Golden Rule and other STM 12 month plans covering pregnancy

[myinsurebiz]

Bye Bye Joe . . . Take *ick with ya . . .

What are you 12? Are you serious? Did you really just post that? And you are a professional? You hold yourself out to the public and ask them to trust you with insurance decisions?

I am at a loss of words.

Seems you have plenty of words.

But really - you said :

" I can’t even be part of this anymore. "

I was saying buh bye Felicia . . .

 

[joe92275]

Seems you have plenty of words.

But really - you said :

" I can’t even be part of this anymore. "

I was saying buh bye Felicia . . .

Take *ick with ya . .

You must have meant take Rick right....take Rick with me....

 

[yorkriver1]

I would ask how they define complications of pregnancy. Pre eclampsia, mentioned above seems that it could be in that category. Trying to hope that whatever came up would be covered is scary, however.

 

[yankee466]

My wife and I live in North Carolina and are on the hunt for a new insurance plan that is outside of the Marketplace for next year because our premiums are going through the roof with them. I started looking at STM's and found one here on ehealthinsurance. If that link doesn't work it is on ehealthinsurance and is a plan underwritten by Golden Rule Insurance for the Short Term Elite Plus A plan. The plan is for 12 months and the monthly cost is much more affordable than what we currently pay.

The question I am trying to find the answer to is that if we start the plan in January 1st and my wife gets pregnant in February (for example) will the plan cover the expenses? As I understand what is said in the brochure (linked here for golden rule insurance plus elite A) the plan does not cover a pre-existing pregnancy before the effective date, but if she were to get pregnant after the effective date it would cover the expenses after we meet the $2,500 deductible since the coinsurance after meeting the deductible is $0.

The plan appeals to me because it is already much cheaper than what we currently pay even with having to pay the monthly cost and meeting the $2,500 deductible. Even if we went with the cheapest coverage on the Marketplace, this would still be cheaper if it actually did cover her pregnancy. Am I right in my interpretation of their brochure or way off? If you all know of any other plans that would meet our needs or any other advice it would be greatly appreciated.

I would go with the UHC short term plan....checkoff the supplemental accident rider....claim the pregnancy was an accident, and maybe they will cover it.

 

[bill3173]

And the peanut gallery agree's that your plan is like a side bet on you health insurance policy......$20X12=$240 a year for a $3,500 benefit.....

I would have to see how the carrier handled that claim before suggesting something like that for pregnancy. The fine print can be a killer, if you plan to stand behind your proposal. However, I do have a client that has mastered the art of filing indemnity claims. I've had him as a client for over 10 years, and if he told me that he was going to make them pay a pregnancy claim, I'd believe him.

He has had every denial overturned on major medical, accident, dental, etc. I would love to work with him in sales, but his whole thing is forcefully fighting with claims, and redefining the terms of their contracts for them. The guy works sun up to sun down six days a week but always has time to fork with the claims department.

 

[somarco]

When I was on the carrier side they would do everything they could to avoid writing lawyers. Too many fights over claims. Some just had lawyers on their auto decline list. Others would quote a lawyer group but used a very high industry load so their quote wasn't competitive.

Carriers would rather settle, especially a large claim, vs getting negative publicity. With everyone complaining on social media anyone has a voice.