Monday, February 14, 2005

As a service...

To my clients, I've added a few product links to the sidebar.
The most interesting of these, in my opinion, is the Special Risk Medical plan. It's not for everyone, but it seems to offer the best (or maybe just least bad) alternative for those folks who are uninsurable.
Most folks, even with various medical conditions, are NOT uninsurable. Generally, once I spend some time digging out the medical info, and checking with the carriers, some offer will be made.
But for those folks who truly can't get past underwriting, there are precious few options:
1) HMO Open Enrollment. By law, HMO's are required to periodically "open the doors" to anyone who wishes to obtain coverage. Generally, these are folks who can't obtain coverage elsewhere, so these enrollment periods are somewhat like Russian Roulette for the carriers. As a result, the premiums for these plans can be pretty hefty.
2) Medical Service Discount Programs (e.g. Care Entree, et al). It's important to note that these programs are NOT insurance. They allow one to access Preferred Provider Organization (PPO) networks, and to then enjoy the discounted rates for various medical services and procedures. The primary drawback to these plans is that the discounts (which may be substantial) are predicated on prompt payment of the entire balance due, usually within a relatively limited timeframe (e.g. 10 to 30 days).
Well, that's fine if that balance is $200 or $300. But what if it's $20,000? Start off in the ER, get moved up to ICU for a coupla days, and this is not so far-fetched.
3) Special Risk plans offer a viable alternative to both HMO's and PPO's, but they are NOT a panacea. The primary benefit of such a plan is that they are often "guaranteed to issue," which means that the underwriting is limited to non-medical issues (e.g. actively at work, not hospitalized in the past "x" number of days, etc). They are reasonably priced, and offer access to both PPO networks (and thus discounted services) and discounted prescriptions.
But they are NOT comprehensive in coverage, and offer limited dollar benefits on claims. And, for out-patient services -- especially doctors' office visits -- benefits are meager, if available at all.
Happy Valentine's Day!
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