Limited Benefit Plans

I can't sell limited benefit plans. I've looked at them umpteen times, because I had clients that couldn't qualify medically for a full-coverage plan. Every time, I came back to the conclusion that I can't sell it.

I had a friend come to me (crying), to say she had a brain aneurysm and needed surgery ASAP, but she found out that the "group" policy she had through her husband's Long Haul Trucking firm was a limited benefit plan. This is a good, hardworking family who may not be very smart nor well educated, but who nonetheless deserves to have good coverage. They purchased it because the employer sponsored it (so they assumed it was full coverage). What a heartbreak. In the end, the hospital & surgeon worked out a deal with the couple to take the limited benefits plus $100 a month for just a few years. It saved her life. When the claims were settled, the limited benefit plan paid a drop in the bucket.
 
except with humana who doesnt count stm, but your prob talkin about something different

Anthem's STM is creditable...is Humana's not for some reason? Clearly says in the broker guide from Anthem that STM is creditable towards pre-existing waiting period. Humana's STM just became available here last week so I know nothing about it.
 
I suppose when the PPAACA becomes fully implemented everyone has to have medical coverage. I wonder what the minimum required coverage will be ? Do you suppose even with insurance companies having to accept those with pre existing conditions, it will create competition in the market place and overall health care costs going down ?
 
Creditable coverage is a state by state, carrier by carrier issue. At one time STM was not considered creditable in OH but that changed maybe a couple of years ago.

Absent state requirement it is ultimately up to the carrier to decide what is creditable coverage.
 
Anthem's STM is creditable...is Humana's not for some reason? Clearly says in the broker guide from Anthem that STM is creditable towards pre-existing waiting period. Humana's STM just became available here last week so I know nothing about it.

i mean they told me they dont count any stm towards their plans, for prior creditable coverage.
 
they told me they dont count any stm towards their plans, for prior creditable coverage.

They are required to do so in GA.

Same for yr end deductible carryover.

State specific.
 
Back
Top