Short Term Med or Major Med?? That is the question.

Sep 19, 2007

  1. senior-advisor-indiana
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    senior-advisor-indiana Guru

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    I have a lady. Actually my grandmother in-law. She is turning 65 in March 08. She just lost her group coverage due to G-pa in-law retired. Well she is losing it Oct 1st. She already signed up for Anthem Acess plan 2. It's gonna cost her $475 or right around there a month. They rated her up to that price because she takes HBP meds and cholestorol meds. She is in great shape besides those 2 things.

    I got a quote for Assurant's STM today for her. It is $205 per month. ALot cheaper.The STM considers the HBP and cholestorol a pre X condition so it will not be covered or any illnesses caused from them won't be covered. A major med plan will cover the pre X because of HIIPA or whatever it is. Should she pay the extra to get the pre X covered or should she go with STM. I am sure alot of major illnesses are caused from HBP. If she had a heart attack that would probably not be covered right?

    What do you guys normally do? Is there another Major med plan that would be cheaper for her. She is in Indiana 46750.
     
  2. 2112Greg
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    2112Greg Guru

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    Sounds to me like a good candidate for an STM policy. Golden Rule's is pretty inexpensive (don't have the no's in front of me). Assurant here in Texas is crazy expensive on everything else, so I would expect their STM to be pricey too. But a six month plan would put her right on track for her birthday...
     
    2112Greg, Sep 20, 2007
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  3. Guest
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    The difference is $270 a month or $3240 for the year.

    The answer is basically her financial position. Can she afford the extra amount? If so she should get it.

    You could argue that she could get the STM and self-insure the 'rest' of her, but if she has the money, why take the risk?

    If she has a HA or a stroke in the next year, it could wipe her our financially.... unless she has very, very deep pockets.

    I would not take the risk if I didn't have to. $270 a month is 'cheap' for a year of good sleep! I would not risk my entire life's savings for that amount.

    But if she can't afford it, then the STM is better than nothing.

    What is her budget? Put it on paper and see if she can afford the extra $270. You will find your answer in the numbers.

    Never take big risks if you don't have to.

    Al
    Adams-Blake Insurance Solutions
     
    Guest, Sep 20, 2007
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  4. senior-advisor-indiana
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    Its only for 6 months Al. I am not sure about her finances. She could probably afford it. She was upset about the $80 rate up for HBP and cholestorol. She is a really healthy lady and in good shape. I am definetly not a individual health guru. But I think there is alot of risk having anything related to HBP not covered. I might try to find a different major med plan that is cheaper.
     
  5. James
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    James Guru

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    In all honesty, people like this are best to walk away from. They are just a disaster waiting to happen.
     
    James, Sep 20, 2007
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  6. TXINSURANCE
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    I can't believe STM would take HBP / Chol combo I suppose it varies company by company - either way she was LUCKY to be accepted by ANTHEM with Rate up most companies she would be DECLINED - she needs to take the offer and run and not mess around with short term.
     
  7. taterpeeler
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    taterpeeler Guru

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    Do not write the stmm.... go with the indy policy, not worth the risk. never ever gamble with peoples health... not only is her financial future on the line but i think your e&o is as well
     
  8. senior-advisor-indiana
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    I cannot walk away from this one. It is my G-ma in-law. I did call her today and tell her about the pre existing. She does not want to risk it so that is good. I told her I would look for a different MM plan but would probably not be able to get a better deal. I told her she might consider raising the deductible from $2.5K to $5K and she didn't want that either. So unless there is a cheaper major med plan then she will be sticking with anthem.
     
  9. senior-advisor-indiana
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    So HBP and cholestorol together is usually a decline with most companies? Is that the same for major med plans too? I would think that A LOT of people have both of those conditions.
     
  10. wildcat
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    wildcat Super Genius

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    I'm not in a waiver state, so what happens if she has a heart attack caused by the HBP which is a waived condition?
     
    wildcat, Sep 20, 2007
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