop considering sex in underwriting individual health insurance policies, but that portion of the law doesn’t kick in for another two years – in 2014.

Some states, like California, New Mexico and a handful of others, have enacted laws banning gender rating. But for most American women, insurers currently can and do charge more for individual policies.

In northeast Florida, for example, a 35-year old healthy woman who does not smoke will on average pay between 14 percent and 16 percent more for the same coverage than her male counterpart for one of the 36 plans offered by Blue Cross and Blue Shield of Florida.  Of the 17 plans offered by Humana, the same woman would pay about 48 percent to nearly 54 percent more than a man of equal age and health status. Interestingly, however, Humana’s premiums for short-term insurance – that is up to six months of coverage – are the same for men and women.

Premiums vary widely from one company to another, so it’s important to shop around. The plan with the lowest monthly premium may not be the least expensive overall when you factor in deductibles and other out-of-pocket costs. This is particularly important for those looking for low-cost coverage. The National Association of Insurance Commissioners (NAIC) offers advice for those considering limited benefit plans or health savings accounts with high-deductible plans. For more information, go to http://www.naic.org/documents/consumer_alert_high_deductible_plans.htm

There are a number of websites that can give you immediate quotes from several companies and spell out what benefits you'll get for your money. The federal government has launched its own website, healthcare.gov, to help consumers find the best plans for their needs. The site provides the user with available plan options and pricing, as well as the percentage of applicants who were turned down for coverage.

Some companies sell medical discount cards, usually for a monthly fee. These are not insurance policies, they are not regulated and sales agents in most states do not have to be licensed. The cards usually offer limited savings, and the number of providers accepting the card may be exaggerated. So, beware.

Also, beware of health insurance scams. Passage of the health reform law requiring individuals to purchase health insurance by 2014 has brought out scammers selling phony policies to those looking to buy low-cost plans. The Coalition Against Insurance Fraud, an anti-fraud watchdog, offers 10 warning signs of a health insurance scam. The NAIC also has issued a consumer alert, listing the red flags to watch out for when purchasing health insurance.

Always check with your state insurance department to ensure the company selling the policy is legit.