When a Florida health insurance member goes out of network, the physician has to persuade the patient to pay the rest as the current reimbursements are to low from the carrier. The charges are called usual and customary, but they are anything but that according to the lawsuit.

This does not put the patient at any risk. But this Florida physician is not willing to be bullied anymore by big corporations. Now he is taking action.

The Florida health insurance plan is not pulling in enough members. As of November 30, 2009 the Cover Florida plans attracted only 5,246 beneficiaries. Over half of these participants are on the Blue Cross Blue Shield Florida plan. In addition, there has been no word from United Health Care on any rates increases on their Cover Florida plans. Blue Cross Blue Shield Florida and United Healthcare are the only two insurers that offer plans statewide.

The reason the Florida health insurance plan is failing is because people are going to use these plans. The sick people that cannot get Florida health insurance anywhere else in the state. This is a perfect example of how a mandated guaranteed issue coverage brought on by health care reform can hurt America.