Limited Health Plans

[arnguy]

It's amazing, the amount of limited health plans that are proliferating! In a supermarket yesterday I found these cards advertising a program called Complete Choice Plus----as little as $160 a month for individuals and $270 a month for families. It is guaranteed issue and underwritten by Pan American Life. Alledgedly covers Rx, AD&D, and Annual Wellness Testing among other things. I believe that Aetna purchased a company that was selling this stuff about a year or so ago. Wow! They use Beech Street for their network. Also, they emphasize that it is "....Real insurance with fixed-dollar coverage...Not a Discount Card." In the fine print it does state that this not the same as nor a substitute for major medical insurance. BTW, it is not approved in 21 states.

 

[InsuranceBenefitsGroup]

Oh!! A what a pain in the arse to cancel. I've replaced about 15 of these deals thru HCCUA in Boca Raton. They do not answer the phone when you want to cancel. They just put you on hold until you hang up. You have to fax in a cancellation. It's absolute junk.

 

[AllenChicago]

3-17-2014

If the proposed HHS rule referenced by this LifeHealthPro article is finalized, will Limited Benefit plans become a better buy for the consumer, or worse? Thoughts?

Ref: http://www.lifehealthpro.com/2014/03/17/hhs-may-kill-stand-alone-indemnity
ac

 

[SamIam]

Maybe I'm not reading it correctly do they only want caries who sell major medical to be able to sell limited benefit & if a carrier only sells limited benefit by itself they would classify as major med.

If I'm reading it correctly those plans would drop out of the market and I think it would be a bad deal.

 

[lifeandhealth]

I'm also a bit confused. So if a person buys a limited health plan only, will they have to pay the penalty($95 or 1%)?

 

[CHUMPS FROM OXFORD]

I hope and believe they do...even though I may get appointed with one shortly.

 

[Happy Texan]

Limited health plans qualify as excepted benefits if they coordinate with a secondary plan, in which the 2 plans combined, constitute medical insurance.
Don Levit

 

[Yagents]

HHS has plans to kill standalone LB plans. (see article posted on thread)
They must be bought and sold to people who have major medical (as a supplement).
If you only own an LB plan, you will also have to pay the penalty.

 

[AIABROKER]

I would never sell one of these plans alone, only with a high deductible Major Med. And even then you need to find a reputable company. Also, look at the schedule of benefits or what they actually pay per procedure. Many of them go by Medicare reimbursed amounts, others are just ridiculously low. Something like heart surgery for example may only pay a max of $3,000. This is the hidden fine print of these plans.

 

[AllenChicago]

I'm also a bit confused. So if a person buys a limited health plan only, will they have to pay the penalty($95 or 1%)?

It will be the 1% of income penalty, L&H. Only people who earn less than 9,501 in 2014 will pay the $95. Oh, I forgot, they will qualify for a hardship exemption. So bottom line is just forget about the $95.

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I would never sell one of these plans alone, only with a high deductible Major Med. And even then you need to find a reputable company. Also, look at the schedule of benefits or what they actually pay per procedure. Many of them go by Medicare reimbursed amounts, others are just ridiculously low. Something like heart surgery for example may only pay a max of $3,000. This is the hidden fine print of these plans.

Agent in our office got a call today from an irate Limited Benefit Plan customer. She had to pay $600 for her Mammogram and was FURIOUS. She thought Santa-Obama was giving every American female free Mammograms. People like her calling in to the state insurance commission will be a catalyst for these stand-alone Limited Medical plans going bye-bye.
-ac