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[Botany]

This message was self-deleted by its author (Botany) on Fri Nov 15, 2013, 07:38 AM. When the original post in a discussion thread is self-deleted, the entire discussion thread is automatically locked so new replies cannot be posted.

[Botany]

2. "The disastrous Obamacare roll out" is a right wing and media talking point

=

[alcibiades_mystery]

31. From what I understand, it is also frequently used by some (predictable) DUers

Luckily, I have all those folks on ignore, so I only see the reference second hand!

[wercal]

3. I'm a little confused by the link

It appears to be a PPO club network...can I ask which state/county this is in?

[BlueStreak]

4. Please ignore the OP. I have been told that healthcare.gov is completely broken :)

and won't be fixed for a month. And this, I heard from Ed Shultz, Kathleen Sebelius, and Barack Obama. So clearly the OPer is uninformed, perhaps suffering from some delusional experience brought on by lack of health care. It isn't possible to use healthcare.gov until December.

(I'm being sarcastic of course. I'm glad to hear you are getting what you need. Healthcare.gov has been working rather well for me the past 2 weeks. I renewed my old policy, but I can cancel that at any time. I may still move to an ACA policy before March. I am waiting to get more clarification on the income rules, as I am in an early retirement situation with a strange-looking 1099.)

[pangaia]

5. I just looked at the benefits.

Choosing Plan 2 as a median.
Just these three items--often the BIG ones..

ICU - $500 daily for up to 5 days
ER - $150 1 day per year
Surgery - $20 - $2000 -up to 3 surgeries/year.

If I am reading the benefits correctly- if anything serious happens you are in big trouble.

ICU will be way over $500/day.

ER- I don't know of any ER service that costs that little. If you are in a car accident? BIG bucks..

Surgery - $20 ! even $2000! I had spinal surgery last year-- $40,000+. ( I have Medicare)

Even Plan 4 is barely any better and you pay a LOT more for it.

Please tell me I am misreading this, for your sake.

ON EDIT: I am assuming the premiums, "dues," are monthly. But even if they are yearly, not much coverage.

[Botany]

7. the coverage is much better then that.

example I will have a $100 deductible expense for a trip to the ER but that
will be waved if I am admitted to the hospital.

[Flatulo]

10. OK, so they waive your deductible if admitted. But their benefit is only $250 per day in

the hospital, whereas average cost across the US is $2000 per day. You'll still be on the hook for $1750 per day, and limited to 30 days at that.

Likewise, anesthesia is covered at 25%. Did you know that this can be as much as $10,000?

You'll go bankrupt under this plan if anything actually happens to you.

Please tell me I'm completely getting this wrong, as I would hate to see someone sold such a crappy policy.

[Botany]

11. I'll double check it but I asked about much of this with a rep from the company today

n/t

[pangaia]

19. I agree with Flatulo

I spent hours, days, weeks, months studying health plans in the few years before I turned 65, and then again when I needed to find insurance for my wife AFTER I turned 65.
I saw many plans like that. What I learned well was exactly what to look for.

I would say your plan is.....worthless.... unless nothing happens to you.
Please, please check into what medical costs REALLY are. THEN go back and look at your benefits.
You're getting fooled.

An MRI can run, oh $9,000 $13,000, somewhere in there. I've had them- Even PT Scans are big $$-- which is of course based on what hospitals call ..rats, I forgot the name.. it basically means 'fake list price.' Ah- 'Charge master.'
No insurance company will pay that, of course. but you get my point.

[Botany]

21. I have not signed up yet ..... I still have coverage w/another company

But I just got off the phone w/ a sales agent who kept telling me about
P.P.O. "re-pricing" where the Dr. or the Hospital will just take 40 to 60%
off the top of any bill and then their insurance will cover the rest w/no
problems.

[pangaia]

24. Right-O.

Can I sell you a bridge. :&gt )
Sales Agent... ooppsie.

Seriously, we are all on your side, here.
You came to the right place, the Official D U Health Insurance Advisory Panel.

[Sgent]

34. Somewhat true

A negotiated price from a PPO cuts 20-95% off of your bill (I've seen some labwork go from $300 to under $5).

That being said, I recently had an office visit that the negotiated rate from BC/BS (which is much better than Multiplan's PPO) was $1,200 including labwork and a few tests (not MRI). This insurance would have covered the first $65 of that, and only 3 times per year.

This insurance would be fine assuming your usually health and can't use a savings account, it might even be ok if you need to use the ER occasionally (although you'll get hit with a bigger bill than expected). It will bankrupt you if you develop a serious disease or have a real accident.

[Flatulo]

36. I don't know what your E/R experience is lately, but a 10 minute visit for antibiotics will run

over $3000 here in MA. I know this first hand from when my own doctor sent me to the E/R based on the symptoms I gave him over the phone on a weekend. That's no labs or bloodwork, just an examination with an MD and a prescription.

[Sgent]

37. I was looking

at the coverage for an office visit -- its somewhat more generous for an ER visit.

For a level 1 OR visit with no labs or tests, $2,000 - 3,000 sounds like a charge master rate. I imagine the negotiated price is $400 or so, maybe $600 in certain circumstances.

[Whisp]

6. Happy for your good news, Botany.

Everyone needs some stress relief and I consider ACA is going to be a great stress reliever for many. Less worries and more smiles.

[Flatulo]

20. Unfortunately, this plan is a scam and has nothing to do with an ACA policy.

These 'network insurers' are multiplying like rats to take advantage of, and even masquerade as, real insurance plans. Look at his schedule of benefits. They pay almost nothing.

I had a feeling these kinds of parasite 'insurers' would start to multiply.

Fuck, just when I thought that people couldn't sink any lower.

[ProdigalJunkMail]

25. the limitations and exclusions

along with the 'benefits' should make this plan now illegal...

sP

[Whisp]

30. oh no... that is horrible.

I hope Botany can get out of it or something.

[Flatulo]

8. Looking at the plans you linked to, they're actually pretty awful. Is your link correct?

Plans like this are illegal in Massachusetts.

[HoosierCowboy]

9. What the MSM isn't telling people

The Federal Website is for people who live in States that didn't sign on to a state health exchange. Those particular States are for the most part TeaBagger influenced, who are now paying the price for being thickheaded and not creating their own system.

Sorry for the people that are having trouble signing up, but they really should put the blame for their predicament on their state officials.

The exchanges in Nevada and California are running smoothly even according to the MSM.

As for the Federal Exchange I am reminded of the statement of Buzz Aldrin who upon landing on the Moon said something like "Here I am on the Moon, sitting in something that was built by the lowest bidder.."

[progressoid]

14. Uh, not exactly.

Our state signed on and when we try to apply we are directed to heathcare.gov

[Flatulo]

12. Upon closer examination, this site doesn't appear to have anything to do with the ACA.

The Healthcare.gov site should not have even directed you there. This is a small network insurer for self-employed contractors that doesn't even begin to meet the requirements of the ACA. I was offered one of these when I was contracting a few years ago. Their coverage is a joke.

I fear you may have gotten swindled.

[grantcart]

15. +1

[kristopher]

16. yep

http://www.complaintsboard.com/complaints/affiliated-workers-association-c430962.html

[Flatulo]

17. Good find. There's just not enough scorn for me to heap on these bastards who

are taking advantage of the confusion around the ACA to scam people. They should be thrown in jail.

[krkaufman]

39. unfair

Their website is working flawlessly, and *that* is the ultimate factor in determining their value.

[Botany]

22. thanx!

n/t

[oberliner]

13. This plan is actually awful

As others have mentioned, if anything happens to you, you will be wiped out.

[bluestate10]

18. Good for you. 50% on Dental is ok, you and your son will get two checkups

per year each, spaced 6 months apart for each of you. Depending upon where you live your 50% may run to about $100 per visit, maximum. But will have over $3,000 in savings to pull that $400 maximum from. My guess is that you get free Physicals where you were paying before and your Rx comes at a lower out of pocket expense for you if you use Rx at a specific rate. Overall, looks like you have a financial advantage that came to you.

[pangaia]

23. Me again..

Monthly fees. How could I miss that.
And again as other have said. this is rip off city.


Here are phrases you should always look out for..

" AWA is pleased to offer its members access to insured benefits that help to address their health care needs. ........, the Flex Health PRO membership plan can help you achieve greater cost savings on your out-of-pocket health care expenses.

This means that if this plan is meant for anything than stealing you blind, it means it assumes you have other health insurance and this is just a 'little extra."

It's basically a scam..

THIS is why we need single payer, Medicare-For-All !

[Botany]

26. I just talked to a rep on the phone and she was very very vague about somethings

..... well I still have my crappy and expensive old policy and I'll keep
looking.

thanx!

[pangaia]

28. WHEW!!

We saved your butt !

good luck, and read the fine print...

[CountAllVotes]

32. Wow is right!

My gawd, the thieves are out with very long knives aren't they!?

Glad that there are some folks around here that were able to help you before you ended up in the middle of an even bigger nightmare!

In the meantime, I hope you can find something better for you and your son!

[pangaia]

27. BBB report

Check out the BBB rating and complaints against the underwriting company - Freedom Life Insurance Company of America.

http://www.bbb.org/fort-worth/business-reviews/insurance-life/freedom-life-insurance-company-of-america-in-fort-worth-tx-97111406/

[Botany]

29. Funny I was just there

BBB files indicate that this business has a pattern of complaints concerning sales practices. Specifically, consumer complaints allege they were mislead and the coverage provided was misrepresented. One complaint alleges despite coverage assurances in the sales pitch, the business only paid a certain amount for the procedure and would not cover the cost for the facility or the anesthesia required. The complaint also alleges no co-pay was required when actually the business only covered a small portion of the doctor's visit. The complaint also alleges the business covered most prescriptions, only to find out a small portion of prescriptions was actually covered.

The business responds to complaints by offering refunds to consumers, and stating the consumer purchased a membership with the Affiliated Workers Association (AWA). AWA provides its members with an array of small business solutions, consumer discounts and health programs. One of the health programs provided is a Certificate of Coverage under AWA’s Blanket Group Indemnity Policy underwritten by Freedom Life Insurance Company of America (FLICA). This limited Scheduled Benefit Health plan includes scheduled benefit amounts for specified types of service. The availability of benefits is subject to the definitions, limitations, exclusions, terms and provisions of the Certificate as well as any amendments, riders or endorsements attached thereto. Homeland Healthcare (Homeland) administers the programs provided by the AWA membership.

[pangaia]

33. Exactly, so you can't trust the A- rating because of the way they figure ratings.

It's the reviews and 'product reports' that tell you what you want to know.

[Liberal_in_LA]

35. kick

[grantcart]

38. Because it is now clear that you didn't in fact get an ACA plan but were

diverted somehow to a misleading supplemental plan that has ethical issues, can I suggest that you edit the OP as a lot of people are reading and rec on bad information.

It would be helpful for others to see how people can be mislead by unscrupulous companies.

[Clear Blue Sky]

40. Crap policy

You get a single lump sum payment of $5K for:

Covered Events Include: Kidney Failure; Life Threatening Cancer; Major Organ Transplant; Permanent Paralysis; First Diagnosis Heart Attack; Terminal Illness; Stroke; and Coronary Artery Bypass Surgery

That will cover your first few hours of hospital care. Then you are on your own. Good luck with that...

[passiveporcupine]

41. are you sure

you got directed to this from healthcare.gov? If so, there may be some kind of virus out there that is redirecting some infected computers against their will. This is exactly the kind of plan the ACA is set up to protect people from.

Also...for those states that don't have a state offered exchange plan, the fed govt. provides it.

Am I the only one who feels there might be something fishy going on here? This just doesn't make sense to me. Is someone shilling for this Flexhealthpro plan? Why did the OP even post a link to it?

[SunSeeker]

42. Weird that the OP has not been corrected by now.

Hopefully folks will read the thread and not just the OP.