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Best Major Medical Plan

Here is another case that actually occurred where the applicant basically spelled out what they wanted and it was up to us to choose the most affordable plan with the most benefits meeting their criteria.  From our substantial list of Florida health insurance companies including Aetna, Avmed, Cigna, Humana, United, and Vista the task can seem formidable.  Due to the advanced age of the prospects another important company to consider was the Aetna AARP plans for the under 65 demographic.

In any event here is the question:

Florida Health Insurance Case Study


As I see it, our major medical expenses at this point in time are prescription drugs.  Between my wife and me, we take six prescriptions daily.   All but one does not have a generic equivalent.  The remaining five will cost us between $500-600 per month.   This is on top of the $1446 per month premium (not to mention the exclusionary rider).

On the other hand, my wife and I usually have two doctor’s visits each per year.  Our doctor does blood work at each visit.   My wife has an annual mammogram.  So covering basic health fees such as office visits or a larger copay for office visits is not that important.  What is important is covering prescription costs.

Please let me know which companies might meet the following criteria:

Prescription coverage

Reasonable monthly premium

Major medical coverage

A good chance of being approved without the exclusionary rider

Even if the plan has a drug deductable of $1000, we would meet that within a couple months.

So, please find attached analysis of AARP plan rates and benefits.  Now based on the underwriting prescreening they would rate you up 25% and Becky would be A rated so you’ll see that reiterated and illustrated on the rate sheet attached.  AARP is much like Aetna in that they cannot issue exclusionary riders since they are not a PPO, they are filed with Florida as an HMO and then they issue POS riders on their contracts to make them act much like a PPO in the sense that you do not need referrals for specialist visits, national networks, etc.  The two plans I think you should especially consider are the Premier 5000 plan and the 2500 deductible plan options.  Although a higher maximum out pocket potentially, the premiums are lower with the rate increase considered and the plan is quite robust.

AARP 1250 Deductible Premium and Benefits

AARP 2500 Deductible Premium and Benefits

AARP 5000 Deductible Premium and Benefits

AARP Health Insurance Brochure

Take a look and let me know what you think; and the Preventive & Hospital Care I included since they are the most competitively rated and may meet your needs as well – at least I thought it was interesting.

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