Outpatient Testing BEFORE deductible?

[joshril]

I have a client that is stating they have a plan that will pay for ultrasounds, lab-work, etc. prior to meeting a policy deductible...

I have told them that this must be some type of limited plan, because I don't know of any plans that will cover these sorts of things with a copay? (I know about the carriers that will cover labwork/testing in the doctor's office with a a $500 annual maximum and that's not what they have)

Any ideas? Does Mega offer plans that cover these sorts of things? This client won't tell me the carrier, and I really don't care about getting them as a client, but I'm curious what this plan could be?

 

[STIBROKER]

Depends on how old the plan is and who it is... ......back in the day Fortis had a co~pay for out patient surgery.....bcbs also had lab and xray copays.....also.....they could be on a group plan.....how much are they paying for this plan....

I have a client that is stating they have a plan that will pay for ultrasounds, lab-work, etc. prior to meeting a policy deductible...

I have told them that this must be some type of limited plan, because I don't know of any plans that will cover these sorts of things with a copay? (I know about the carriers that will cover labwork/testing in the doctor's office with a a $500 annual maximum and that's not what they have)

Any ideas? Does Mega offer plans that cover these sorts of things? This client won't tell me the carrier, and I really don't care about getting them as a client, but I'm curious what this plan could be?

 

[taterpeeler]

josh, i think u are here in texas?... the new unicare and aetna offer outpat. testing b4 ded in allot of circumstances with no dolar limit. it has to be billed there. cant speak of ultrasounds...

the bcbs select blue advantage fell into that group as well

 

[joshril]

I think this is an older plan or something... I'm calling Aetna and Unicare to inquire about ultrasounds... Peeler, I thought the new Unicare plan had a limit on labs and what not...?

 

[joshril]

Also, which Aetna plan are you referring to Peeler? The "First Dollar" plans?

 

[joshril]

OK, this is an individual plan and it's a 45/46 year old couple paying about $400 per month with a $5000 deductible.

This can't be an old Fortis plan... the premium would be 3 times this high. This has to be a Mega type plan or something.

BlueEdge caps at $750 (I believe) and only applies to same-day stuff in the dr office... I think the premium with BlueEdge might be slightly higher anyway...

 

[taterpeeler]

Josh, the new unicare do not have a limit on that as per dawn holeman and unicare staff... and of course the old aetna plan had that benny on pre 7-1-08 plans and as per jackie fenton and aetna staff the new plans have that as well.. the deductible plans.. dont know about the no ded plans, cost 2 much.. and value plans i have no clue aboutas i dont sell them.

also the aetna plans have an urgent care benny for places like care now and that is all inclusive with .... i think... 75$ co-pay... may be 50$ i cant remember

 

[taterpeeler]

OK, this is an individual plan and it's a 45/46 year old couple paying about $400 per month with a $5000 deductible.

This can't be an old Fortis plan... the premium would be 3 times this high. This has to be a Mega type plan or something.

BlueEdge caps at $750 (I believe) and only applies to same-day stuff in the dr office... I think the premium with BlueEdge might be slightly higher anyway...

josh, that would fit right in there with the aetna plans... also, there is a world policy i think through jim cashen and that group in ft worth that is called freedom? and it has an additional co-pay for that stuff but going off memory there may be a limit... if there is the agent probably did not tell them that... of american comunity which has a limit... bet u the agent never told them about the limit

 

[joshril]

Peeler... are you referring to the Aetna "PPO" series of plans? I didn't think labs and testing was covered with a copay unless it was preventative. I'm pulling an outline of coverage now...

 

[taterpeeler]

josh. i just remembered, i had a client get an ultrasound and another got a colonoscopty with only the copay with aetna early this year