Opinions, ideas, comments welcome and sought

abuddingrose
on 2/27/10 2:56 am - Essex, MD
I am crrently on Cobra for health insurance.  I know most people have difficulty finding health coverage that covers wls surgery or pre existing conditions.  My question, concern, idea is as follows.  I have been communicating with a company called National Association of Business Leadership thier web site is www.ahahealthplans.com .
The rep tells me that even though I have preexisting conditions and I am seeking the coverage mainly for having wls covered that there is no problem with coverage as long as I am not taking injectabel insulin for diabetes. Which I am taking metforman for at this time.  This is not Major Medical but the rates are negotiated on as PPO network.
I don't have nything in writing such as Cetificate of Coverage which I will be getting in the mail soon.  The rates are not much different than my COBRA charges now.
245 compared to 113 per month.
My questions are these.

If I take this coverage can I go back to cobra?
Has anyone heard of this company or dealt with them. If you have please let me know your experience be it good or bad.



never settle for less than you deserve and you deserve only the best.                            
(deactivated member)
on 2/27/10 11:15 pm - AZ

That looks like a really horrible plan!   They really don't pay for much of anything and it's a plan designed for those that don't have medical issues. ;o)

The problem with a plan such as this is that they are not likely to contract with many doctors or hospitals and therefore there is no contracted amount for various procedures.  A hospital charges around $80K for bypass but the contracted amount is much less, maybe they charge BC/BS $20K and write off the other 60K.  If this company does not contract with the hospital they'll pay $1K a day (on their best plan) and so they pay $3K and you pay $77K.  See what I mean?

Also, no private policy covers WLS.  Don't let them fool you.  If they claim they will pay for WLS then they can put it in writing, give you the contracted amounts of what they will pay, what you will pay, and what the hospital will write off.  Not an insurance agent that contracts with them, but a representative of the ins co itself.  Do not accept anything spoken, it all has to be in writing.

There are several folks that were told WLS benefits were covered on a private policy.  They bought the policy and then discovered WLS were not covered.  Some people will do anything for a buck, you know?  Ins co's don't cover WLS on private plans because then everyone would get the policy just for the WLS and then after surgery dump the policy.  No ins co could afford that.

From the looks of this policy I'll bet you a dollar it would be cheaper to go out of country and self pay.

No, COBRA does not have to take you back if you leave them.

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