Declined for Strep Throat. WTF?

There's an entire thread on it. But download the Unicare brochures and make a chart showing each benefit then compare it against other companies. That's what I did.

Did a search and couldnt find the thread. Since you made the chart you should be able to tell me the holes then right?

Joshril made a comment on another post about Unicare's holes also. But I compared the "holes" he listed with Aetna and they cover the same thing. He said Ambulance both Aetna and Unicare pay 80% up to $1000.00. He also stated reproductive disorders and neither company covers that. So im still trying to figure out the holes?
 
Did a search and couldnt find the thread. Since you made the chart you should be able to tell me the holes then right?

Joshril made a comment on another post about Unicare's holes also. But I compared the "holes" he listed with Aetna and they cover the same thing. He said Ambulance both Aetna and Unicare pay 80% up to $1000.00. He also stated reproductive disorders and neither company covers that. So im still trying to figure out the holes?

If after your research you've come to find that there's no holes in Unicare policies that don't exist in other policies issued in your state then I guess you're fine. Those weren't mind findings.
 
There is nothing wrong with Unicare policies, most are $5 million with UNLIMITED prescriptions - I would argue Assurant has far more holes than Unicare - but each agent will have their own opinions.

Unicare is a Wellpoint company i.e. the biggest health benefits company in America - no small potatoes here. Also in my opinion their rates historically have been more stable than Assurant , Blues or anyone. Unicare just started minimal blocking of rates this year - prior to that there were no blocks.

I have personally had them for years, rates are still the best 5 years later (H S A ), and my claims are processed in 48 hours or less - not one problem.

They are however very tight on their u/w guidelines they do not want blood pressure or anything pre-ex will be rated / ridered, they are not going to take on risk like other carriers such as Blue.

I have nothing bad to say about Unicare other than it is hard to get anything pre-ex through - which is why their blocks are so stable, low premiums, high benefits - if they are healthy and no pre-ex Unicare is a great choice.
 
now how do you know that the doctors did not write in her records that she might also need her tonsils removed in the near future.....I had a guy get a GB waiver one time and he thought the insurance company was crazy because his doctor never said anything about his GB.....turns out in his MR the doctor noted that he thinks he might have a polyp on his GB.....and never told his patient....

Completely believable. I had the same thing happen with a client in January. Underwriting requested records and discovered some pretty serious issues (fatty liver, very high percentile for cardiac risk, etc.). Client (who I know very well) SWEARS the doctor tells her she's fit as a fiddle with no required treatment or meds. Because of HIPAA, I can't call the doctor and discuss it with him directly to get to the bottom of the story. And, I was advised by my GA not to tell her the specifics that underwriting found in her file. Instead, I suggested that she meet with her doctor and review her medical records personally. She did meet with him, and she even asked him to write a supporting statement telling the underwriters she's in good health. He wrote the letter!

So, how did all this mumbo jumbo get in her records? Either the underwriters are lying, the doctor/nurse/tech made a mistake on her records, or the client is lying. At this point, I simply don't know who to believe!

For now, she's keeping her Assurant policy (which she's had for four years), letting it blow over, and then shopping other carriers in a few months. Wish us luck when THAT time comes.
 
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