Wednesday, May 09, 2018

Bait & $witch, Part 1

Regular readers may recall the story of Dave and Sally, (now former) longtime clients who ditched their Medical Mutual grandmothered plan for the (allegedly) greener pastures of a Health Care Sharing Ministry. As I told them last summer:

"Don’t blame you. I actually know someone who’s in one of these and is pretty happy with it."

So, fast forward 10 months, to yesterday:

"Medishare is not working out so well for us.  What are our healthcare insurance options?  I looked on Medical Mutual's site and it looked like they might not be offering individual policies anymore.  I'm hoping you have a good idea!! - Thanks, Sally"

Before I could reply, she followed up with a question about a plan she'd come across on-line. Well, actually, the plan came across her:

"Hi, I noticed that you were recently online looking for health insurance quotes. I have a much better way to obtain a low cost brand name major medical health insurance plan... with a low or zero net annual deductible!"

Wow, sounds great, and Sally wondered if I had access to it and what I thought of it.

Well, maybe, and I'm willing to take a look:

"United Healthcare currently has the best rates of any major medical carrier on their medically underwritten health plan. If you are in reasonably good health, this plan offers substantially better benefits at a much lower cost than any other health plan."

Oh, so a UHC plan. Okay, decent carrier, decent plans and prices in general, but no ObamaPlans, and this one sounds like a short term medical plan, which we do have access to and like. But then there's this:

"United Healthcare Major Medical Plan with Deductible Eliminator"

Hunh. I suppose one could call a Short Term plan "major medical," but that certainly implies a lot more than I would be comfortable with. But what's this "Deductible Eliminator?"


"Deductible eliminator GAP supplement pays 100% of medical expenses subject to your deductible in the hospital, and 50% of expenses subject to your deductible on outpatient expenses."

Now that doesn't seem familiar, but maybe I missed a memo, so off to the UHC quoting site. Nope, no "Deductible Eliminator" here.

Hmmm, what to do now?

So, I reached out to our friends at Cornerstone, who took one look at the email and referred me to UHC's home office. Who were quite puzzled as well, since they had no idea what this agent was pushing, but it certainly wasn't one of their products. I thanked them, and promised to keep them in the loop.

By this time, I'd received a follow-up email from Sally:

"I am going to use the sharing plan more effectively.  I found that if I lower our deductible from $10,000 to $7,500 our premium only goes up $18 a month! I'm thinking this is a better option that anything else right now."

Okay, I get that. But I took a chance and asked if she'd mind asking for more details on this "other" plan, and she readily agreed to do so. Here's what the other agent sent:

"Hi [Sally], Here is the info about the United Healthcare major medical plan plus another popular plan from a top selling carrier ... United Healthcare Term Major Medical Value Select A."

So, just as I had suspected: a short term medical plan. I'd like to think that her misrepresentation of it was a typo rather than intentional.

Seems like there's something missing though, no? Where's that fantastic (literally, apparently) "Deductible Eliminator?"

And something I think is even more appalling: the lack of disclosure that this is, in fact, a Short Term Medical plan and thus not ACA-compliant. This is critical for a number of reasons:
■ The plan doesn't cover pre-existing conditions
■ It leaves them subject to the fine/penalty/tax (which is a double whammy in this case, since they'd be coming from an ACA-compliant Sharing Ministry, which exempts them)
■ These plans aren't renewable, and currently have a 3 month maximum term
There's actually more, but we'll cover that in Part 2.

Stay tuned....
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