Here it is our annual list of companies that will most likely sue us at some point! But I wanted to include this page, as it is more important than me going on and on about the drug plans in Texas, for example. First, lets discuss what traits to avoid in a health insurance plan.
These traits include any plan that does not have a defined out of pocket maximum. The out of pocket maximum is your deductible plus coinsurance per year, and is usually no more than $5000. Of course, you can go higher depending on your own risk analysis but as long as you are cognizant of the plan limits you won’t get burned when you buy your health insurance plan. Some plans have 20% coinsurance on a plan with no limit. That means you are paying 20% of all your medical bills and there is no end in sight! These companies include some of the smaller HMO’s and, of course, the usual suspects.
What else? How about any plan that has a maximum amount that they (not you) will spend on a particular medical procedure? For instance, Mega Life and Health often gets away with their hijinks by having a ceiling on each hospital stay or a general surgery. You might see it as a maximum of $100,000 cap on hospitalizations.
These first two traits are very common to the Mega, Midwest National Health Company, and United American (all owned by Health Markets, your friend in killing you). There are, of course, a ton of these companies but I don’t know the names of them as we refuse to sell any company that has any of these traits. That is why we would, in fact, like to hear which plans you have been ripped off by, and you are encouraged to share your rip off stories here.
Our second and most common thing to avoid is the coinsurance trick. This is done by the bulk of the health insurance companies, and they are forced to try to hide their coinsurance maximums due to the fact that there is no way to start a health insurance company in the United States without a ton of money and agents. Agents only will sell a product if there is a ton of commission being paid or the company is well known, preferably both of course. Freedom Life and Health is guilty of this as they pay very high commissions and have way more coinsurance than their competitors like Aetna, Blue Cross, etc. because there is no way to pay such high commissions and use a contracted network and still be competitive.
That is the last trait to be leery of. You want your health insurance company to have their own network. This is an instant giveaway, as I said above. If they don’t have their own network, that means their costs are infinitely higher and they will be resigned to compete by maintaining high coinsurance. These companies also include Time/Fortis, Mega, Midwest, Freedom, and Avalon.
Stay away from indemnity plans like Cinergy, ALR, United Benefits of America, CRA, Health Care Solutions, UMR, Advantage Health Care, CHBA, Cornerstone, American Health Benefit.