Mike.gibble

49 minutes ago, Blues said:

So the only way for us to get information on this plan is to talk to you, and you don't actually know what it is.  And in fact called it a "major medical plan" until challenged.  Wow.

Correct, don't know why they title it that way. And yes, it is a major medical plan. Any challenge accepted my friend. I stand behind the coverage that I have for myself and my family. If there's anything better on the market, please bring it to my attention so I will produce those plans. 

6 minutes ago, Zulu said:

If you buy a plan in one of these 6 states, is the plan "portable" (ie, usable in any state)?

Finally, it would sure help if there was some kind of state-by-state grid that showed what is/is not covered.

Yes. The coverage is on the Cigna Nationwide PPO so the insurance policy taken in the person/families' home state is the coverage that travels with them.

13 hours ago, Blues said:

I think that's the point--make people have to talk to a salesman to get information.  And my problem with saying that all questions will be answered is that the customer has to know there's a question to be asked. 

Like what is the significance of the plan being called a "Specified Disease/Sickness Plan"?  I asked upthread what this means, and didn't get an answer.  Major medical plans as we know them aren't called "specified disease/sickness plans," so what's the difference? 

It's common wisdom that when buying an extended warranty on an RV, it's better to buy one that covers the RV but with certain stated exclusions than one that limits its coverage to specific items listed.

And I notice that you didn't call it a "specified disease/sickness plan" in your first post.  You called it a "major medical plan," which we now know it isn't, but only because I pressed. 

Even if there are variations from state to state, there apparently is a basic framework for the plan, and there's no reason why the basics couldn't be explained on a website or in a post.  And there's definitely no reason to call it a "major medical plan" when it is not, if the only reason for lack of transparency is that plans differ from state to state.  It would also probably be best not to post in a public forum, "I am willing to share all the details if you are interested," if those details are available only to people from one of five states who have to call you to get the details.  That's not sharing with others--that's selling to individuals.

That's right, I am trying the help individuals and families try to obtain what, in my opinion and I haven't found anything better for my personal family as we have this insurance, the top coverage on the market. You have to qualify. Period. But if you do, it will not disappoint. 

I do not know why it is called, "specified disease/sickness plan" and yes there are exclusions that vary from state to state which is why you have to reach out to a licensed agent in that State. I am only licensed in 6 States so can't talk to all of the details in all of them.

There is no perfect Health Insurance plan. It doesn't exist. We deal with what is available. Every plan has exclusions, every plan has the fine print. Regardless of the carrier.  Just like RV insurance.

10 hours ago, Zulu said:

Kudos, tx for doing the heavy lifting.

Blues and Zulu, I've tried to explain things as best I can on the forum since the plans have a great deal of details and options but these vary from State to State. As you can see in my signature line, I'm licensed in just 5 of them so can't simply blanket post brochures of the coverage as the variations would be false advertising depending on the specific State the person is in.  The US Health Group knows this as well which is why it can be taken that they are not being transparent but, in fact, they are trying to abide by the health insurance regulations for the Feds and every State on one website.  We just had this issue where I live in Maryland where outside agents within our own company were not used to the different details for the State and told  potential clients curtain details that were not true for the coverage available here.  Due to this, Maryland and Pennsylvania have close their borders to outside non-resident agent.  So only resident agents can sell the coverage within their home State.  I'm not trying to make excuses but the details and insurance regulations vary ALOT between States so I'm just trying to explain. But I can definitely understand how it can be taken as a lack of transparency!

All I can say is reach out to agents and they will review the plans, options and details until there are no more questions.  We are required to do in person or screen share presentations to all potential new clients to review the coverage and answer all questions.  

11 hours ago, Blues said:

Okay, major medical type coverage, not major medical, as most of us understand it.

Which plan are you selling?  The only one I can see that has a deductible is the SecureAdvantage, and for that one, you get a specified disease/sickness plan, and apparently have to get an additional plan to cover "doctor office visits, x-ray, laboratory and prescription drug coverage," and yet a third indemnity plan to get "wellness and health screening services."  Is that the one?

If so, what is the significance of its being called a "Specified Disease/Sickness Plan"?  Are only specified diseases covered?  If so, what are they?  I can't find a list anywhere on the website, or even a description of what it might mean with respect to the type of coverage is offered.

Ok. Let me try to review everything.  This post may get a little long so bare with me.

We offer 3 kinds of coverage products available for sign up year round and cancellable at anytime because they are off the ACA.  All are on the Cigna Nationwide PPO.  Two of those products the party must qualify for from a health perspective and are underwritten. The other is a guaranteed approval coverage. All the plans are broken out into 3 parts, sickness/disease, accident and health/wellness because the benefits are different depending on the plan options.  So let me go through the 3 coverage options;

SECURE ADVANTAGE (Major Medical TYPE Coverage also a hybrid of the best parts of most medical options on the market) - underwritten coverage from a health perspective - No Co-pays or money due at any doctor visit

- Fixed deductible options for sickness/disease and accident (80/20, 70/30, 60/40) with deductible options set at $5,000, $7,500 or $10,000.

-Coverage is guaranteed for any major medical occurrence until client is 65 yrs old with the exception of mental/emotional disorders and maternity.

- The health/wellness part of this plan is a fixed indemnity coverage where the client is guaranteed to get that monetary benefit amount regardless if the doctor charges less for the visit.  If the doctor charges less for the visit, the client will get a check in the mail for the difference.

- Supplements to this plan are additional accident protection (you can get money to match funds spent towards the deductible), critical illness protection (maximum check amount to cover ancillary bills like morgage etc during treatment), income protection (up to $1,500 for 12 months while recovering from any treatment), Dental and Vision Plans are available also.

PREMIER CHOICE (Fixed Indemnity Coverage) - underwritten coverage from a health perspective - No co-pays or money due at any doctor visit

- No deductible plan and has 3 levels of fixed benefits for everything except mental/emotional disorders and maternity. This plan is also broken out into sickness/disease, accident and health/wellness.

- Riders included to guarantee insurability, even during a claim, to move up benefit levels 

- Rider included to guarantee insurability to a $4,000 deductible during a catastrophic event covered up to $25 million.

- All 3 levels of this plan is a fixed indemnity coverage where the client is guaranteed to get that monetary benefit amount regardless if the doctor charges less for the visit.  If the doctor charges less for the visit, the client will get a check in the mail for the difference. If the charges are over the benefit amount, the client will be responsible for the difference.

HEALTH ACCESS (Fixed Indemnity Coverage) - plan is guaranteed approval with no underwriting - No co-pays or money due at any doctor visit.

- No deductible plan and has 1 levels of fixed benefits for everything except mental/emotional disorders and maternity. This plan is also broken out into sickness/disease, accident and health/wellness.

- Level of this plan is a fixed indemnity coverage where the client is guaranteed to get that monetary benefit amount regardless if the doctor charges less for the visit.  If the doctor charges less for the visit, the client will get a check in the mail for the difference. If the charges are over the benefit amount, the client will be responsible for the difference.

- This plan comes with an independent business association membership which includes programs like; tax talk, WebMD (24/7 doctor website visits where prescriptions can be written over a web video call), catastrophic medical coverage etc.

Obviously there are many more details depending on the person's resident state and options.  But I tried to outline the highlights of the coverage options. Please keep asking questions or reach out to me with them privately.  I'm here to help as much as I can for my fellow RVers and campers. I hope everyone is staying safe and well during this trying time!

22 hours ago, Kirk W said:

If you look to the upper, right hand corner of the window of the Escapee header you will see your name and a down arrow. If you click on that down arrow a menu will open, click on account settings there and another window will open down the left side with a series of choices. Go there and click on signature and you can set up a signature your signature which will show at the bottom of each post that you make. You can make a link there to you website or one or an email to you, or pretty much anything you wish to put there, within reason. 

Again, thanks Kirk. I got it set up I think...

1 hour ago, Kirk W said:

If you look to the upper, right hand corner of the window of the Escapee header you will see your name and a down arrow. If you click on that down arrow a menu will open, click on account settings there and another window will open down the left side with a series of choices. Go there and click on signature and you can set up a signature your signature which will show at the bottom of each post that you make. You can make a link there to you website or one or an email to you, or pretty much anything you wish to put there, within reason. 

Thanks Kirk.  I will take a look and put all this information on my profile

2 hours ago, Blues said:

 

I went to the website for US Health Group.  On the first page, it says, "Apply anytime of the year."  My understanding is that major medical plans (what most of us consider to be "health insurance") are available only during open enrollment or if a person qualifies for a special enrollment period.  Enrollment any time of the year is usually a hint that a plan is not major medical, and is probably short-term insurance or an indemnity plan or somesuch.

So I dug some more, trying to find a major medical plan.  I couldn't.  There are three that look like health insurance:  "PremierChoice," "SecureAdvantage," and "HealthAccess."  But all of them are called "Specified Disease/Sickness Plans" (without any indication of which diseases will be covered), and state that they are not "traditional major medical plans" (in footnote 2 of each plan's description). 

Where can we get information on the major medical plan with a nationwide PPO network that US Health Group offers?

 

Blues; you are correct in your analysis.  These are major medical type coverage.  The coverage is a hybrid of major medical, meaning 80%/20% with a $5,000 deductible for catastrophic instances but have fixed indemnity benefits for annual screenings or physicals.  The reason the plans are outside the ACA is that they do not cover maternity or mental/emotional disorders and are underwritten from a health perspective.  Again, these plans are all on the Cigna Nationwide PPO.

14 hours ago, Zulu said:

Is it based out of particular state(s)?

The plans are offered to residents in 35 different states but the PPO is available nationwide.  I tried to enter my contact information under my profile "about me" section if anyone is interested in reaching out to my personal cell phone to explore more.  I am always open to analyzing a person or family's health insurance situation to see if we can work out better options whether it is with me or others.  I always try to recommend the most appropriate way forward.

The insurance company is the US Health Group, a United Healthcare Company

Kirk, you are correct.  The asking for the driver's license is simply to verify that the insurance card matches the identification card (driver's license or ID).  Health insurance cards typically do not show the person's address on them.  The medical facility just needs to know where the bill is going and how to handle the visit based on the coverage.

Wow! Great News!  All the best!!

The nationwide network is on the Cigna PPO.  There is a suit of customizable plans that will cover everything or can be limited depending on how the specific person or family wants to build the coverage and on their budget.  There is guaranteed approval coverage as well as underwritten coverage from a health perspective that can save more money on a major medical package.

It also looks like the federal government is going to open up a "special enrollment" period due to the current health pandemic. My home State of Maryland has already done so for those who do not have insurance.

Ok Kirk.  Thanks for the advice.  As I said I am new and trying to figure this out.  I've added my facebook page to my profile but do have an agent website and business website.  I'll try to figure out how to add them to my profile later today or tomorrow morning.  This quarantine situation has me very busy trying to keep my kids entertained during non-typical business hours.  Haha

Sorry y'all.  I haven't checked this since a few days ago.  I'm not a spam generator but a licensed health insurance agent for both group and individual insurance.  My full name is Mike Gibble.  You can check out my business page on Facebook @gibblehealthandhealthinsurance.  I don't know if providing my cell number to help people out is ok or not on this site.  I'm new to posting on these forums.  Simply interested in helping people out.  If I can't help, I know agents throughout the country who can...

I recognize I am late to this discussion.  There is another way with a nationwide PPO which is perfect for RV'ers.  It is a major medical plan but still falls outside the ACA.  I am willing to share all the details if you are interested.

Zulu is correct.  Health Insurance companies care where your permanent residence is and what your drivers license says.  Also, please let me know if you'd like to review health insurance options.  RVer's need good nationwide coverage so they don't have to worry.