Coventry One

Aug 26, 2008

  1. taterpeeler
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    taterpeeler Guru

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    Ok, Coventry One has now danced into Texas and I have a few questions.
    First, What are you Coventry boys getting on first year and renewals?

    I looked over the contract, not in great detail yet, but noticed a clause related to "rolling" and it said no agent shall attempt to move a client from Coventry One nor shall an agebt contact a client for that purpose. Any comments?

    Also, are organ transplants a mandated benny here in Texas? I cant remember. Coventry states in big bold type, organ transplants NOT COVERED

    Their rates suck, about 100-200 more that the other guys. However I just got them and need more study on the subject.

    Does anyone have any other comments regarding this outfit?

    Peace, Out
     
  2. moonlightandmargaritas
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    moonlightandmargaritas Guru

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    Back at the beginning of the year they announced plans to roll out here in Floirda third-quarter (the one we're in) this year. Never heard any more...
     
  3. Paradigm
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    Paradigm Guru

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    In GA there is coverage for transplants (deductible plus 70/30 up to coinsurance max no coverage out of network

    Short Term Therapies ​
    30% 40% 30% 40% 30% 40% 30% 40% 30% 40% 30% 40%
    • No Visit Limits
    • Physical, Speech, Occupational and Respiratory Therapies
    • Cardiac and Pulmonary Rehabilitation

    Chiropractic Services ​
    $10 Copay Not Covered $10 Copay Not Covered $10 Copay Not Covered $10 Copay Not Covered $10 Copay Not Covered $10 Copay Not Covered
    • Limited to 24 Visits

    DME, Prosthetics, Orthoses ​
    30% Not Covered 30% Not Covered 30% Not Covered 30% Not Covered 30% Not Covered 30% Not Covered
    • Limited to $2,500 Annual Max, All Combined

    Transplants 30% Not Covered 30% Not Covered
     
    Paradigm, Aug 26, 2008
    #3
  4. moonlightandmargaritas
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    moonlightandmargaritas Guru

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    Humana One...
    United Health One..
    Coventry One...

    Which One?
     
  5. Paradigm
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    Paradigm Guru

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    Coventry
     
    Paradigm, Aug 26, 2008
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  6. Paradigm
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    Point taken. I went to a paid UHC focus group where we choose colors design and name for UHC individual. They paid us 400 to sit at a table for an hour and a half to look at various design and rate them as to whether we liked them. Insurance companies tend not to have many creative types, they go with what works.

    Well at least they served a good lunch.
     
    Paradigm, Aug 26, 2008
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  7. TXINSURANCE
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    24 month pre ex and no online application in Texas - correct me if I am wrong.
     
  8. taterpeeler
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    taterpeeler Guru

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    tex, would prior credib. coverage over ride the 24 months?
     
  9. dmason
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    dmason New Member

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    Prior creditable coverage overrides any pre-ex waiting periods in Texas. That house bill (cant remember the number) passed in 2007.
     
    dmason, Aug 26, 2008
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  10. jbage007
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    1. Why would any responsible agent need to look into any product any further if they didn't cover transplants??

    2. NOTHING overrides the pre-x clause. The fact of the matter is if it is pre-xing enough, it'll get RIDERED OUT, or you'll get a total decline. That pre-x clause is only for the liars and cheaters who refuse to disclose pertinent health history. Bottom line: Pretty much NO WAY to get a true pre-x condition actually "covered" under an individually underwritten plan.

    3. What the hell have you guys been smoking? :twitchy:
     
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