Texas Options

[somarco]

The WSJ (and others) have made a big deal out of Lisa Kelly's situation. She purchased a limited benefit plan and is now making the headlines because the hospitals want up front cash before they treat.

Here are some links.

Cash Before Chemo: Hospitals Get Tough - WSJ.com

Harold Pollack: "Cash Before Chemo" Two Arguments for Health Reform - Politics on The Huffington Post

I just don’t know what to say « After cancer, now what

The Kelly's are self employed (rental property). Is there a reason why they could not have bought a small group plan, even after diagnosis, and had full coverage?

How about the TX risk pool?

 

[moonlightandmargaritas]

$20 for a pair of latex gloves. People wonder why health insurance premiums are so high...

 

[STIBROKER]

hummm,,,,

Mrs. Kelly, 52, signed up for AARP’s Medical Advantage plan, underwritten by UnitedHealth Group Inc., three years ago after she quit her job as a school-bus driver to help care for her mother. Her husband was retired after a career as a heavy-equipment operator. She says that at the time, she hardly ever went to the doctor. “I just thought I needed some kind of insurance policy because you never know what’s going to happen,” says Mrs. Kelly. She paid premiums of $185 a month.
A spokeswoman for UnitedHealth, one of the country’s largest marketers of limited-benefit plans, says the plan is “meant to be a bridge or a gap filler.” She says UnitedHealth has reimbursed Mrs. Kelly $38,478.36 for her medical costs. Because the hospital wouldn’t accept her insurance, Mrs. Kelly paid bills herself, and submitted them to her insurer to get reimbursed.

 

[somarco]

Sure, it was a foolish choice.

So, what about options?

I have quite a few folks in GA on small group plans because they are totally uninsurable otherwise. I have two with M.S., quite a few folks with multiple ills (nothing major but enough to get them declined).

Wrote a guy last week who is 6' 4", 340# and HTN.

But he has his own buiness. He put his wife on the payroll and we wrote a 2 person group with Humana.

GA does not have a risk pool but I use the small group route as often as I can.

 

[STIBROKER]

Sure, it was a foolish choice.

So, what about options?

Set them selfs up with the rental prop. as a business with a inc. naming both as officers and do a 2 man group......or she might be eligible for the risk pool if her current plan is less in benefits than the risk pools......they really needed to talk to an agent a long time ago......

 

[somarco]

they really needed to talk to an agent a long time ago......

No argument from me.

They are already on the hook for $145k in addition to $45k they have paid out of pocket. Even though they did something stupid from the get go (buying a limited plan) they could have gone to a small group or risk pool vs. going $200k+ in the hole.

 

[moonlightandmargaritas]

Another foolish "do-it-yourselfer" who bought from an AARP mailing.

As I've ranted extensively - the consequences can be devastating as proven here.

What are you doing to warn your potential clients of these dangers?

 

[STIBROKER]

What are you doing to warn your potential clients of these dangers?

SELLING THEM TRUE INSURANCE....I had one that went that route a year ago.....now some things have cropped up and has been declined......so if she would have listen to me a year ago(vimo lead) then her bills would have been paid....so this time around I have her husband and kids on Humana and she is talking to UA until we can get her back on her group plan in Oct.....

 

[HomeService]

The TX risk pool is very high$$ and we don't have those "small group plan options" that you keep speaking of, somarco.

 

[STIBROKER]

The TX risk pool is very high$$ and we don't have those "small group plan options" that you keep speaking of, somarco.

yes we do.....