All of these guaranteed issue plans work the exact same way - they use a fee schedule. I'm not exactly sure how it's of any benefit to someone who has a $25,000 surgery to find out that their "Platinum Plus Diamond Series Executive Plan" pays $280.
As you can see from the surgical fee chart, there pretty much is no benefit. This particular chart I'm showing is the AWA Platinum:
Homeland HealthCare for $258 for an individual.
It gives a doctor's office and wellness benefit but only three visits a year at $75 max each. The ER max benefit is $150. So run the math:
$258 X 12 months = $3,096
Max visits is $75 X 3 = $225
Max ER = $150
Ambulatory Surgical (outpatient surgery) $150 per day max benefit.
So outpatient if they used all services they're capped at $525 but have spent $3,000+ - and we've already ascertained there's no surgical benefit worth talking about.
http://www.homeland4one.com/manage/m...y_Schedule.pdf
This also doesn't pass pre-authorization requirements. If a surgery is scheduled the hospital admin will call the insurance company to obtain pre-authorization. They want to make sure the surgery will be covered.
However, when the admin. dep't makes that call the insurance company will inform them that they only pay "$175" for the gall bladder operation. Then the patient gets a call from the hospital. The surgery's off until the client can pay for it.
Guaranteed Issue Health Insurance
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