- 403
In VT, yes, with proof of prior coverage. Don't know about other states. But I suspect some do.
Lifetime Maximums - Important?
- Thread starter moonlightandmargaritas
- Start date
- 14,809
All I can say is when all financial incentives go away what you end up with is the French space shuttle.
Guess it depends on how you define . . . "it works".
As long as everyone who can afford health insurance is willing and able to pay a significantly higher premium to cover the sick, then it works.
Where it starts to fall apart is as costs escalate, so do premiums to the point that carriers and policyholders alike opt out of the system.
Isn't VT the home of a former presidential candidate dufus?
Curiously, eHealth does not offer coverage in VT.
So how is it working for you?
No waiting period on pre-existing conditions in Mass under 2 different conditions. For individuals, you need to have had a policy within the last 63 days. For groups, there is no waiting period. If you qualify for a state subsidized plan, then there is no waiting period.
I probably should also change my name to Ex-HM-agent. Left Healthmarkets at the beginning of the year and have a big smile on my face along with increased income.
I probably should also change my name to Ex-HM-agent. Left Healthmarkets at the beginning of the year and have a big smile on my face along with increased income.
Heart pump? Who considers this DME? Not trying to be contrary, but a heart pump is inserted into the body. Didn't think that met the std. definition.
Before you start throwing sh--t at me, I do have a good deal of personal experience in filing medical claims for family members. Another question, who has higher limits on DME?, besides BC. Anybody know much about this subject?
DME limits will vary by state, carrier and group or individual. No way to answer that question.
Can't say I have ever seen a pump classified as DME but orthotics and prosthetics (which can be surgically implanted)usually are. Even still, I don't make a big deal out of those lines of coverage. If you get into nitpicking every little thing you will lose your prospect.
Hit the big stuff. Make sure they understand the need for full Rx cover and how the OOP works. Anything beyond that and you are asking for an E&O hit later on when the claim is denied.
Had a lady email me today. She had talked with Humana and the rep told her colonoscopy's are covered as part of her annual "free" exam.
Oh really?
I don't think so.
Told her I would go to the source after she gave me the name of the guy who told her they would be covered.
Then I lightly chastised her for not calling me first.
Can't say I have ever seen a pump classified as DME but orthotics and prosthetics (which can be surgically implanted)usually are. Even still, I don't make a big deal out of those lines of coverage. If you get into nitpicking every little thing you will lose your prospect.
Hit the big stuff. Make sure they understand the need for full Rx cover and how the OOP works. Anything beyond that and you are asking for an E&O hit later on when the claim is denied.
Had a lady email me today. She had talked with Humana and the rep told her colonoscopy's are covered as part of her annual "free" exam.
Oh really?
I don't think so.
Told her I would go to the source after she gave me the name of the guy who told her they would be covered.
Then I lightly chastised her for not calling me first.
- 403
Lifetime Max, VT, & Howard Dean
The year I left VT, my (self-employed, 1-life group) health premium went up 50%.
His staff later caused the whole state to run out of money, (buying off-budget computers, they said).
When he was Dem Prez frontrunner, polls said he wouldn't carry his own state of VT.
Dean now chairs the Democratic National Committee. FOB, etc.
Howard Dean, MD, former HMO doctor, governor, and Dem Prez candidate, made VT the first state to pass "health care reform," which scared away all but a dozen carriers (including HMOs & BCBSVT).
The year I left VT, my (self-employed, 1-life group) health premium went up 50%.
His staff later caused the whole state to run out of money, (buying off-budget computers, they said).
When he was Dem Prez frontrunner, polls said he wouldn't carry his own state of VT.
Dean now chairs the Democratic National Committee. FOB, etc.
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Yes. I was trying to be polite. I think DME is important, particularly for cancer patients on IM policies, but in my experience, that is the only time I've seen prolonged use of expensive DME with a person young enough to be on an IM. Most of the heart, emphysema, etc. patients that have an ongoing need, are covered under the med supps anyway.
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