Golden Rule Pre-ex 2 year exclusion

Why doesn't GR simply remove that absurd six month waiting period for reproductive-related events language and be done with it.

I enrolled a lady in GR who knew she needed a D & C. They ok'd the request but it was within the 6 month wait. GR didn't check that and she had it done and is now stuck with the bill. She tried to pull a fast one and it backfired. Of course she cancelled.

There is also a wait for other procedures that people know they need like tonsils and appendix. The carriers aren't stupid.
 
I enrolled a lady in GR who knew she needed a D & C. They ok'd the request but it was within the 6 month wait. GR didn't check that and she had it done and is now stuck with the bill. She tried to pull a fast one and it backfired. Of course she cancelled.


Rabbi, have you considered upgrading your clientele?

oops, forgot...you've got me on "ignore"...:D
 
Why doesn't GR simply remove that absurd six month waiting period for reproductive-related events language and be done with it.

Same reason other carriers do not - claims. I have read reports the number one claims loss in the first year is female related issues.
 
I tell my female clients about the GR six month waiting period for anything reproductive. Most pass without even hesitating. I have plenty of other carriers to sell without such language.
 
Just got some excellent client service from Golden Rule.

New client who had been without health insurance for about twelve months.

After issue, goes for ob/gyn exam. Early stage cervical cancer found. Even though there is a six month wait on reproductive stuff with GR, they will waive it and take on the claim.

Very impressed.

HOGWASH.:no:
Something fishy in the water, 'mate.:twitchy:
 
I had a client who had to get a reproductive surgery within the 6 mth wait. It wasn't an emergency but wasn't something she could wait on. GR denied the claim at first, 21K. I helped the client fight and we got them back 18K.
 
I had a client who had to get a reproductive surgery within the 6 mth wait. It wasn't an emergency but wasn't something she could wait on. GR denied the claim at first, 21K. I helped the client fight and we got them back 18K.

Is this for real? This is not UHC's style. I avoid them like the plague when their are pre-x or someone tells me that they think they have problems.

After M&M and your story, it seems that there may be more to GR than meets the eye.
 
Paying extra-contractual claims is not the norm (with any carrier), but I have had good luck with GR on underwriting and claims.

The default for most carriers on a questionable claim is to deny. If you make a plausible argument for paying the claim more often than not they will.

In some cases a rider with GR is preferable to a rate up or even a rider with another carrier.
 
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