THE TOUGH CUSTOMER- Buyer beware: Understand what 'medical discount plan' means
I received a call recently from Jean DeMarco about the medical discount plan she purchased in April from an Arizona-based company called Easy Life Health Care.
The plan caught her attention because her health insurance, through her husband's employer, recently changed to a high-deductible plan, meaning it required up-front out-of-pocket costs that left DeMarco feeling like "I can't go to the doctor."
Medical discount plans are not insurance plans. A health insurer agrees, for a premium, to assume responsibility for a portion of your medical expenses. Medical discount plans, on the other hand, grant access to a network of providers who have agreed to give participants a discount on their services, but the plan itself assumes no liability.
In their marketing, however, these plans use the buzzwords of insurance plans, such as emphasizing that there are no co-pays or deductibles to worry about, and pre-existing conditions are not a problem– and that can cause confusion. Among other things, regulation tries to ensure that health insurers comply with the terms of their policies and have sufficient reserves to cover claims when policy owners are in need of help.
"These plans may seem like health insurance sometimes, but they're not regulated," says Jim Ware of the State Corporation Commission Department of Insurance. In other words, consumers will receive no more or no less protection than in any other commercial transaction, although with health care the stakes could not be higher.
"Some medical discount plans claim to provide big discounts from hundreds of providers for a wide range of services, from doctor visits and dental exams to hospital stays and prescription drugs," the U.S. Federal Trade Commission warns. "But many plans fail to make good on those claims."
That's what allegedly happened to DeMarco. She signed up for the Easy Life plan at a cost of $80 per month, charged to her credit card. The telemarketer who sold the plan promised DeMarco she could use any medical professional she chose at a discount, even her current physician– just, ahem, what the doctor ordered for DeMarco, or so she thought, until she met her high deductible.
When DeMarco finally tried to use the service, however, she found out, first, discounts are offered only by certain in-network doctors, and second, there is not an in-network doctor within 100 miles of Charlottesville.
DeMarco immediately tried to cancel the plan, but this was easier said than done. The company's customer service department did not answer its phone. After a second month's payment was charged to her credit card, DeMarco canceled her credit card.
DeMarco then noticed in Easy Life's literature the mention of another company, Careington International Corp. It turns out that Easy Life is a marketer for Careington's plans, so she called them and they put her in touch with Easy Life. Still, the company refused to do anything.
That's when DeMarco called me.
The next day, before I had even a chance to do anything, DeMarco called again to tell me she had heard from Kris Virgin, Careington's Director of Licensing and Regulation, who called Easy Life's marketing representations "unacceptable," and said Easy Life would be refunding all DeMarco's money. So far, she has received one-half, or $80.
It appears to be working out for DeMarco thanks to her own persistence, and perhaps a little luck. And Careington deserves credit for standing behind its product.
But more seriously, when it comes to health care, a word to the wise. Before shelling out any money, be sure what you're getting and with whom you're dealing. Once you're actually sick, learning that you don't have what you thought you had will be no laughing matter.
If you're uncertain, get in touch with the Virginia Department of Insurance. You can find contact information at scc.virginia.gov/division/boi/webpagesboiconsumer.htm-contactus or call toll free 1-800-552-7945.
7 comments
Let me first introduce myself...my name is Schad and Im the sales manager for Easylife Healthcare. I just happened across this article. I am quite familiar with Jean DeMarco as I was the one who approved the refund she received. Not because she was lied to, but because she was unhappy. We pride ourselves on the satifaction of all 7.3 million customers we have to date. We understand that our plans are not for everyone. We also know that we cant please everyone all of the time. Although we try awefully hard. There are several statements in the article above that concerns me. I would like to take an opportunity clarify a few things. Pleas do not take this as an attack on Jean or those that wrote and submitted the article above, thats not my intention. It is true that we are not an Insurance company. We NEVER claim to be. In many ways we are better. We do boast that we have no co-pays or deductables. Why? Because we dont. We do accept everyone...pr-existing doesnt matter for us. Can your insurance company provide you with that same service for under a $1000 a month? I think not. Can you give me a name of any insurance company in the world that "...fail to make good on those claims". Again, I doubt it. I find it odd that the Jean stated that she had to reach a high deductible. As the article states we have NO deductibles. In responce to Mr. Jim Ware's claim that our customers will receive no more or no less protection than "...in any other commercial transaction..." I challenge that. I can provide documented proof refuting that claim. Can he do the same...again same answer, I doubt it. Jeans claim that there are no providers within a 100 miles radius is absolutely preposterous. Jeans zipcode is 22963 and the web address for our provider search is; http://www.careington.com/search/search.aspx?agentcode=ADCH6662CI . I challenge anyone and everyone, after doing the search yourself, to claim that we lied about our network of doctors. As your claim above states that "Some medical discount plans claim to provide big discounts from hundreds of providers...". That may be true for some of the smaller less reputable companies, but Easylife Healthcare uses the LARGEST provider network in the country. Over 950,000 providers from the Atlantic to the Pacific. This is the SAME network that the MAJOR Insurance companies use. No matter where our customers are we have providers there to help them. On vacation, moving to a new area or state, or just crossing the street, there will always be a provider there for them. Speaking to Carrington, I learned that the upper Executives would NEVER speak with a customer about a complaint. Especially one for $80. Not saying that each complaint is not worthy of of that type attention, but... thats why the Customer Services Dept. has been put in place. To handle those calls. Im not saying that Jeans concerns are not valid. With as many customers that we have, sad but true, some fall through cracks. We do our best to accomidate the customers needs, but sometimes thats not enough. There is not a single company out there, insurance included, that can make every one of their customers happy all the time. We're no ecception to that rule. In closing I would like to ask all those that may read this to do your due diligence before crucifying anyone, person or company a like. There are ALWAYS to sides to every story. Not all companies out there are out to scam and rob people. There are those that have the best intentions, that has the customers well being first on the list. In closing... Are there Insurance Programs out there that are better than what we have...Sure. Are there programs out there that cant hold a flame to ours...Absolutely. This program is best suited for those people that have been turned downed time and time again due to a pre-existing, or they simply cant afford issurance. I dont know about you, but I have yet to hear of an Insurance company that has dropped their rates. In fact they continue to raise their rates annually. You may be able to afford it today, but wait... They will dig deeper and deeper! We are for the 45 million people nationwide that cant afford or get approved for Insurance. They should NEVER have to pay 100% out of pocket for benifits that we as Americans deserve! If you would like to contact me, I have left my email address. I welcome your comments and concerns. By reading this, I thank you for allow me the opportunity to give our side.
Dear mr. schad, I recieved a call from some group associated with carrington insurance. My concern is that they want you credit card info right away even tough I asked them to send me some paper work on the company but they wouldn't do it becuase people would think it's junk mail and throw it away. Sounds kind of fishy to me. I will continue to do research on you guys. Can you send me any other info about your company in my email?
I received a robocall regarding easy life healthcare and shortly after Crystal W. got on the line. She explained the Ultra plan to me that included all the health care one person would need with no deductible, no copays, no waiting period and no pre-existing conditions. I told her this was too good to be true and it could very well be. I asked her for the website address (easylifehealthcare.com) and she provided it. I pulled it up on my computer and looked at the fine print located at the bottom of the webpage and noticed Careington International as the parent company. There are 3 kinds of health insurance in the U.S.: First, group health, the one your company pays for and you get a discounted rate. Second, private health, the one you pay full premium for you and your family. And third, the indigent person insurance which is the best out of the 3 since there are no premiums, no deductibles, no copays or waiting period. You just show up at the emergency room and by law, you have to be treated. Heck, you don't even have to be an american citizen to get this insurance. I knew a guy once who was on welfare, section 8 housing, food subsidies, etc.. He got a tooth ache and headed straight to emergency at the hospital. He was treated just as well or even better than anyone with comprehensive insurance. The problem with self-pay private insurance is that it is so darn expensive. I'm paying $547 per month and I don't even use it at all. It's just for peace of mind. When I do use it, I have to satisfy a $250 deductible and come up with a 20 percent copay per doctor's visit. If I sound frustrated with the status of health insurance in our country, I urge you to watch the movie "Sicko" by Michael Moore, and you will realize the point I'm trying to make. I almost packed up the house and moved to France after seeing this movie. Please allow me to be blunt: insurance companies are motivated by profit and greed. They are powerful entities with powerful lobbies in Congress. Why didn't Hillary Clinton's national healthcare work? Getting back to Crystal M. and the subject of easy life healthcare, I realized during our lengthy 40 minute conversation that to have no deductible, no copay, etc., the actual doctor's visit would have to be discounted in order for this type of insurance to work and that is exactly what it is. I checked my doctors and they are in network. I also noticed their extesive continental provider network so I'm covered where ever I go. I signed up today for $194.95. I'm convinced that discount healthcare is in our future and if you are not sure, I suggest buying a catastrophic policy just in case, or for peace of mind.
It's sad to see so many people falling for these scams that are out there.
First and foremost the service that they are selling the public, the public already has for FREE. IF YOU DO NOT HAVE HEALTH INSURANCE AND YOU GO TO THE DOCTOR THEY WILL GIVE YOU THE SAME DISCOUNT IF YOU PAY THE DAY OF THE SERVICE. This is a courtesy that doctors and facilities like to give there patients because it saves them money on billing.
Think about it, These so called "Discount Plans" will tell you that you MUST pay your portion at the time of your visit IN ORDER TO GET THE DISCOUNTED PRICE!! SEE YOU'RE PAYING THE PLAN A PREMIUM FOR A "DISCOUNT PLAN THAT YOU HAVE ACCESS TO FOR FREE. Another thing that the public should be looking at before purchasing plans is either go to the "DEPARTMENT OF MANAGED HEALTH CARE" web site and go to "LIST OF ALL LICENSED PLANS" If there name does not appear they are not a legitimate plan. Even if they are a "discount plan" they must be licensed in the State that they are selling to. Don't take my word for what I have just said, call the "Department of Managed Health Care" yourself and ask them, I did and that's how I found out.
I worked at EasyLife HealthCare they are a bunch of scams, when they hire you, they hand you a script and tell you when the phone rings answer it and sell them the program say and do whatever it takes to get the sells. They treat their employers like crap always yelling and cussing at us. I recommend no one to associate with them i the near future or even corevington itself, because they knew how EasyLife Healthcare was selling there insurance.
I see there are some warnings against using disparaging language on here. Is it okay to use the word "disingenuous"?
If so, then Schad's 800-word defense of EasyLife is disingenuous. Consider
Schad states:
We do boast that we have no co-pays or deductables [sic]. Why? Because we dont [sic].
Now what is a deductible? It's the amount that the insured must pay before the insurance company begins paying anything. Since the Careington policy pays nothing regardless of the amount due, it's the same as having an infinite deductible. But then again, it's the same as having a zero deductible. It's just nonsense to talk about a deductible if there isn't any coverage.
What is a co-pay? That's the amount that the insurance company doesn't pay, and the patient or insured is required to pay. Since the insurance company doesn't pay anything, the co-pay is 100% of the charges.
So whether you call these statements outright lies or merely deceptive statements, the effect is the same.
I'm all in favor of free speech, and Schad's statements ought to stay on here, but there should be an obvious visual indication of the fact that his statements are not trustworthy. Maybe a picture of Pinochio next to his post would get the point across.
Careington/EasyLife Health Care's numbers just don't add up. The savings they promise are unrealistic and not real world numbers. Their BBB logo with an A+ rating is for a subsidiary with only 1 complaint. It's just too good to be true and unfortunately, it's not true. They are a scam company, pure and simple.