Core Value Medical Plan review: Failure to service bad policy 8

It's 'insureme' again. I want all of you to understand what you need to KNOW before purchasing a policy! First of all, do your due diligence. All of these type plans MUST STATE CLEARLY ON THE APPLICATION, 'THIS IS NOT HEALTH INSURANCE' - Believe it or not, that plan has it, but most consumers overlook it because they trust the agent 100%. All agents aren't bad (I know I'm not), and some don't even throughly understand themselves what they are selling because they count on the fact that they understand more about insurance than you do. Insurance policies are LEGAL DOCUMENTS drawn up by lawyers. They are legal. Most companies operate legitimately, but you will always have some that won't. Now, I am going to give you some valuable advice from the inside. The woman mentioned pregancy. Most major policies WILL NOT COVER A PREGANCY unless there is a medical risk involved. You have to purchase a pregancy rider, or SEARCH for a company that will cover pregancy specifically! You may also (and listen CLOSELY TO THIS) be able to purchase a life insurance rider when you take out insurance that will cover you when you cannot work (esp. for disability), and guess what, it's CHEAPER TO TAKE IT OUT THAT WAY! If you are still in your working years, take out a TERM life policy and include a disability and critical illness rider. Some of those riders can cover you just like long term care, and make sure you get 'An accelerated benefits' rider on life. That means that if anything happens to you, the life policy will pay out (usually 92%) of the face value EARLY BEFORE YOU DIE when you really need it to pay hospital bills or just bills for living day to day. On health insurance, NEVER, EVER, NEVER, NEVER buy a policy that says, 'LIMITED BENEFIT' on it because you are asking for trouble. That is what the policy you are discussing is. Always ask for a 'MAJOR MEDICAL' POLICY. If your benefit amount is not in the millions of dollars, you are screwed. Because think about it, 50k may sound like alot, but you can hit that before you ever even have a major surgery. If you cannot afford MM, then your next best bet is a Risk Pool (if you have a major health condition), if not, then look at indigent care because ALL hospitals will work with you on a sliding scale and don't take 'no' because they all get gov't funds for people that cannot pay the bill. Use community clinics, you get the same care (usually from the same hosp), but if you have health ins, you will not qualify. Just remember before you sign for a 'limited benefit' plan (that usually won't pay hardly anything anyway), if you become REALLY ILL, you will end up going on Medicare early (you don't have to be 65, you can be under 65 and STILL GET MEDICARE (DUE TO DISABILITY). If you don't qualify for Medicare, they will give you MEDICAID, so either way you will be covered. If you do not qualify, take the little you can afford for a premium, ck out the community health centers, ck out mobile screening labs for annuals, and High risk pools for everyone with serious illnesses. You will be a lot healthier and definitely happier financially! God Bless you all!

Sallyshell50;

I have it set to notify me when there is a comment related to this insurance. All states are supposed to have a risk pool now. I found this for you (Tn. got it in 2006) The info below is from a google search, just put in "Tennessee health insurance risk pool": (good luck!)
Tennessee Risk Pool - Health Insurance for the Uninsurable
Risk Pool Name / Acronym AccessTN. Insurance Regulation Establishing Risk Pool Established in 2006 as part of Governor Bredesen's Cover Tennessee program.
www.healthinsurancefinders.com/.../tennessee/risk-pool.html - Cached

. We have been paying for this ins. for about 2 yrs. and lucky we have not had to use it. The complaint i have at this time is, i have tried to get ins. cards. We have yet to get one. I have had a bad feeling about this Co. from the get go. I only wish i had checked CVM Co. out a long time ago. I have learned a valuable lesson today. Thank all of you for posting your complaints. And to insureme, i'm trying to find out if Tn. has a risk pool. No luck yet. I have called Commerce & ins. but so far they can't tell me anything. I have to call them back in the morning. If anyone knows how to get the info about Risk Pool please post it and i will follow up on it.

anything related to AMLI, American Medical and Life Insurance Company is really bad news. Might as well just throw the money out the window cuz this company is rated B- by AM Best and you don't but insurance from a B- company. Ooops, I forgot to mention all the states that have won lawsuits against AMLI for defrauding the public.

I'm not sure about the claim payments (haven't heard anything from my doctors office yet...?) but I am one of those who could not qualify for a major medical plan in my state due to a pre-existing pregnancy and the broker sold me this plan as the only option. They have the worst customer service I've ever dealt with - try calling the number on the medical card and see how many times you get transferred and if your question can ever be answered. I couldn't get a simple question answered such as "how much will you cover for an ultrasound?" Also when I called to inquire about cancelling the plan once my company insurance became effective on the 1st, I was told I should cancel retroactively that way I'll be covered through the 1st if needed and wont' have to pay for the additional half month after the 1st that I did not need. Now when I call I'm told that's not possible. Also it took DAYS for the doctor's office to even realize they accepted this type of insurance - don't be fooled when they tell you they are part of a national network - NO ONE has heard of these people. Warning to anyone else who is in the same boat I was: my old health insurance via a major medical plan would have covered the pregnancy if it was "high risk", which now in retrospect I realize I might have been covered under due to my age (39), so I didn't actually need so switch at all I just did so in a panic. Talk to your doctor before switching insurance!

hope this helps!
I was an agent who sold these plans. When I first started out, I really didn't understand what was realistic amounts for a health ins plan (since you are young with no health probs, 20-50k for example sounds really good & like it would be enough coverage ). As time has progressed however, I stopped selling these plans because I'm now contracted to sell Major Medical plans. The prob is most of the people that get these 'limited benefit plans' cannot qualify for Major Medical due to health reasons (all the more reason we need reform in healthcare!).
Hopefully this will help all of you: Most states now have what's called a "RISK POOL." The ins companies will never tell you this because they do not make a dime off this (and neither do I as an agent). These risk pools offer major medical insurance or people who otherwise could never qualify with insurance companies for major medical. These risk pools are overseen by either the state or the federal gov't for each respective state.
I did not write very many of those limited plans because they always made me feel uneasy, but at the time, it was all I could offer anyone who could not be approved any other way. I was always checking to see if the risk pool was offered in my state (which it was one year ago). At that time, I notified everyone I had written one of those plans for to let them know that they NEED TO JOIN A RISK POOL! Believe it or not, most haven't done so (because it cost somewhat more, but it is so worth it because it is Major Medical, and I do not earn one penny in commission, insurance agents do not write these policies, they are written by the state).
I no longer write these plans at all since the risk pools are in my state, and I am glad I don't. I hope this info will help those of you needing a plan, or if you have one of these plans, drop REAL MM cov. BEFORE SOMETHING BIG HAPPENS! GOD BLESS YOU ALL!

This is so true. I have submitted my claim on 4 different occassions, and I still have not been given a statement of benefits. I called and spoke to a representative who told me they received the claim, only to call back 30 days later to check on the status at which point I was told that they did not receive the claim after all. This has happened twice, and then they keep calling me back to tell me they require additional documents. Now that I have provided everything, they keep denying that they received the claim, even though I have numerous email and fax confirmations to the contrary. This company is a scam artist - do NOT make the mistake of paying any premiums or doing business with them. You will not receive your benefits.

We are having the same problem with Core Value Medical - it is an absolute waste of money - - we have paid hundreds of dollars in premiums and have yet to have the first claim paid. When I threatened to turn them into the Insurance Commission - I was told well you won't be the first one to do it.