Why does the DoI care about replacement?

[arnguy]

.... However, here is a better idea - when an ILLEGAL seeks medical treatment, INS picks them up at the hospital detains and deports them. How many illegals would seek medical care if they knew before release they would be deported?

Why stop at illegals?

Why should ANYONE with no insurance receive care without collateral?

Great idea, Tex. Then we could have the FBI pick up the citizen at the hospital, but then where do we send him/her? Maybe we could ship him/her to Alcatraz or Devil's Island!

 

[TXINSURANCE]

Great idea, Tex. Then we could have the FBI pick up the citizen at the hospital, but then where do we send him/her? Maybe we could ship him/her to Alcatraz or Devil's Island!

Finally some good ideas are coming out...

lol...

 

[djs]

but get rid of the copay's and let doctors compete for business just as any other business does on the market.

Hmm, I'm confused on this thought.

I pay my gardener a flat rate, he mows my grass.
I bought the extended warranty on my car, something breaks, I pay $100, it gets fixed.
I pay a few dollars a month to have someone keep my computers running.
I pay my auto insurance so if I hit something, I pay a deductible and my insurance covers the rest (and the person I hit).

Why should I not be able to buy health insurance with copays when I can do this with virtually everything else in life?

I agree, I should have the choice, but don't take the choice away. Doctors can compete for my business, regardless of whether I make a copay for a full pay. When I'm sick enough to go to the doctor, I don't want to make 2 hours of phone calls to see who is running a special that week

Dan

 

[TXINSURANCE]

Originally Posted by salpro22
but get rid of the copay's and let doctors compete for business just as any other business does on the market.

Only one slight problem - group insurance plans are for the vast majority CO PAY plans, and since over 90% of insured individuals receive their insurance employer sponsored - this is the core of the issue.

But don't get me started on group insurance... That is another thread.

I agree co pays are worthless, I don't have them for my family - never will. However the largely uneducated, and largely broke Internet client I am dealing with wants the co pays. They are not educated enough to understand basic math in some cases, and as soon as they use that "great" H S A plan with no co pays the agent raved about what does the client say? They say "this plan is horrible , it pays for nothing..." I get calls every day from people on H S A / non co pay plans some other Internet agent sold them and their perception is it pays nothing.

Small biz owners, educated people, people with money - sure I agree 100% co pays are out the door if possible - these broke, transitional, young Internet leads - good luck it is a hard sell unless you really cherry pick your clients, which we don't do.

Just my take anyhow...

 

[somarco]

Why should I not be able to buy health insurance with copays when I can do this with virtually everything else in life?

You can buy health insurance with copays. The question is, why would you want to?

Copays are just phantom coverage, not insurance. The carrier overcharges you. When you go to the doc, or purchase an Rx, you pay a portion of the actual cost of the service or product, the carrier uses your money to pay the balance.

Only when they run out of YOUR money do they use any of their own to pay claims.

Any money left over at the end of the year from the surcharges, the carrier keeps.

Think of it like this.

The Blue Cross Bank and Trust will gladly accept all excess deposits. You will not earn interest on your money. The Bank will decide if and when you can use any of YOUR money to pay YOUR bills. Any money left over at the end of the year belongs to the bank. At the end of the year they will charge you more than they did the year before, and pull the same trick as before . . . overcharge you then dare you to make a claim for the overcharge.

How do you like that arrangement?

 

[Agent Jeff]

Only one slight problem - group insurance plans are for the vast majority CO PAY plans, and since over 90% of insured individuals receive their insurance employer sponsored - this is the core of the issue.

But don't get me started on group insurance... That is another thread.

I agree co pays are worthless, I don't have them for my family - never will. However the largely uneducated, and largely broke Internet client I am dealing with wants the co pays. They are not educated enough to understand basic math in some cases, and as soon as they use that "great" H S A plan with no co pays the agent raved about what does the client say? They say "this plan is horrible , it pays for nothing..." I get calls every day from people on H S A / non co pay plans some other Internet agent sold them and their perception is it pays nothing.

Small biz owners, educated people, people with money - sure I agree 100% co pays are out the door if possible - these broke, transitional, young Internet leads - good luck it is a hard sell unless you really cherry pick your clients, which we don't do.

Just my take anyhow...

Then I have an important question along these lines for the experienced health agents.

Lets say a client has a $5000 deductible PPO plan with a Blue Cross that pays nothing until the deductible is met and everthing once it is met.

While the annual deductible is being burned off, is he still certain of paying only up to the Blue Cross PPO rate limits for services? I assume Blue Cross would be motivated to make sure the deductible lasts as long as possible so I guess he would, but how is this enforced?

 

[HomeService]

Keep in mind, if someone has coverage and it's issued correctly, they may not be issued a policy with the next company, or it may have new waiting periods, deductibles, different coverage, different excluxions, questions/answers on the app may have changed since the last one was issued, etc. The client may give up coverage -and then not be issued coverage. So, it's usually a good idea to not drop the original coverage until the replacemnet gets issued, but clients don't always do that. So, the DOI is looking out for the consumer.

 

[TXINSURANCE]

Keep in mind, if someone has coverage and it's issued correctly, they may not be issued a policy with the next company, or it may have new waiting periods, deductibles, different coverage, different excluxions, questions/answers on the app may have changed since the last one was issued, etc. The client may give up coverage -and then not be issued coverage. So, it's usually a good idea to not drop the original coverage until the replacemnet gets issued,

Yes - particularly with individual health insurance.

In a lot of states moving individual to individual insurance is not considered credible and a new 12 month pre ex will begin - a lot of agents don't understand this, or just don't care.

Every state is different, every company is different. In Texas we now have a law that individual to individual is credible (including short term) - this is assuming they can make it through underwriting without waiver, which trumps the pre ex.

 

[djs]

You can buy health insurance with copays. The question is, why would you want to?

Copays are just phantom coverage, not insurance. The carrier overcharges you. When you go to the doc, or purchase an Rx, you pay a portion of the actual cost of the service or product, the carrier uses your money to pay the balance.

Only when they run out of YOUR money do they use any of their own to pay claims.

Any money left over at the end of the year from the surcharges, the carrier keeps.

Think of it like this.

The Blue Cross Bank and Trust will gladly accept all excess deposits. You will not earn interest on your money. The Bank will decide if and when you can use any of YOUR money to pay YOUR bills. Any money left over at the end of the year belongs to the bank. At the end of the year they will charge you more than they did the year before, and pull the same trick as before . . . overcharge you then dare you to make a claim for the overcharge.

How do you like that arrangement?

I understand every bit of this, and for the most part, for most people, agree with it. For lots of people I work with though, it's more about looking at what their issues are. I know you know this, but the general statement copays are a bad thing always bothers me.

Without copays and a high deductible, you still pay the health carrier and don't get the advantage of using it. They overcharge you to take care of the chance you'll have a major claim. That part actually stays the same whether you have copays or not.

For most people, putting money into the insurance company, to take it out later, in the form of an office visit for a cold, is lousy finances. Most guys get this since they go t the doctor once every 18 months. For others though, especially mom with 2 kids, she wants stability in her home finances. It's a different thought process, where money numbers don't calculate, but the stability does.

In my area, most doctors charge those paying cash much more than those with insurance. The local Walmart is the one exception to this. Ironically, this is largely due to the effect of government programs, but we'll leave that for another thread. Once you realize this, you want to make sure you have a plan that at least gets you the carrier rates, even if you pay them.

Just the other day, I was trying to talk a client into a $395 a month plan for her and her children, but she didn't want the deductible ($1500), she wanted $0 coverage, office visits, etc. We're signing her up on a $900 a month Blue Cross HMO plan tomorrow. Go figure, makes no sense to me, but it does to her. Now, I don't particularly care, since I make a bit more money, but what I want for the client, what makes sense to me, isn't always what the client wants, or what makes sense to them.

Of course, I have a lot of people with $250 auto deductibles, that should have $750 deductibles, but, even though they can afford to pay $750 if they needed to, want the security of the $250. Heck, many want a $0 deductible, which I simply don't even offer.

Dan

 

[J.R.]

There are millions of non citizens living in the U.S. - my wife being one of them (she has insurance and of course in not illegal). I also have a guest here from another country - she is a visitor (she has insurance also through IMG, and of course is not illegal either).

I assume you were speaking of illegals - and I agree 100%... However, here is a better idea - when an ILLEGAL seeks medical treatment, INS picks them up at the hospital detains and deports them. How many illegals would seek medical care if they knew before release they would be deported?

Why stop at illegals?

Why should ANYONE with no insurance receive care without collateral?

Good catch, and you're right, as I have quite a few friends who are in the process of becoming citizens. Some of them went as far to join the military to get their citizenship.