Comin' Off COBRA

[Bob_The_Insurance_Guy]

I have a 63 yr old female, who is coming off COBRA in May, and has some health issues:

6/1/04 Cataract surgery right eye only. Procedure successful; complete recovery.

11/20/07 Total hysterectomy with removal of ovaries and TOT Bladder repair. Procedure successful; complete recovery.

Meds = Estrace Vaginal Cream 42.5gm - 1 gm 2 times per week. tissue maintenance. Estradiol tab 1 mg.- HRT maintenance.

Given her age (2 yrs away from Medicare), should I put her on STM for 24 mos, or should I try to get her underwritten with Major Medical? My gut is to put her on STM for 24 mos. However, part of me thinks she would give me less grief if I try to place her on Major Medical.

My thought is, the last surgery is too soon for anyone to cover.

 

[GreenSky]

I have a 63 yr old female, who is coming off COBRA in May, and has some health issues:

6/1/04 Cataract surgery right eye only. Procedure successful; complete recovery.

11/20/07 Total hysterectomy with removal of ovaries and TOT Bladder repair. Procedure successful; complete recovery.

Meds = Estrace Vaginal Cream 42.5gm - 1 gm 2 times per week. tissue maintenance. Estradiol tab 1 mg.- HRT maintenance.

Given her age (2 yrs away from Medicare), should I put her on STM for 24 mos, or should I try to get her underwritten with Major Medical? My gut is to put her on STM for 24 mos. However, part of me thinks she would give me less grief if I try to place her on Major Medical.

My thought is, the last surgery is too soon for anyone to cover.

If she was in California, she would likely be okay except for the medication. The cost might cause a carrier to rate her up or decline.

Rick

 

[somarco]

Estrace - $84
Estradiol - $9

Possibilities, Time, Aetna, GR, Humana, KP

I don't see a problem as long as the hysterectomy wasn't due to cancer.

 

[J.R.]

Estrace - $84
Estradiol - $9

Possibilities, Time, Aetna, GR, Humana, KP

I don't see a problem as long as the hysterectomy wasn't due to cancer.

What site(s) do you use to check the prices?

I use canadadrugs.com and pillbid.com

 

[Bob_The_Insurance_Guy]

Estrace - $84
Estradiol - $9

Possibilities, Time, Aetna, GR, Humana, KP

I don't see a problem as long as the hysterectomy wasn't due to cancer.

Thanks, #1. It'll either be Time, KP, or Humana. GR and Aetna will never get my business.

BTW, Imerica's back in Georgia. Stronger product line, and some good perks, if you're interested. Let me know, and I'll give you the FMO's number (Imerica no longer goes direct)

 

[somarco]

#2-

Didn't feel comfortable with Imerica the first time around. Can't see any reason for using them now. Maybe you know something I don't.

If using HMO docs isn't the issue, KP is probably the best bet. If they take her (and I see no reason why not) she has full coverage for pre-ex. Only reason I threw out Time was sometimes they have attractive rates on 60+ folks.

JR -

I look up pricing via a Humana site. The links you provided are fine for mail order but to get a ballpark AWP Humana links for work fine.

 

[moonlightandmargaritas]

Didn't feel comfortable with Imerica the first time around. Can't see any reason for using them now. Maybe you know something I don't.

I was under the impression they went "tits to the sky" about maybe two years ago?

The HO was here in Tampa. They only had about 10 employees - everything was outsourced; u/w, admin, etc. all done by HPA.

Hell, it wasn't even approved for sale here in Flor-ee-duh.

 

[somarco]

Looks like they relocated to get a Rocky Mountain high.

Can't imagine how a change of scenery can improve the way the company was being managed.

 

[Bob_The_Insurance_Guy]

Well, all I can tell you is that my three individuals I have on their plans have had no problems with claims, physicians or customer service. In fact, all three have renewed their plans with Imerica. They actually like it that they can speak directly with a human being on the first call. And, I've been told that they actually say "please" and "thank you".

None of their commission checks have bounced, and they have been able to underwrite some people who others would not.

I actually like the FMO I'm working with, and they actually respond faster, and are more knowledgable that Imerica's employees. Reminds me a little of Assurant, Humana, and World.

Now, can they pull a Conseco or a Golden Rule, and be here today and gone tomorrow - yes. But, you know what? While they were "out of Georgia", I still got commission checks on time, that cleared, and my clients still got great customer service from Imerica.

That's the bottom line.

 

[somarco]

I understand the "national" FMO for Imerica is AHU out of TX.

Correct?