Health Insurance

[Presley Senior Member Find all posts View Profile Close Presley]

Follow all that?

No, but I am interested in learning more.
My insurance went up this month. They removed the dental benefit without saying anything. So, really the insurance went up a lot higher than they are trying to make it look. We were paying $680something/month with dental benefits. Now, we pay $745/month without dental benefits.

I want the discount thingy instead of insurance.

[JLB Please excuse me, I'm a Dick. Not a moron just a Dick Find all posts View Profile Close JLB]

This agent also handles traditional plans . . . Aetna, Golden Rule/United Health, Humana, etc., but he recommended Assurant Health because we are approaching Medicare, and, mostly, because if we need medical care, which we have not in the past, we will actually get most of it paid for through the combination of network discounting and a benefit amount from the git-go, instead of after a deductible has been met.

I looked to see if I can post a link to the plan, but it is zipcode and password protected, and tailored just for us.

I could copy and paste the benefits, such as this:

Office Visits $50 per office visit

But that requires some explanation for each of them. In this case, what that means is that if the fee for an office visit is $100, the network will first discount it 40%, to $60. Then, the plan pays the benefit amount, $50, and we pay $10.

Our premium is quoted at $399. DW's will be "a little under" $200 once I head off to Medicareland.

What I prefer is that if this pans out, and is what we go with, I just give you the agent's phone number or email address, which I will only do by PM or email.

We actaully said Yes to this plan and our app is saved by the agent and ready to go. Then I heard from a "traditional" plan agent with an Aetna plan in the same price range, but with a $10,000 deductible.

Since April will be the Grace Period for our present plan, when we don't have to pay a premium, I am wanting to make sure I make sure what coverage is right for us.

Speaking of not getting any benefits until after the deductible is met, there are riders that handle that. A critical care rider pays cash (like Afflac) for the major illnesses that would cause you to get up to a high deductible, but at a much lower premium than a low-deductible plan. The "traditional" agent today said that, for instance, if we had a God-forbidden major illness that cost us our entire out-of-pocket, say $15,000, the cash payment would pay that and $5000 or $6000 more.

No one had ever told me about critical care riders before, but they an inexpensive way to be protected against the high cost of cancer, or heart attack, or, well, you know the list.

Here's their impressive network:

http://www.providerlookuponline.com/...o7/Search.aspx

[JLB Please excuse me, I'm a Dick. Not a moron just a Dick Find all posts View Profile Close JLB]

From the agent:

Backbone of policy is network percentage. Under $300 bill is average of 40% repricing, over $300 is average of 60% repricing with no deductible that has to be met. Also take into consideration a 10k deductible only gets you to the coinsurance 80/20 split till you meet out of pocket max which in my opinion is virtually not enough coverage for the majority of Americans. Not many have 10k plus sitting around to write a check god forbid.

[Presley Senior Member Find all posts View Profile Close Presley]

Not available in California.

[JLB Please excuse me, I'm a Dick. Not a moron just a Dick Find all posts View Profile Close JLB]

Anyone had any experence with Assurant Health?

Instead of having a deductible, there is a very extensive network and each service provided is discount. Then the benefit amount is deducted from that. What is left is what you pay.

Also, the network includes a myriad of providers. Within 100 miles here in Florida, more than 10,000 doctors, 92 hospitals, beaucoup Urgent Care Centers, plus nursing homes, rehab centers, etc. So, it's not a limited healthcare program.

For instance, if you had a broken arm and the total cost is $4000, it is discounted 40% to $2400. The benefit is $2000, so the out-of-pocket is $400.

. . . as opposed to having a deductible of, let's say, $10,000. In that case, nothing would be paid for by insurance, so you would have to pay the entire discounted amount, $2400.

Follow all that?

We're going with this, for $400/mo., m/l.

Why?

We have always paid for our healthcare ourselves, and have used our high-deductible health insurance only to use the network to discount what we pay. We have been comfortable with a potential $20,000 out-of-pocket for a critical illness, which we have never had. But $550/mo for that, to pay everything out of our own packet and still face a potential $20,000 out-of-pocket, that's too much!

This plan not only discounts our costs, 40% or 60%, but the network is amazing, everything we can imagine having a need for, and, it actually pays a benefit from the git-go without having to wait for a high deductible limit. The network is not just one or the other, but all of them.

As far as the God-forbid critical illness, it pays up to $10,000 per year in direct cash, and an Aflac-like weekly income supplement up to one year.

The only thing left would be if it actually does what it claims to do and how difficult it is to deal with, but, then, isn't that the question with all of them, the problem that has prompted anyone to take on the third-rail of healthcare reform?

Like, for instance, we are not allowed to deal with Golden Rule/United Health by email. That does not seem like a big deal until you start wading through their telehone menu, only to wind up getting the wrong person/department, and, then, not having anything in writing. I had one of those regarding a miscoding billing error by the physician's office on DW's annual checkup. Because there was no way I could include GR/UH in the email thread with the provider, it turned into a 9-month ordeal, which was finally resolved only after I found the email address of the right person at the physician's "hospital", the "hospital" also not allowing communication by email. Once I found that person, the billing administrator, he wrote-off that bill because the physician's office had miscoded it to begin with and then did not follow up with the resubmission of it.

There are few things more aggravating and time-consuming than an individual trying to deal with the arrogance and carelessness of the health care industry, well, other than being stuck with unwanted timeshares . Is it not that fact that has prompted healthcare reform; if the industry was consumer-friendly and not out-of-control, would reform be necessary?

[JLB Please excuse me, I'm a Dick. Not a moron just a Dick Find all posts View Profile Close JLB]

I see that I did not discuss what would happen in the, God forbid, case of a critical illness, our agent's answer to which prompted us to go with this plan.

First, we previously have been willing to ante up $20,000-$25,000 per year in the event of a critical illness, our maximum out-of-pocket, for a much higher premium.

With the new plan, and according to our agent, for whatever that is worth, fees over $300 are discounted at least 60%. He said that high, critical care-type expense are discounted in the neighborhood of 80%. Then, there is a significant, meaningful benefit paid for each item before we would pay what is left.

Then, after that, the critical care and Aflac-like cash benefits, and, in his example, we wind up money ahead, "$5000 or $6000" in the example he gave us.

Somewhat related, on the Branson forum the past few days there is a discussion about Joey Riley having Stage 4 colon cancer, and not having health insurance, and there being a benefit show for him. As someone on this forum knows, Joey had been Mickey Gilley's sidekick for 20 years, and DW and I have a connection to them, so that is hard for me/us.

There's gotta be a better way.

[M. Henley Class President Find all posts View Profile Close M. Henley]

You think the OF Herd will attend the benefit?

[JLB Please excuse me, I'm a Dick. Not a moron just a Dick Find all posts View Profile Close JLB]

You think the OF Herd will attend the benefit?

Maybe if there is free Keystone Light.

[Marti Super Moderator Find all posts View Profile Close Marti]

Health Insurance - Original Medicare - BCBS Includes most RX


RE: Federal Retirees


Original Medicare

Medicare A: No Cost when you qualify
Medicare B: Optional
Most people pay the Part B premium
of $104.90 each month in 2013


Blue Cross and Blue Shield Service Benefit Plan

BC BS Standard Family Plan

Retiree pays $433.63 monthly
Government pays $920.73 mo
Total Monthly Cost $1354.36

[Carolinian Super Moderator Find all posts View Profile Close Carolinian]

The bartender at a local restaurant near our house in eastern North Carolina said that she had been quoted $852 a month for her health insurance, due to the changes from Obamacare, and she cannot afford that. It looks like Obamacare will make health insurance unaffordable for her.

[Marti Super Moderator Find all posts View Profile Close Marti]

Get the Facts on Health Reform


What the New Health Law Means for You and Your Family.

TOPICS

At a Glance
About the new Law
Relief for You
Myths and Facts
Health Care News
Health Care Topics

http://www.whitehouse.gov/healthreform

[JLB Please excuse me, I'm a Dick. Not a moron just a Dick Find all posts View Profile Close JLB]

It has been mentioned in this thread that there are many instances where new customers get a better deal, that introductory deal offered only to new customers to lure them in to a company's "boil a bullfrog" rate increase scheme. It seems like so many employ that pricing policy . . . insurance, TV, Phone, Internet, etc.

Is there a reasonable reason to be loyal to service providers any more? Don't they all do the same thing? Don't you think they figure the bulk of their customers will not take the time and effort to jump ship? A momentum thing, probably, so that a person at rest will tend to stay at rest.

Is there anyone here that actually jumps every few years to get the reduced rates as a new customer, like, say DISH to DIRECTV or vice versa? If you do, how long is it before you will be considered a new customer with the old provider, so you can jump back?

We dumped Comcast/Xfinity last March and when we came back this year we got their $62 Internet for $25.

Now Xfinity has a discounted rate to attract new customers that POs new customers already on discounted rates. Now when I get on the Internet there is an Xfinity ad for $19.95 for the first 6 months.