A long time ago, I had a sales manager who told me “you can’t compensate for other peoples’ ignorance.”
What he meant by that was that, when other folks make stupid decisions, I shouldn’t take it personally.
In the post below, Bob Vineyard tells of two of his clients who either bought coverage or chose not to, and the consequences of those decisions. He characterized the stories as two sides of a coin. In a flippant e-mail, I asked “only two sides?”
Well, turns out there’s a third:
Recently, I wrote a policy for a family. There were some health issues, but we were able to get coverage from one of the two more lenient carriers in this market, at what I considered a reasonable cost. After a month or so, they asked me if there was a better plan available, and I suggested that we apply to the other lenient carrier. Of course, I urged them to continue the existing plan until we had the new one in place. This shouldn’t have been a problem, since we didn’t need to send a check with the new application.
So, of course, they let the existing policy lapse, and then called me to get the new one started. And, of further course, it needed to be in place immediately.
So, we sent in the app to the other carrier, which immediately asked for additional information on the husband. Weeks later, he eventually calls the 800# that I’ve given him, to speak directly with the underwriter’s assistant, in order to provide that “additional information.”
Which information, of course, resulted in his being declined for coverage. They’ll issue a plan on the wife and kids, mind you, but not on him. And since this is PHI (Protected Health Information), I have no clue what caused the underwriter to decline coverage on him, making it even more difficult to obtain coverage elsewhere.
I just called with the “good news, bad news.” He is not a happy camper. And I feel bad for him, because I am human. But I don’t feel too bad for him, because I had – a long time ago – a good manager.
I’ll keep you posted when this is finally resolved.
I hope.
First, thx for the kind words, and the link to my site.
ReplyDeleteIt's situations like with Jane that make you want to pull your hair out. But then a "Joe" comes along and it justifies some of the stuff we have to go through.
Don't misunderstand. I do empathize with both, and I certainly don't wish ill to either of them. But Joe's situation brings home the reason why I stay in this business.
Your third side reminds me of a situation I am going through now with 2 different, prospective clients. Both have children with ongoing illness which some carriers consider to be serious. I am trying to get both mom's to understand the most important issue to consider in searching for a plan is COVERAGE, not price or choice of docs.
One lady has already had her child declined. My opinion on that one is the underwriter erred BIG time but that is for another day. Her carrier of choice allows her to keep her current docs. However both her children are in daycare which means about a dozen trips to the doc each year for colds, earache, etc.
Her preferred carrier will consider these minor ailments to be pre-ex and will not cover any doc visits or meds (for the pre-ex) for the first 12 months. My recommendation is she give strong consideration to an HMO, which requires changing docs and driving a bit further, but will give complete coverage for the kids including the minor stuff.
Prices are about the same, but her carrier of choice will most likely cost her an extra $2000 or so a year in non-covered doc visits and meds.
Lady #2 has a child that will be declined or ridered by every major carrier. There is a possibility her preferred carrier will accept her autistic daughter, but will put up to a 3 year waiver on coverage for treatment related to autism. At the very least the carrier will not cover autism treatment for the first 12 months.
The HMO may cover her daughter, and provide more extensive coverage, and charge a lesser premium than the other carrier, and not impose a pre-ex. The only way to know for sure is to make application and see what happens.
Instead, lady #2 wants to check the internet, and look at other plans to see which carrier has the best price and richest benefits, especially in the psych area.
Rates are not what should be the focal point. It's all about coverage. No coverage means you paid too much.
Both ladies have my number.
I am waiting on their call.
Just ask for the blue guy . . . the one holding his breath.
Both these women fit into my "if you haven't found it yet, it doesn't exist" filing cabinet.
Like your blog. Found it searching for like minded souls out there.
ReplyDeleteAll blessings, Dental Care