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-   -   Pre-Paid Health -- ? ? ? (http://www.insurance-forums.net/forum/individual-health-insurance-forum/pre-paid-health-t55898.html)

Davis B 08-06-2013 09:55 AM

Pre-Paid Health -- ? ? ?
 
Hi Friends,

I got wind of a pre-paid health company in Florida and not sure what to think of them.

Florida Health Solutions. Looks like no Major Medical...so i wonder what is the value of this plan and who is it targeted to?

[FONT=Century Gothic][I]"PHC (Prepaid Health Clinic): Florida Health Solution Corp. is a Florida licensed prepaid health clinic (PHC). Members will pay Nominal copayment when receiving PHC healthcare services.[/I][/FONT]

[FONT=Century Gothic][I]DMPO (Discount Medical Plan Organization): This plan is not insurance. This plan provides discounts at certain health care providers for medical services. This plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all health care services, but will receive a discount from those health care providers who have contracted with the discount plan organization. The corporate name and location of the DMPO is: Florida Health Solution Corp. 7350 NW 7th St. Suite 204 Miami, FL 33126"[/I][/FONT]

What's up with this type of coverage?

They have a list of providers....and i contacted one of them and they are in the group. The Agent emailed me a list of coverages...and it mentions Surgery deductible of $30.

This can't be true....

Anyone ever hear of anything like this?

Yagents 08-06-2013 01:41 PM

Re: Pre-Paid Health -- ? ? ?
 
It's a true................discount plan, and illegal in 2014 and/or won't absolve you from paying the penalty

Todd Preston 08-07-2013 07:50 AM

Re: Pre-Paid Health -- ? ? ?
 
[quote=Yagents;729669]It's a true................discount plan, and illegal in 2014 and/or won't absolve you from paying the penalty[/quote]

I also called that company (since i'm here in Fla) and their rates are ridiculously low. (something like $50mth for someone 40yrs old).

Bill, so you are saying that in 2014, discount plans will become illegal?

Yagents 08-07-2013 08:00 AM

Re: Pre-Paid Health -- ? ? ?
 
[quote=Todd Preston;730058]I also called that company (since i'm here in Fla) and their rates are ridiculously low. (something like $50mth for someone 40yrs old).

Bill, so you are saying that in 2014, discount plans will become illegal?[/quote]

I shouldn't say "illegal", but they will definitely be sold differently to a different subset of the population (those who decide to pay the Obamacare penalty for not having creditable coverage), with a whole bunch of HUGE disclaimers. No more of this "we cover pre-ex conditions" health plans, and this does NOT qualify as creditable insurance under ACA. At first, I thought they wold be abolished, but it seems or gov't didn't write the law tight enough.

Are you considering selling the plan?

Todd Preston 08-21-2013 01:55 PM

Re: Pre-Paid Health -- ? ? ?
 
...i don't know if i would recommend the plan myself. But, i called the network they have and they said they take them.

Not sure how it works...but must be some kinda administrator distributes the monthly premiums to the network.

Amazing...we have so many people who don't speak English down here....so it doesn't surprise me that they are able to sell it.

I don't know what will happen to them if they need to go to a hospital. I believe its all out-patient centers who are participating.

CStnagent 08-21-2013 03:51 PM

Re: Pre-Paid Health -- ? ? ?
 
I am not sure if this is what you are referring to but there are some NEW things coming down the pipe and some old things that were deemed legal through ObamaCare.

CalStar/AHIR is working with a group of clinics right now on a system called Direct Primary Care. This is legal under ObamaCare. It is where a major clinic charges the customer a set monthly fee to access all procedure performed by a Primary Care physician for a set co-pay. They claim it will cover 70% of all procedures and it only cost about $70 per month and get this.....it meets the coverage requirement for ObamaCare....go figure.

There are about 6 clinics in NV and 1 Clinic in CA that are experimenting with this right now.

The most surprising thing is that it does NOT fall under the Department of Managed Care. again....go figure.

AllenChicago 08-21-2013 08:53 PM

Re: Pre-Paid Health -- ? ? ?
 
[quote=CStnagent;736503]I am not sure if this is what you are referring to but there are some NEW things coming down the pipe and some old things that were deemed legal through ObamaCare.

CalStar/AHIR is working with a group of clinics right now on a system called Direct Primary Care. This is legal under ObamaCare. It is where a major clinic charges the customer a set monthly fee to access all procedure performed by a Primary Care physician for a set co-pay. They claim it will cover 70% of all procedures and it only cost about $70 per month and get this.....it meets the coverage requirement for ObamaCare....go figure.

There are about 6 clinics in NV and 1 Clinic in CA that are experimenting with this right now.

The most surprising thing is that it does NOT fall under the Department of Managed Care. again....go figure.[/quote]

There has to be a [U]name[/U] for this type of arrangement and some document and/or website that explains WHY and HOW it's ObamaCare compliant. A consumer, agent, etc.. can't do research without facts about this program.

When someone finds out enough information to enable research, please post that information to this thread. Thank-you.
-ac

somarco 08-21-2013 09:50 PM

Re: Pre-Paid Health -- ? ? ?
 
[quote]DPC is a great tool for competing on exchanges (something explicitly called out in Obamacare). Not only can the offered health plan be significantly less expensive by removing the insurance bureaucracy tax from the equivalent of a visit to Jiffy Lube, it’s a risk mitigation strategy. Why? A key risk health plans have is they aren’t able to underwrite the way they have in the past under Obamacare. Thus, if one wants to mitigate claims, nothing has proven itself more effective than DPC at reducing downstream utilization of expensive healthcare services. [/quote]

[url=http://www.forbes.com/sites/davechase/2013/07/12/direct-primary-care-consumer-perspective/]Direct Primary Care: Consumer Perspective - Forbes[/url]


[quote]In Health Insurance’s $4.4B Bunker Buster I outlined a clause in Obamacare that most health insurance companies are asleep at the wheel in their response. It is both a threat and an opportunity to traditional health insurance companies. Previously, I have called this new model “concierge medicine for the masses.” Officially, it is called Direct Primary Care (DPC). In the Marcus Welby/Steve Jobs Solution to the Medicaid-driven State & County Budget Crisis the scale of impact on healthcare costs of little-noticed clause (Section 1301 (a)(3)) was detailed.

In my study of disruptive innovation in healthcare, I haven’t seen anything come close to DPC in its positive impact on what healthcare wonks call the “Triple Aim” (improved patient experience, health of the population and per capita costs). Not Accountable Care Organizations. Not Patient Centered Medical Homes. Not the Swiss health system. Don’t get me wrong, there are all significant steps in the right direction — just not as impactful as DPC. Skeptics would rightfully ask “If it’s so great, why isn’t it more popular?” One reason: Lack of adoption by health insurance companies.[/quote]

[url=http://www.forbes.com/sites/davechase/2012/07/24/david-clause-in-obamacare-ready-to-slay-the-healthcare-cost-beast/]"David Clause" in Obamacare Ready to Slay the Healthcare Cost Beast - Forbes[/url]


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