GOLIFEANDHEALTH
New Member
- 1
Hey everyone, I recently spoke with a client who thought she had major medical insurance, but after reviewing her application, I realized it’s actually a fixed indemnity plan. She had been shopping for major medical two years ago but was sold an indemnity plan instead.
To make matters worse, she doesn’t have proper coverage documentation—just the application, without even a coverage brochure. Buried in the e-application was an "applicant statement" confirming it’s not major medical, but a fixed indemnity plan, which I pointed out to her. The agent never explained this, didn’t go over the coverage, and despite the application stating there would be follow-up, she never received any calls to clarify.
I’ve seen this happen with this company before, so I recognized the issue right away when I saw the company’s name.
Now, she’s self-employed and earns too much to qualify for premium tax credits, so she’s looking for real major medical options—specifically a PPO plan outside of the marketplace. Or does she still need to purchase through the marketplace?
Any suggestions or advice on where to explore reliable, self-employed PPO plans would be greatly appreciated!
Thanks in advance!
To make matters worse, she doesn’t have proper coverage documentation—just the application, without even a coverage brochure. Buried in the e-application was an "applicant statement" confirming it’s not major medical, but a fixed indemnity plan, which I pointed out to her. The agent never explained this, didn’t go over the coverage, and despite the application stating there would be follow-up, she never received any calls to clarify.
I’ve seen this happen with this company before, so I recognized the issue right away when I saw the company’s name.
Now, she’s self-employed and earns too much to qualify for premium tax credits, so she’s looking for real major medical options—specifically a PPO plan outside of the marketplace. Or does she still need to purchase through the marketplace?
Any suggestions or advice on where to explore reliable, self-employed PPO plans would be greatly appreciated!
Thanks in advance!
