Health Insurance That Is Not Recommended
There are numerous types of policies that someone can find and purchase that cover or claim to cover health-related expenses. When searching, you will likely come across qualified health insurance plans and other policies that seem like health insurance. Understanding the difference between these can help save you from expensive medical bills when using the plan. Unfortunately, many of the people that enroll in health-related policies that are not actually insurance end up finding out the plan will refuse to pay for any claim that you submit. This also tends to happen after you have already paid months or even years of premiums to this company. Since these plans have no regulating body and are often sold out of state, you have no recourse for the cost you paid for the plan or medical bills you now owe. All legal health insurance plans have a state governing body. This division reviews the plans and is a resource to use in case the plan is refusing claims. Here some ways to spot scam health insurance that is no recommended by our office.
They Claim to Cover Every Doctor in the U.S.
There is no health insurance plan in the United States that does this. Even Medicare, which probably has the largest list of contracted doctors, does not cover every provider. All health insurance plans have networks. Within these networks are doctors that have agreed to work with the plan and only charge you a certain amount. If a plan does not have contracted providers, the provider will charge you the street rate for your visit. This is generally much higher than a negotiated rate. It also is often the reason for these scam policies to deny a claim. The excuse they use is the price for the service is outside of the usual and customary amount. What this really means is the doctor is charging too much and the company won’t pay because of that.
Drastically Reduced Prices
The price to purchase health insurance is not cheap. This is certainly a hot topic right now in political debates. While there are a lot of discussions about change right now, the current insurance plans in the market today cover all qualified medical services. The plans also provide you with financial protection. For this to be even financially possible for a business, they must charge you a certain premium to have the ability to pay claims in the event of these catastrophic medical situations. If the plan you are considering is only costing you $50 a month, stop and ask yourself how it would be possible for the company to pay a $50,000 hospital bill by collecting such a small amount. The reason these companies can charge you so little is that they specialize in denying claims.
No Out of Pocket Maximum
The maximum out pocket amount is what protects you financially in case of an extreme injury or illness. In 2020, the most that amount can be is $8,150. If you pay this much in medical expenses during the year, you will be covered for all remaining expenses until your plan renews. Scam insurance policies do not have this. In fact, the policy will have a Calander Year Maximum or something similar. This will be the total amount of dollars that the company will pay until they can stop paying claims. Although you will most likely never get close to that amount in claims paid, that number is there to protect the business, not you the consumer.
There are many other ways consumers can be tricked into buying junk insurance plans. If you ever have questions about a policy or need help, a health insurance broker is a no-cost resource to consult. Our office can discuss how insurance plans should work. We can let you know if the plan you are considering is a legal health insurance policy. We also do not charge fees and you will always pay the same amount for the plan that you choose.