Guaranteed Health Plan

[J.R.]

I think the plans offer a false benefit. Instead of paying $50,000 to a hospital for a surgery, the bill might be reduced to $30,000. Either way, the patient is screwed into thinking they really have a benefit.

What I'd love to see is a plan for uninsurables at a zero cost (or close to it) which just puts them into a PPO network. No other benefits. They would know what they are getting. No false promises but simply a reduced cost for services.

Will it keep them solvent if there was a major claim? Of course not. But it would help lower their cost for routine and preventative care. Maybe enough to catch something early enough to keep them out of the hospital.

Rick

It's being worked on! You can either rent or start your own. That major problem with creating the networks is the lack of information about what the competitors pay (e.g., BCBS, PHCS, and the hundreds of other networks).

I like your idea, but I don't think it will fly just by itself. People need to take responsibility for themselves and actually get the physicals, blood, work, etc. to prevent most of the major illnesses, but who is going to pay for it??? A reduced rate by itself isn't going to help much.

 

[NewHealthStrategies]

Kuddo's to John (IHIAA) for at least bringing a solution to the table for those uninsurables that have NO OTHER OPTION.

You yahoo's that trash the mini-meds amaze me.... tell me about all the great major med plans that...... hmmmmmm...

....limit office visits that are covered
....limit PT/ST/OT
....limit DME
....limit Rx
....Don't cover Brand name drugs at all

Tell me about the great Mental Health benefits you're selling in all your do-or-die major med plans?

The point is that limits are being installed by carriers at every level as the last defense against run-away medical inflation, which isn't going to end anytime soon.

Mini-med might get a client to the extremes of those limits a bit quicker than you high-and-mighter types... but.... OH, YEAH, we're talking about people that CAN'T QUALIFY FOR MAJOR MEDICAL.

So... let's see, Mr Health Insurance Professional... how much of your "marketing" is about how you're "concerned" about clients and you'll work to help them, explain options, etc.... OH, YEAH... but as soon as you can't qualify for the Cadillace of health plans (major medical) then how quick you are to flick them off the phone...... at least give them the "finger" so they'll be no doubt how you feel about your prospects.

 

[NewHealthStrategies]

What I'd love to see is a plan for uninsurables at a zero cost (or close to it) which just puts them into a PPO network. No other benefits. They would know what they are getting. No false promises but simply a reduced cost for services.Rick

Hmmm... being a Libertarian.... I wonder if you could explain WHY a PPO network would offer a "free" plan or "free" access to it's discounts? Sure you're not an Obama-plant?

 

[GreenSky]

Hmmm... being a Libertarian.... I wonder if you could explain WHY a PPO network would offer a "free" plan or "free" access to it's discounts? Sure you're not an Obama-plant?

PPO networks get support of doctors because they get more patients. I've looked for docs in my PPO network to get the best benefits - those docs get a new patient.

Why wouldn't a network want to provide their discount to people who otherwise wouldn't see their docs?

It's a very libertarian concept because it's done entirely in the private sector.

I'd be willing to be a "network" insurance provider at a reduced commission of I could have someone feeding me clients.

As far as being an "Obama-plant," damn you! It was supposed to be a secret.

Rick

 

[Crabcake Johnny]

All I know is actually receiving the network discounts for these type of plan seems difficult. This is where discount cards fail; they claim network discounts - client pulls up a list - sees a doctor - doctor has no clue as to any type of discount.

This was my major argument when looking into Ican: "How do I know the policy holders will actually receive the network discount." After touring their member services department I was left satisfied.

But I agree - my dentist gives our family a discount simply because I asked. I have no idea why networks can't be made available to uninsurables simply for the cost of administration.

I believe some people here think they are "junk." Fine - I disagree. I think receiving the network discounts for people who currently have nothing can prove to be very valuable without talking about the basic benefits.

 

[somarco]

What I'd love to see is a plan for uninsurables at a zero cost (or close to it) which just puts them into a PPO network. No other benefits. They would know what they are getting. No false promises but simply a reduced cost for services.

This is about as close as you will get to free.

I don't promote it, but I do show it to uninsurables who have looked at similar plans with $50+ app fee's and monthly fee's of $80 to over $300.

For some reason, they would rather pay more for essentially the same thing.

Benicard

client pulls up a list - sees a doctor - doctor has no clue as to any type of discount.

And here is a clue for you.

The doc's have no idea about pricing when you flip out your Aetna, BX or even Medicare card.

But they (or more precisely, their office staff) do know real insurance when they see it and who pays, who doesn't. Perhaps that is why so many providers ask for cash in advance when they see these cards, mini-meds and even . . . Mega.

 

[Crabcake Johnny]

It doesn't end with Mega. Some of my HSA clients have been told to pay the estimated charges at the time of visit.

I have also been extremely disappointed when my clients fax me their EOB and the discounts applied in some cases were an absolute joke. In one case, $12 was taken off an office visit.

 

[somarco]

My clients don't have problems with their providers. Most providers here are willing to bill after the fact, especially if it is a long time patient. If they insist on payment at time of service, my clients are instructed to pay $30 with a promise to pay the balance after the claim has been adjudicated.

The only complaint I receive is on patients who went to a non-par provider.

The adjustments to pricing are based on the strength of the network. Primary care visits are typically in the $40 - $50 range + lab services.

 

[Crabcake Johnny]

I've seen UHC dig deep - over 70% off lab

 

[NewHealthStrategies]

Virtually every doctors office and hosptial will give people a "self-pay" discount... MOST offices come pretty darn close to the discount that would otherwise have gotten through a PPO network....

PS: Here's a hint.... self-pay discount at large hosptial in Atlanta is the same they pay BCBSGa.... go figure.

Wonder how many actually ask?