- 990
Covers outpatient chemo
Can we see this in writing?
Can we see this in writing?
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You should always quote 3 with the 700 being the last one and show them the difference, after explaining them you will sell the richer plans about 95% of the time.
ex.....40 m broward co
Plan 700 $130
Plan 504 $314
The more benefit rich plan is almost 3x the cost of the hosp/surg plan.
If ya can, do show us that chemo bit in print?
I'll say one more thing about this.
There is a market for such plans.
Some, will look at a price and a deductible and tell themselves that they have it sussed out. Some people are obsessed with the deductible. Exclusions / limitations, and their relevance are beyond such a person's capacity. At that's o.k. it doesn't make them a total waste even if I or someone else thinks they are denial ridden.
Honestly, from time to time I have considered leaving my monogram plan for this Plan 700. Haven't been able to bring myself to do this.
I had a woman a week ago complain how her husband and her had to pay $2800 for an M.R.I. at the hospital when he had a cyst looked at. They didn't know to go to an in network advanced imaging center where I am told they would have paid $150.
Also had a client tell me last week that he woke up in the hospital after having a seizure in his friend's driveway. He wasn't able to research and go to Quest diagnostics for blood work or an independent diagnostic facility or an advanced imaging center between bouts of consciousness at the hospital ...
since most of you obviously have never read the contract for the Plan 700 you are just blowing smoke up everyone's asses and sell the higher priced plans just to pad your commissions. I'm ot going to do your homework, but here is just one part of the contract relating to Inpatient confinement:
Hospital Services
Inpatient:
[FONT=Arial,Arial][FONT=Arial,Arial]The following may be Covered Services when rendered in an Inpatient Hospital setting: [/FONT]
[FONT=Arial,Arial]1. room and board in a semi-private room when confined as an Inpatient, unless the patient must be isolated from others for documented clinical reasons; [/FONT]
[FONT=Arial,Arial]2. intensive care units, including cardiac, progressive and neonatal care; [/FONT]
[FONT=Arial,Arial]3. use of operating and recovery rooms; [/FONT]
[FONT=Arial,Arial]4. use of emergency rooms; [/FONT]
[FONT=Arial,Arial]5. respiratory, pulmonary, or inhalation therapy (e.g., oxygen); [/FONT]
[FONT=Arial,Arial]6. drugs and medicines administered by the Hospital (except for take-home drugs); [/FONT]
[FONT=Arial,Arial]7. intravenous solutions; [/FONT]
[FONT=Arial,Arial]8. administration and cost of whole blood or blood products (except as outlined in the Drugs exclusion of the "What Is Excluded?" section); [/FONT]
[FONT=Arial,Arial]9. dressings, including ordinary casts; [/FONT]
[FONT=Arial,Arial]10. anesthetics and their administration; [/FONT]
[FONT=Arial,Arial]11. transfusion supplies and equipment; [/FONT]
[FONT=Arial,Arial]12. diagnostic Services, including radiology, ultrasound, laboratory, pathology and approved machine testing (e.g., EKG); [/FONT]
[FONT=Arial,Arial]13. chemotherapy and radiation treatment for proven malignant disease; [/FONT]
[FONT=Arial,Arial]14. Physical, Speech, Occupational, Cardiac Therapies; and [/FONT]
[FONT=Arial,Arial]15. transplants as described in the Transplant Services category in this section. [/FONT]
[FONT=Arial,Arial]Exclusion: [/FONT]
[FONT=Arial,Arial]Expenses for any Services rendered in an Inpatient Hospital setting are excluded when such Services could have been provided without admitting you to the Hospital. [/FONT]
[FONT=Arial,Arial]In addition, expenses for the following and similar items are also excluded: [/FONT]
[FONT=Arial,Arial]1. gowns and slippers; [/FONT]
[FONT=Arial,Arial]2. shampoo, toothpaste, body lotions and hygiene packets; [/FONT]
[FONT=Arial,Arial]3. take-home drugs; [/FONT]
[FONT=Arial,Arial]4. telephone and television; [/FONT]
[FONT=Arial,Arial]5. guest meals or gourmet menus; and [/FONT]
[FONT=Arial,Arial]6. admission kits. [/FONT]
[/FONT]Note: [FONT=Arial,Arial][FONT=Arial,Arial]This Contract does not provide coverage or benefits for maternity/obstetrical care, except for complications of pregnancy, unless the Contractholder purchased such coverage under an Optional Maternity/Obstetrical Care Benefits Endorsement, if available. [/FONT]
[/FONT]
One more paragraph from the contract, there is nothing that says it has to be related to a surgical event or hosptalization. Maybe you will actually research the facts next time before making an assumption:
Diagnostic Services
[FONT=Arial,Arial][FONT=Arial,Arial]Diagnostic Services rendered in a Physician‟s office or an Independent Diagnostic Testing Center may be covered. In order to be covered the diagnostic Services must be ordered or rendered by a Physician and are limited to the following: [/FONT]
[FONT=Arial,Arial]1. radiology, ultrasound and nuclear medicine, Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiogram (MRA), Positron Emission Tomography (PET), Computed Tomography (CT) ; [/FONT]
[FONT=Arial,Arial]2. laboratory and pathology Services; [/FONT]
[FONT=Arial,Arial]3. Services involving bones or joints of the jaw (e.g., Services to treat temporomandibular joint [TMJ] dysfunction) or facial region if, under accepted medical standards, such diagnostic Services are necessary to treat Conditions caused by congenital or developmental deformity, disease, or injury; [/FONT]
[FONT=Arial,Arial]4. approved machine testing (e.g., electrocardiogram [EKG], electroencephalograph [EEG], and other electronic diagnostic medical procedures). [/FONT]
[FONT=Arial,Arial]Exclusion: [/FONT]
[FONT=Arial,Arial]1. Diagnostic Services that are not ordered by a Physician; and [/FONT]
[FONT=Arial,Arial]2. Oversight of a medical laboratory by a Physician or other health care Provider, as described in the "What Is Excluded?" section. [/FONT]
[/FONT]