When she learned the cost of an operation that opened her husband’s clogged arteries last fall, Maria Rodriguez was glad she had signed the couple up for health coverage several weeks earlier.
But then Blue Cross of California said Raudel Rodriguez, a 53-year-old self-employed scrap-metal hauler, had failed to disclose preexisting conditions—including chest pain—that made him uninsurable. The company canceled his coverage, returned $1,700 in premiums and left the couple instead with a $130,000 hospital bill.
The Rodriguezes insist they answered the Blue Cross salesman’s questions honestly in a telephone conversation in Spanish. If anything was amiss with the husband’s application, they say, the fault lies with Blue Cross because the company filled out their applications in English, a language they do not understand.
“What we want is the deal they promised us—if we paid them, we were covered,” Maria said in Spanish.
Blue Cross, a unit of WellPoint Inc., declined to comment.
With a lawsuit accusing Blue Cross of reneging, the Santa Ana couple has raised an issue that experts say could plague the health insurance industry in coming years as it increasingly reaches out to cover immigrants: Insurers could face legal problems unless they make sure they are doing business with customers in a language they understand.
The case “could have a very dramatic impact in terms of elevating awareness on the part of [health] plans to make sure that they are communicating in the appropriate language with all their members and not just assuming contracts in English are going to be understood,” said Gerald Kominski, a professor at the UCLA School of Public Health.
Auto dealers and other retailers that sell products with financing long have been required to put contracts in Spanish if that is the language used to make the deal, said Alejandra Cedillo, a Los Angeles County Neighborhood Legal Services lawyer. That protection recently was expanded to consumers who speak Asian languages.
“There’s nothing that would apply to health insurance,” she said.
That’s about to change. The state Department of Managed Health Care expects to finalize rules this year that would require health plans to put key documents in the consumer’s primary language and to pay for interpreters to accompany patients to doctors’ offices and hospitals.