The Experience of a Single Mom:

Two months ago I switched health insurance carriers due to changes in my occupational and family situations. As a healthy, young, non-smoker with two young children; I did not expect to have a difficult time acquiring the needed coverage for myself and family. Though not extremely familiar with the ins and outs of the health insurance business, I am fairly computer savvy; so I felt competent in my abilities to investigate health insurance carriers and benefits. After looking at the popular carriers in my state, I decided to go with a specific carrier by applying directly with the company via an online application process. A nurse called the next day to confirm the information, and the following day I was approved to receive the coverage I selected for the agreed upon monthly premium.

Easy, right?

Yes, until I needed to use the policy. I have only one reason for needing specific health insurance coverage…a reoccurring, monthly prescription. Every month, I have a generic prescription filled that costs $160. Quarterly, I visit my primary general practitioner for a check-up concerning this medication. I do not have any other health concerns outside of this one prescription. I have taken this medication for two years now, and I disclosed this as the primary reason why I wished to obtain health care coverage when I submitted my application.

When I spoke to the nurse or received an email explaining my benefits package, did anyone speak with me about the possibility that the one health care concern I had, may NOT be covered? No.

When I went to get my prescription filled the first month under my new health insurance plan, was I informed that I had a $200 prescription deductible that needed to be met before the benefits would allow me to pay the $10 prescription co-pay, upon which we agreed? No.

When I called the carrier to verify that a $200 prescription deductible was really a valid part of my plan, did the representative explain that the prescription I need filled is not covered by this carrier at all? No.

So, after paying my initial premium, $160 for my prescription, and my next month’s premium; I found myself at the pharmacy the next month requesting my filled prescription expecting to pay the $40 to fulfill my $200 prescription deductible…only to hear, “That will be $160.”

WHAT?!

Sur-prise! Sur-prise! Sur-prise!

Again, I have to call my insurance carrier; but this time the representative tells me that the prescription medication I require is not covered by them on any plan available nor do they cover any circulatory system medications or any maternity costs (my medicine has nothing to do with these health issues, by the way). To which I respond, “Ok. So when I called in last month about this same prescription, you guys couldn’t explain this to me then? Instead you led me to believe it was not covered simply due to an unmet prescription deductible, which was also not disclosed when signing up for this plan? Ok. I see.”

Am I dealing with Barney Fife? Though I cannot deal with the incompetence displayed by this company (a.k.a. Barney Fife), I began to wish I was in Mayberry! At least then, Andy Griffith would walk in, realize the discrepancy found between the service I have received and the service I requested and for which I paid, and rectify the situation. What happened to a society that truly cared for the person rather than the profit? What happened to honesty and integrity in the business world? Where was my Andy Griffith?

It was then that I knew I had to find someone to help me decipher the health insurance maze. I immediately called Richard Monello (a.k.a. my Italian Andy Griffith), a local health insurance expert, to help me find the best health plan with the most reputable carrier for the most affordable price. Richard is the founder and CEO of Custom Health Plans, Inc. located in Plano, Texas. He immediately understood my frustration, identified my health care needs, and sent me price and plan comparisons from the leading Texas health insurance companies. With his personal assistance, I have now not only found a health care plan that provides the coverage I need at an affordable price (I have a better plan and am saving $75 a month!); I now have a personal health insurance representative that will haggle with the insurance company if I ever have another problem concerning my benefits and coverage.

What did I pay for Richard’s services? NOTHING! The insurance company pays him, and I receive a better suited plan at a cheaper price!

Sur-prise! Sur-prise!

So what are you waiting for? Call Richard Monello today at Custom Health Plans, Inc. 877-749-2241 or locally for those in the Dallas/Ft Worth area at 469-361-4032, or go to the website at www.customhealthplans.com. I assure you that you will receive quality service with the respect and the friendliness found only in old-time TV shows!

What would you do if every time you went to the grocery store to gather the essentials you need for you and your family, you had no idea how much it would cost once you checked out?

What if you were told that the milk in the blue carton had a regulated cost because it was produced locally (in-network); but the only milk available was in the red carton, which meant the price was unregulated (out-of-network)? You are left with a decision…not purchasing milk could ultimately damage your health, but purchasing the red carton milk could devastate you financially.

What would you do if, when checking out at the grocery store, the names of the items you purchased were written in a language unknown to you with random, previously unknown prices attributed to each item? How would you know if you were receiving a quality product at a reasonable price?

In situations when the consumer is unsure if the quality of the product is worth the cost, the individual will shop around to get the best quoted or advertised price for the item/work needed. When your car begins to make a noise or not operate properly, most people take the car to different mechanics to determine the nature of the problem and to receive a quote on what the cost will be to fix it. However, if your car breaks down on the interstate, you will most likely take it to the nearest mechanic in order for it to be drivable again (because we all know that towing charges are expensive, in and of themselves).

Yet, when it comes to health care, we do not usually know exactly what we are purchasing or the costs of the product(s), Sometimes we don’t even know if we need the product or what the product is that we are purchasing. So how can we shop around for the best price? When the price of an item is known, one can determine if the item or service is needed or affordable, but when the entire process is elusive, how can the average consumer know how to negotiate or to navigate within the Texas health care system?

Though the Healthcare Blue Book (www.healthcarebluebook.com) is a helpful resource for identifying average prices in your area concerning non-emergency medical services, the problem that most people have concerning health care costs centers on the costs incurred when emergency medical services are needed. As with the car scenario mentioned above, a person is not going to shop the price or even consider the possible costs of medical care in the case of an emergency.

So how can you best prepare for these types of expenses? How should you budget for health care costs? What should you expect to pay? How can you know if your current health care plan is a lemon?

By contacting a licensed Dallas health insurance expert at Custom Health Plans at 877-749-2241 or locally for those in the Dallas/Ft Worth area at 469-361-4032, or go to the website at www.customhealthplans.com; an expert can teach and guide you through each step of the process with no extra cost to you. Utilizing a personal representative allows you to take charge of your health care needs and find a plan that will work within your budget. A health care expert can share with you about the possibility of setting up a health savings account and why one could benefit you. Finally, a Custom Health Plans representative can discuss ways to shop health care costs, to negotiate health care spending, and to navigate the health care system. Let us make sure your current plan is not a health care lemon.

The Kaiser Family Foundation recently discovered that Texas has the most uninsured women in America, according to Mann (2009) with The Texas Observer. This information may not be that surprising, since Texas is known for the highest uninsured population in the country. 28% of Texas women are uninsured due to the rising costs of health care and the indisputable fact that women still get paid less than men. What is even more alarming is that over half (52%) of all low income women in the state of Texas are not insured (Mann, 2009)! With no other state even reaching 45^th percentile, this statistic is alarming!

Mann (2009) goes on to explain that this lack of health insurance coverage is correlated to increased health issues in the lives of uninsured women. Due to the lack of preventative care and expensive medical treatments only females require (primarily concerning pregnancy and childbirth), women seem to be discriminated against when comes to establishing health insurance benefits. When did being a female become a pre-existing condition that ultimately increases premiums and health care costs?

What about the children of these women who are mothers? Are uninsured mother’s establishing health insurance for their children? I would assume that they are not; therefore, there is an entire population of women and children in Texas (especially those with low incomes) who are uninsured.

Texas is known for the pride of its citizens. Yet, with evidence stating that Texas is the home of the most uninsured women in America, I question where are we are placing our Texan pride? If the health of these women (and most likely their children) is significantly correlated to whether or not they are insured, then I believe it is of primary importance that these women find an affordable Texas health care plan to enrich their quality of life.

So, what can you do to help?

You can direct those you know who are in need of expert health insurance advice to Custom Health Plans, Inc. A personal health care representative will find a plan that will work within their budget with no cost to them. Even if a health care plan is already in place, a Custom Health Plans representative can discuss ways to shop health care costs, to negotiate health care spending, and to navigate the health care system.

Who knew that directing someone to a health insurance expert could be considered as conducting a community service?

Contact a licensed Dallas health insurance expert at Custom Health Plans at 877-749-2241 or locally for those in the Dallas/Ft Worth area at 469-361-4032, or go to the website at www.customhealthplans.com

Mann, D. (2009, November 13). The Texas Observer. The unhealthiest among us. Found November 17, 2009, at http://www.texasobserver.org/pi/the-unhealthiest-among-us

Tis’ the season for employer-sponsored Texas health insurance programs to offer open enrollment. Should you consider changing your current health care provider?

What is open enrollment?

According to National Association of Insurance Commissioners (NAIC), open enrollment requires insurance companies to accept anyone who enrolls in a health insurance plan during this time “without underwriting or evidence of insurability.” Due to the availability of coverage offered, it could be the perfect time for you to re-evaluate your current Texas health insurance coverage.

Should I go hunting?

When deciding on a health insurance carrier, the NAIC suggests that one needs to investigate the in-network doctors and hospital affiliated with each carrier, evaluate if your spouse and/or children can be covered, check for pre-existing condition exclusions, check prescription clauses, and read thoroughly through the coverage agreement.  Imagine how much time that could be spent searching for that perfect plan?

Who has time to do all of this?

No one has time to check all this information on all the possible carriers and plans available in order to decide whether or not change their health insurance benefits.

So what should you do if you decide to go hunting this health insurance open season?

You should contact Custom Health Plans, Inc. We have licensed health insurance experts who want to guide you to the best Texas health insurance coverage at the most affordable cost by calling us at 877-749-2241 or locally for those in the Dallas/Ft Worth area at 469-361-4032 or visiting us online at www.customhealthplans.com.. Let one of our personal representatives help you take control of your health care decisions by explaining the many options available to you in this ever-changing climate of health insurance modifications. We are here to help you by tracking down the best plan for your family, all while saving you time and money. Call us today or visit our website at www.customhealthplans.com

Reference:

National Association of Insurance Commissioners. (n. d.). Health insurance open enrollment: Choosing the best option for you and your family. Found on November 12, 2009 at http://www.naic.org/documents/consumer_alert_health_insurance_open_enrollment.htm