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US Health Advisors, US Health Group, Freedom Life a very well orchestrated scam, pulling the wool over the eyes of unsuspecting people. The Agents start by saying they have a "no deductible" This is deceiving. The primary plan (Premier Choice) is a Limited Benefit health plan. It pays $75 for a doctor's office visit for sickness. The insured gets 3 sickness visits. The same goes for accidents. None of the providers want this type of insurance. Prescription coverage is a joke. ($35 max for brand name) Same for lab work ($30 max). The Agents will tell you there is an upgrade to "major medical" even while in-claim., subject to a $3, 000 deductible. While true, the agents fail to tell you that when you upgrade, you'll pay a much higher premium (not specified) and that all back premiums must be paid as well. In addition to increased premiums (amount not disclosed) and paying all back premiums from inception, the insured, if he upgrades, must switch to a government plan the first moment it's available. Thus transferring the risk and subsequent claims. For Agents, it's a classic example of greed over fiduciary responsibility. The commissions paid to Agents is enormous. By the way, insureds will not get any wellness visits or immunizations for children. Much of the time, agents omit this or try to "sell you" By the way, the insureds will pay a huge penalty/tax of 2.5% of income in 2016. You will be tipped off by a required membership in an association you’ve never heard of in order to get the insurance. In essence, the insurance policy is issued to the association and the insured is getting a "certificate". This is the loophole that US Health Advisors, US Health Group, Freedom Life. By the way, US Health Group is a subsidiary of Credit Suisse. Agents use this to make it sound more legitimate. US Health Group owns US Health Advisors as well as 2 very small insurance companies, Freedom Life and National Foundation Life. Agents will say that these insurance companies have an A+ rating. This is a BBB rating and NOT an AM Best rating. The AM Best rating is the only rating that matters. Look it up. The rating is "B-Fair" Credit Suisse is now prohibiting the use of their name in marketing materials and agent presentations. (Complaints are mounting) Beware of this Junk Insurance Pre-existing conditions issues. These plans are subject to medical underwriting. They only take healthy people because they do not want claims. Insurance companies have been notorious for telling people that "even though you just found out you had xxxxxxx disease/condition, you no doubt had it before you were insured" In other words, it was 1st manifested before your issue date, therefore all associated claims are NOT COVERED. Do not be fooled by these gypsies in the insurance business.
When I purchased health insurance with USHinsurance, I had to go through a 45-minute interview to see if I would qualify for it! I'm a 54-year-old female with excellent health. I explained to the insurance broker, Jessica Rivera Hoyos, that I only need the insurance for my yearly women's health checkup, which includes preventive mammogram, lab tests and pap smear. I've been paying since October 2022 $460 dollars per month. I just got billed over 1,300 dollars from the in-network hospital due to my yearly checkup.
When I called the insurance, they tell me my plan unfortunately does NOT cover preventive care! I repeat, I specifically explained to Jessica Rivera Hoyos that my yearly checkup is the only time I go to the doctor since I have excellent health.
I do not recommend USHinsurance at all! It would have been cheaper to just have the tests done and pay out of pocket. Very disappointing how they play with people.
I could of told you this. I am a broker but only represent real insurance us health many of the agents are misleading. I would contact your State Dept of Insurance and file a complaint. Agents have to carry errors and ommissions insurance. You can make a claim under Jessicas coverage to get your claims covered.
Always do research first if the price is too good to be true then its bad.
This has many False claim about US Health. First on the plans not offering well or sick visits is not accurate. As well as the vaccine claim. Next, the mo deductible is false. US Health offers first dollar plans. Meaning you don't have to meet your deductible to receive care. As you pay your share of a highly reduced claim, it applies to the deductible.this is what you would find in jobs that offer benefits with Blue Cross.My husband needed insurance due to no employer benefits offered as well as the high cost of adding him to my plan was rediculously high. Not to mention I was planning on leaving my job to spread my wings. After shopping around I decided to go with US Health. We got him an outstanding plan that allows him to see the demtoligist for his psoriasis. If you think the name brand is high try using good RX. When my agent sold us the plan, he was very honest about accessing better prices than many of the top rated insurance. Such as my Blue Cross. I have opted to use good RX on many occasions and receive a very low fee and I Carrie top notch medical insurance. Not only am I aware of what US Health has to offer, I am a Insurance agent as well. This listing mere marketing ploy. For Freedom Life to allow such marketing plots is outlandish. Every insurance has it pros and cons. It really depend on what the individual needs. And plans very to the needs. The added coverage is also shared with lack of true information. You can add extra or extended benefits offered my us health if you find your plan is unable to cover everything. They allow you to buy this needed coverage and it is available immediately..
People Google is your friend do your research
January 26, 2017, Los Angeles, CA — A Mid-City woman said she was duped by an insurance company that sold her junk insurance.
A year and a half ago, DeeAnn Davis lost her health insurance along with her job. “The Cobra insurance they extended was $900 a month. So I had to search for my own policy, ” she said.
So Davis called the 800 number listed on the Covered California website.
She found a PPO plan that cost less than $400 a month. “I knew it wasn’t a top-notch plan but didn’t think it was a no-coverage plan, or that it wasn’t real insurance, ” Davis said.
She said she discovered she was duped when she became gravely ill last month and called the company that sold her the insurance.
She said she was shocked to learn that her insurance would only cover emergency-room visits only if she was in an accident.
“If it doesn’t cover when you get sick, then what is it that you’re paying for?” Davis asked.
When her fever spiked to 103 degrees, and her blood pressure plummeted, her friend insisted that she go to the emergency room.
“I couldn’t sit up straight. I couldn’t walk, ” she recalled.
So the 46-year-old was admitted. “I just remembered crying wondering: Do I leave? Because I don’t know if I can afford this. Or am I really sick? Or do I stay?”
Four days later, Davis went home after her condition stabilized.
Then the hospital called. “They wanted to inform me that my insurance only covered $250 a day, and that my bill was in excess of $30, 000, ” Davis explained. “They wanted to know how I was going to make arrangements to pay for it.”
The freelance advertising executive was stunned. “That’s a huge amount of money. It kind of just takes your breath away, ” she said as she held back tears.
Jerry Flanagan, Consumer Watchdog‘s Litigation Director, said Davis was sold junk insurance.
“DeeAnn was taken advantage of by a fraudulent company, fishing on the internet for unknown consumers who are looking for Covered California, ” he said.
“By selling this coverage as a PPO insurance plan, the company was committing fraud, ” Flanagan explained.
He said Consumer Watchdog plans to sue the company that calls itself US Health Group: America’s Trusted Choice, based out of Fort Worth, Texas as listed on its website.
Not only does Davis owe $31, 010.61 as a result of her hospital visit, she has to pay a penalty because her old plan with US Health Group was not legally considered insurance.
Expect more cases of junk insurance if the new administration allows insurance to be sold across state lines, Consumer Watchdog warned.
US Health Group sent a statement saying what Davis had was “supplemental” insurance, and that a customer service agent will be reaching out to her about her hospital bill.
How do you people who sell this scam sleep at night? Your parents must be proud. Just lay it on the line. If you have a $100, 000 Hospital bill and have one of your scam Freedom Life or Us Healthgroup plans what will the client pay for that visit. This is an indemnity policy that up to last year got you fined if you fell for this crap and bought it. Why do your clients think they have Cigna as the insurance company? Why are no actual policies found online? Its all sell and [censored] for your thieves.
Prove me wrong post the policy with no selling.
We purchased this insurance and have been paying via auto withdrawals of 500.00 every month. Will Brown of Rogers, Arkansas came into our business we own and sold the policy. We have called and called and called his number for over a year with no return phone call. We have never been provided any other phone numbers, instructions, a copy of policy, list of do's and don'ts, list of what is and/or is not covered, insurance card, etc.
I finally being fed up and frustrated of this bad service for months and months on end, physically drove to the address that was the one thing will brown did provide, to find the office had been abandoned with no forwarding information whatsoever.
discouraged and disappointed need to know how, what when where etc, need my respective information.
Charles A Schroeder, owner
HIGH PERFORMANCE WATERCRAFT
8995 SUMMER SHADE ROAD
ROGERS, AR 72756
[protected]
[protected] SOMEONE PLEASE PLEASE CONTACT ME RE THIS SERIOUSLY NEGLECTED MATTER, THANKS!
Contact Arkansas Dept of Insurance..they will investigage
US Health Group is just another iteration of the now defunct Mega Life and Health/ Health Markets/ Cornerstone/ NASE. The above complaint is indeed 100% accurate. Do your research on this and the past companies, better yet just look elsewhere. US Health Group cannot even legally call third offering insurance.
USHEALTH actually has better reviews rated 3.0 stars on Google much better than Kaiser Permanente at 1.5 stars. Most complaints about ex-employees aren’t true. I’d say the complaining employees never put in the work and expected gold plated paychecks from company. Customers’ complaints are very far and few. Over 15 millions satisfied members at USHEALTH Group. A few complaints are followed up and resolved by agents and by the company. People who are on the plans at USHEALTH love their plans. I am attaching the 2 links to Google reviews search to compare USHEALTH and Kaiser. Remembers: competitors will post faked complaints sometimes to compete. Noone is overseeing the accuracies or these opinionated complaints. Best, Ben Lee - Binh Ly (call or text to me anytime) [protected] if you need help with your insurance needs. Web: usahagent.com/benlee . US Health Group — junk insurance exposed https://www.google.com/search?source=hp&ei=8KHEW6KeCY2c_QbW1J-YBA&q=kaiser+permanente+reviews&oq=kaiser&gs_l=psy-ab.1.2.0i67l4j0j0i20i264j0i67j0j0i20i264j0.7277.11426..14066...5.0..0.150.1142.9j3...0...1..gws-wiz...0..0i131j0i10i67j0i10.LUTysStRWnw
My father had a stroke on PremierChoice. He received a critical illness benefit for $12, 000. He upgraded his plan to PremierMed, got $800/night for every night he was in the hospital, had a $4000 deductible and then was covered 100%. He received over $13, 000 from the insurance company and only owed $4000. So in essence, my father was paid $9000 for having a stroke and got care at a top hospital in the area. If he was on an ACA plan he would have been paying more than twice as much monthly, would have had a $6800 deductible and would have been treated at the worst hospital in the area. Yes, I would imagine some agents are not as thorough as others when selling the product. But as someone who needed the insurance in one of the worst case scenarios this insurance did exactly what is was set up to do. Yes, he had to move to an ACA plan at the end of the year, but the alternative was paying and being on that ACA plan for the last 3 years. My father was certainly much better off on PremierChoice. If you are looking for a plan that covers wellness, doc visits, prescriptions, and everything under the sun from first dollar, that plan does not exist. If "free" wellness is super important to you than go get an ACA plan for twice as much a month. Those complaining never understood how the plan works, and that may be the agent that sold them the plans fault, or it may be the consumers fault for being a [censored].
@PeterBBBBB IF your father was on an ACA plan probably had zero premium as missy that shop in market don't or they pay at a substantial subsidized premium so you can't make the comparison.
Unless you understand net asset value you cannot write a comparison .
If someone can live with the risk of these types of plans than good for them. I hope that's all the coverage they need
Only people with low income would have zero premiums. If your household income is medium or high, ACA premiums will be very high with high deductibles. USHEALTH plans are not limited benefits. They are fixed indemnity or excepted benefits. If and when you have critical illness you can upgrade to plans that cover 100% medical expenses with no additional underwriting. I welcome a call or a submitted form from you or anyone on this board. Watch the video, call or submit form from webpage USHagent/benlee
I agree US Health is not true major medical insurance. It is very mis leading. I have seen agents sell it as if they are getting United Healthcare. Buyer beward.
I use to be an agent of US Health Group from 2007 to 2013. When I started with them we sold real major medical health plans, mostly HSA compatible plans. Once the ACA was implemented, USHG didn't want to comply with the law so they created the sickness only, accident only with fixed indemnity plan for doctors visits and Rx. Plus they had fixed benefit plans that were being sold as primary plans. I saw the writing on the wall when Troy McQuae came to helm of US Health Advisors. Let's go back to 2003, when I first started in the health insurance industry and didn't know anything (That's who they like to hire, by the way. People who don't know much about the industry). I was with NASE/Mega Life for my first year. The "cheerleading" atmosphere/culture they had got you all pumped up to sell. You needed that pump up because it was basically garbage that you were selling. I saw many customer get upset with me. I left just shy of a year and went to another company for 3 years (United American) which wasn't that much better. I was thinking of leaving the industry all together until I came to USHG. It was a relief and I was happy with what I was selling, finally. That's until 2013, when the ACA squeezed profits away from major medical plans and they had to make cuts. First cut, agents commissions. So in order to still offer full commissions, they created these "go around" plans. Basically, once Troy took over, USHG "sold out". I left and created my own agency selling ACA plans with fixed indemnity plans as a supplement to their ACA plan. Yes, the commissions are not that great. However it's true major medical plans that cover everything. And when you have customers that have great insurance and hardly any complaints, you get referrals off those, and lots of them. I'd rather take a tiny commission check for an ACA plan and get lots of referrals from it, than have to use sleazy sales techniques to get full commissions on garbage plans. I haven't made a cold call in 8 years. Everything has been referrals. When you do the right thing, you get rewarded handsomely. It's no wonder people get frustrated and lose trust in the health insurance industry. Do I believe that USHG/Freedom Life is a bad company? No. I do believe they pay what they say they are going to pay, on paper. Do I believe that the agents selling their product leave out information, over sell and misrepresent what they are marketing? Absolutely! They have to because of the plan designs. Just my thoughts.
What a joke, that an insurance company claims that they will allow you to buy more coverage when you need it the most. How does that make sense. They fail to tell you that you have to make all the back premium payments. The problem with US HEALTH are the agents. They make the customer think they are purchasing traditional health insurance when in fact its an indemnity plan. The customer has to submit the claims NOT the provider. So US Health does NOT have a contract with the providers. This company has been around for a while. Their product brochure use to say "this is NOT health insurance" Not it says that it does not comply with the ACA coverage, so no coverage for pregnancy, mental health and substance abuse. They also medically underwrite. They dont want the customers to have claims.
I just hope customers do their research and that the agents explain the product correctly. Indemnity plans can help supplement your traditional health insurance to lower your out of pocket. A review said a hospitalization for a stroke ONLY cost $13000. There is NO way that the hospital bill was $13000, that was probably the bill for 1 day. I was in the hospital for 5 days and had 5 stents put in the bill was over $150k.
So be aware of what you purchase. Critical Illness and Accident Indemnity plans do provide value ie AFLAC. But these plans are NOT supposed to replace traditional medical health insurance where the carrier has a contract with the providers. US HEALTH is now owned by United Health Care. I hope United did their due diligence and make sure AGENTS do their job in explaining the product. An accident plan should run less than $20 a person. Anything more than that is not worth it. Critical illness is abased upon age and coverage. There is also hospital indemnity plan. This is what US HEalth attempts to do. They sell you all these different products, but you think its 1 product. Very misleading. Good luck I hope this helps someone.
Owners:
Jason Price
[protected]
Home:
19203 N Creekshore Ct, Boca Raton 33498
Corey Shader
[protected]
Home:
5051 NE 24 AVE LIGHTHOUSE POINT FL 33064
Office location for both:
1600 S Federal Highway
Suite 300
Pompano Beach, FL 33062
https://www.facebook.com/NCE-unified-health-one-300-2154011904826347/
We had a salesman come into our office and, though he was extremely nice, I couldn't understand what he was talking about and I'm a reasonably intelligent woman. I asked if I could get a breakdown of costs and what the insurance would cover the same way Blue Cross Blue Shield does to help me understand but I did not get this information. Instead, I keep getting calls both at home and work from this salesman telling me how foolish it is to not insure your body. I agree. Being a single mom I had health insurance through the ridiculous Obamacare Exchanges for 2 years. I had very high deductibles and had to pay for items I don't need nor want such as maternity (I'm 48 and not able to have any more children) and "birth control, " etc. When the premiums skyrocketed in 2017 I was simply unable to purchase any insurance...not because I didn't want to but because I simply didn't have enough income to pay those premiums and my mortgage! My family has been uninsured this year. I would like to find a good company but, frankly, I am not seeing a value in this plan for me. I would pay in hundreds a month and well visits, the one time a year my family actually goes to the doctor, isn't covered. Well visits are pretty costly, particularly for women. I don't know that I would classify this insurance as a "scam" but I'm very wary of any company that won't show you in clear writing exactly what you get for your money. I've been told by US Health Group how bad other companies are but I'm just not being told what they actually will do and how this is a value to me. I'm turning it down and will continue my search.
I will gladly show you all of the plans available. I will also spend as long as you need to to ensure that you are fully aware of all of the benefits of what is and not covered. Please email me contact info and best time to call at landis.barrow@ushadvisors.com.
do not do it this whole company is a scam Christin Bing is my agent and im pastering is name all over social media i have a 41000.00 bill due to his lies i reported it to insurance commissioner and local Tv stations this company has to be shut down US heth group is the worst
Wow. They called us. The guy kept evading our questions and beating around the bush. He talked and talked and didn't listen much. At first, he wouldn't give us the website, but then we looked at it and typed, "review." He even called us after we already told him no thanks and hung up. Pretty persistent people, which raised a few red flags. No deductible sounded almost too good to be true, and he wouldn't tell us the pricing of the "upgrade." Thank you for your reviews, guys... almost considered buying this "scam" if you could call it that.
Post on ripoff:
My name is Eric, [protected] (cell), serving North Texas, and you may call me with any questions or concerns.
I ask that those who have had a negative experience call me, and/or refer someone to me who you are not friends with, and keep tabs on their situation to see how it goes for them.
I do not try to discredit anyone’s complaints, or argue any of these points. In fact, I see where some of the former clients are coming from with their discontent, and I would largely attribute their experience to not receiving adequate explanation of their plans.
My approach (which is also the way we are trained in our office), is to fully educated each applicant at the initial appointment as to all that our plans do AND what it does NOT, and explain how/why. I then meet to recap everything when I do a face to face review of their policy once it arrives in the mail. Even then, I don’t expect everyone to remember everything in the event that they actually need to use their coverage; therefore, I insist that each client put my cell number in their phone contacts so that they can call me with any future questions, concerns, and issues.
Just as with any business, insurance or otherwise, there are varying degrees of discontent as well as those who are completely satisfied, both clients as well as agents. I am not trivializing anyone’s experience or perspective as a client or former agent. I hope you all are doing well, and are happy with your current policies or current careers. All I can attest to is my clients’ feedback, and my experience with this company as an agent and with my own family as a client.
Send me your most disliked acquaintances, so you can either have a laugh, or so you both get to see what RIGHT looks like.
For further reviews of this company’s substantiated complaints, please visit the Texas Department of Insurance site at http://www.tdi.texas.gov/consumer/index.html
I wish you all the best,
Eric
The main complaint here seems to be from a disgruntled agent who did not attend all his training classes, or perhaps did not understand how the policy works.
Hi,
Apologies for how you were treated. not all agents are created equal.
Do you have premier choice? if so what level association benefit do you have, for example "executive diamond"
That is a typical combination but it vary's state to state, and because it involves sickness and accident care, with a number of supplemental benefits it does get confusing.
Determine that information, if you have it, (it is helpful but not totally necessary)
And then call customer service, they will send you or re-send you all your coverage information via mail, and additional insurance cared asap via email.
This policy is fantastic accident and injury policy. it is a "first - dollar" policy and does not require an annual deductible.
It has 3 levels of coverage. many people get the level one coverage because it is the cheapest. but what if something just happened, the oh my gosh! situation regarding an accident or illness?!
Well, you have the cheapest level, but most likely you have access to all three levels with out additional underwriting. and your upgrade costs are only to pay the last 90 days increased premium. my experience is that it will not break the bank, and remember you get some cash back to use for personal bills, to help upgrade - step up your coverage or use for personal expense because life just got tough for a bit.
What? yep, you keep your costs low until something happens, then you use your insurance card, at urgent care for example, and if things are much worse than expected, you can activate a step-up rider up to 90 days after the terrible incident happened. when you call customer service, just tell them you want to keep this option open, and they will assign a specialist to assist you in your decision making process. it is totally your decision, but you do have to give the company a "heads up".
Then you call your agent & call customer service and file a 2nd claim to activate the cash back provisions.
What? yep, you get health care. great accident and illness coverage. and because many of the policy holders are small business people, the company provides cash back as well to help you cover incidentals, or personal expenses while you recover.
Kinda cool right?
The biggest confusion is that this is an unusual policy, and as such people make assumptions, and do not cal their agent. it is crucial to include your agent in the process if you want the best result. unfortunately, just like mds and attorneys 50% of all agents in every insurance company graduated in the bottom half of their class. - pause and think about it. this is a good company and truly tries to do the best they can to help the consumer, but you have to help. so i'm posting helpful hints on how to get the maximum benefits.
If you want to go it alone, remember the following.
1) use your insurance card
2) call customer service and file an additional claim for accident or illness cash back/ maybe you also have the accident/income protector, if so, file a claim for that as well.
3) tell customer service you want to keep open, and consider the step up rider, it does not obligate you, at all, but it does help keep things properly aligned in your benefit. you now have 90 days form the incident, accident, illness diagnosis, to determine if you want to increase your health care coverage, up to 90 days retro active.
How cool is that?! so up to 90 days after ward, I can say oops, can I get the better stuff instead? yep. you can even use the cash back money to pay for the 90 days of higher premium at the higher rate. they do not charge back to day of inception, that is not correct. 90 days only, because you have 90 days worth of additional coverage. how fair is that?!
So please folks
Just relax.
It is a fantastic sickness and accident policy. it has multiple cash back opportunities as well, depending upon your policy choices.
You can step - up to better coverage, just pay the difference in premiums, it won't break the bank.
There is an unlimited catastrophic coverage, see the policy or company brochure for details.
Contrary to what one agent said, this not just supplements on steroids, it covers a ton of stuff, but you have to know how to use it.
I hope that helps
Look folks all I know it that my experience as a customer of US Health Group, National Foundation Life has been a good one. Their networks are strong in my area and along with what they pay towards a Dr. visit, labs, rx etc I hardly have any out of pocket costs. Have dealt with two medical issues at the urgent care and ER and both were several thousand dollars, accident issues, the most I paid out of pocket was $500. Beats the heck out of what I had to pay with my last insurance because of the high deductible I had. One thing I did was take time to ask a lot of questions and read over the coverage, it was not a secret, it is all in black and white. And no it does not start off as an unlimited coverage plan however I can change to that type of coverage if I need to, when I need to. So I am paying a much lower rate until I need it. I am a 56 year old man with a 53 year old wife and two kids, 21 and 23 in college. It was nice not to have to pay the same price as someone who is really sick and this coverage allowed me not to have to pay for things like maternity, peds, substance abuse counseling etc. One thing I was warned about by an agent selling ACA was you will have to pay for the annual exams and I would for sure have to pay the tax penalty if I went with US Health. What I found out was that about 60% of our annual and screenings were covered through the network discount and I fit some kind of rule that made it so I did not have to pay the tax penalty (called tax exemptions, I think, on the www.healthcare.gov website. It has worked out good for me however I took time to understand it and did not listen to the gaggle on google and the yahoos on yahoo, I did my own research, called the Dept of insurance etc. Thanks for reading my rant here.
Thank you for your comment as a customer of USHEALTH. We have so many happy customers who say they “love” USHEALTH plans not just “liking it.”. Of course ther are always rooms for improvements but we are proud to serve our customers and our communities. USHagent.com/benlee
I would like ut
Let’s address the complaint factually and leave the over wrought language to the drama club.
Each state has an insurance regulatory body, that reviews and approves which insurance plans/offerings can be sold in their state. “Frauds and Scams” I highly doubt are approved by state regulatory boards.
Do people purchase insurance policies without understanding them? Apparently so. SO the best advice is “buyer beware” and take your time to fully question and understand what ANY insurance policy covers or does not cover, and if possible HOW it pays (preferably before a medical bill shows up)
These plans provide benefits for accident and illness. (they do not pay a benefit on preventative health services such as annual physical exams, and routine preventative tests such as mammograms, Pap smears and colonoscopies) They will pay a benefit on those tests if they are done for diagnostic purposes.
These plans are transparent in their pricing (as you can tell by the complaint, they list a bunch of benefit amounts for services). What the complaint does not lay out, is an actual side by side comparison, between the actual out of pocket between this and what they term “real insurance”. So let’s use the exact same example and see how an Obamacare plan and this plan would handle an office visit because of the flu.
Obamacare: Go to office, pay $20-$40 “co-pay” at the window for privilege of seeing the doctor. See doctor and doctor charges $150 for office visit and prescribes “Tamiflu” (a name brand drug) The bill goes to the Obamacare insurer for the $150 office visit, the negotiated price is applied making that bill now a $100 charge. The Obamacare Insurer sends you a letter stating that since you have not met your $7, 000 deductible, you owe the provider $100. You go to the pharmacist, get the Tamiflu prescription filled. The pharmacy charges $59 for the drug (priced by goodrx) and your Obamacare plan handles this one of two ways...It charges a “co-pay” to you for name brand drugs of $40-$80. and you get your drug for “free” or you haven’t met your deductible and you are responsible for the $59
Premier Choice: Go to office, pay $0 “co-pay” at the window of privilege of seeing the doctor. See the doctor and the doctor charges $150 for the office visit and prescribes Tamiflu (a name brand drug) The bill goes to USHealth, for the $150 office visit, the negotiated price is applied making the bill $100, and this insurer pays up to $75 for an office visit. This insurer sends you a letter saying that you owe the provider $25. You go to the pharmacist and this insurer pays $35 of the $59 the pharmacy charge for the drug, leaving you with $14 to pay.
Out of pocket Obamacare: $40 copay, $100 office visit, $59 drug totals $199 (because your $7000 deductible has not been met)
This insurer: $25 office visit, $14 drug cost total $39 out of pocket. (first dollar coverage, no “annual” deductible to meet)
Would you rather pay $199 or $39 and then which one would you call a “scam”?
This insurance is designed so that you pay for the insurance you need, when you need it. Obamacare is designed to pay for EVERYTHING even if you don’t need it. This insurance does not cover mental health, drug rehab or pediatric vision and dental. You have the choice to select three levels of base coverage with the ability to upgrade mid claim if you choose to. First level does not include in or outpatient surgery, the second level includes outpatient surgery but not in patient and the third level includes both. Each level has its own premium amount, as you are getting more benefits. To move up to the level desired you pay the difference in premium between the levels from the start of the policy. This company provides an “upgrade manager” who is basically your personal accountant who does the math of the cost of the bills, versus the cost of upgrading and what the benefits would cover. You choose what to do, once all the bills are in. No guesswork. Again transparency.
This is different than other insurances and some people don’t like having options or understand the concept.
The major medical type insurance is sitting there waiting to be activated if needed. If it is activated, then you have to pay the premium amount for it. The easiest way to understand it is to think of it a “boat insurance” you only pay boat insurance when you put the boat in the water. (the boat is not going to sink sitting on its trailer in your driveway) The boat goes in the water, you pay the insurance premium. You activate your major medical coverage, you pay that premium. If you never activate it, you never pay it. AGAIN, pay for what you need when you need it. The deductible for the first 9- day period is $4000 and then it is 100% insured. (no 80/20) the subsequent 90 day period deductibles are $1000 each, so if you were in a major medical type situation all year, you would pay $7, 000 in deductible, “the boat insurance“ premium and you would be 100% insured.
Since the passage of Obamacare, all insurance plans are basically year to year. This complaint, correctly points out that this plan is designed to get you to the next period of open enrollment, allowing you to select a more suitable plan, now that you have a “pre-existing condition” this insurance UNLIKE short term medical plans, will carry you to next open enrollment. Short term medical plans will only insure you for that first 90 day period, and then decline you for the next ones because you have a “pre-existing condition” leaving you without any insurance until the open enrollment period (Imagine begin diagnosed with cancer on a short term plan in January and that plan only lasts until end of March. When April arrives, you will be denied coverage in April because of your pre-existing” cancerous condition. And then you are pretty much on your own with all the bills /treatments etc until you get to open enrollment. The USHealth plan assures you coverage through until the next open enrollment period and yet the complaner calls this “unethical” and a shirking of “fiduciary responsibility”
The complainer suggests that this insurance is the only one subject to the “penalty” when in fact all non Obamacare plans are subject to the penalty. People can avoid the penalty through 13 different exemptions they may qualify for and any agent worth their salt can do that math for you or you can do ti yourself on any of the free calculators online (Unaffordable exemption so the most common one people qualify for., Basically if the cost of the cheapest Obamacare plan in your area, is more expensive than 8.03% of your monthly income, you qualify for the exemption and don’t have to pay the penalty. Additionally President Trump signed an Executive Order instructing the government to basically not enforce the penalty. (Again if you are going to make a fully informed decision, get all the facts)
Is this insurance for everyone? Certainly not. It is underwritten which means you have to medically qualify for it. If you have pre-existing conditions you simply will be declined coverage. However if you are healthy and want to explore an option that rewards you for your good health, it is worth looking at and fully understanding what this insurance does and doesn’t do. If you are honest on the application, you have little to fear about claims being denied as “pre-existing”, if you have a pre-existing and claim you didn’t, the insurance company has recourse because you basically committed fraud. However if after you hold the policy for a year, and your fraud goes undiscovered, you will then be insured fully. Again, get the facts, be fully informed, and make decisions that are in your best interest. These plans are appealing because their rates are typically 30-50% less than those on the Exchange, and you know exactly the dollar amounts you are exposed to paying if something "bad happens"
As you can only purchase these plans through USHealth agents, other “brokers” hate the plans (notice the complainer mentioning high commissions?kind of makes the complainer look like a competing insurance company agent wouldn't you say? )Think of US Health as like Southwest Airlines, you can only buy tickets from Southwest, and what do travel agents think of Southwest airlines? Right….the travel agents all want you to fly United.
this is very correct...thank you for putting this prospective for those who do not completely understand how it works...everyone is looking for free.
Well put!
Absolutely Correct. The person who wrote this review has no idea how it works. He has not done a side by side comparison. The policy has three different parts to it that wrap around. This is no scam.
Were are links to policy coverages? Do you need to be a member to even look at what their packages cover.
I sat through a recruiting presentation. I wanted the details of how this actually worked and what I would be selling. Unfortunately they could not provide one piece of information that would help me understand how their plan works. Your blog post was much more useful. I would like to understand how transferring to a major medical plan works. I understand that you would need to pay the difference in the plans from the first day plus the deductible.
e.g.
Assume the plan differences in Obamacare (ACH) and US Health Group are $400/month
ACH Annual Deductible is $3500
ACH Perscription Deductible is $ 1000
Sign up for the US Health Group plan Jan 1 develop cancer Nov 1 ( 10 Months)
10 *400 = $4000 (Plan Difference) + 3500 (Deductible of new Plan) = $7500
Medications Deductible $1000
Total Conversion Cost = $7500+$1000 = $ 8, 500
What if I have had my US Health Plan for two years? Am I looking at a conversion cost of 10+12 =22 * 400= $8800 + 3500 (medical new plan)+ 1000 (perscription) = 12, 500?
Thanks for the guidance.
I would love to help you with this, but have no clue with what you are proposing here.
@William Everimann it appears you write these types of policies, that's great. However, your analysis fails when comparing the cost to PPACA because those using PPACA are not paying the monthly premium, the taxpayers are or the federal printing presses.
I just had a call from an agent. Nice lady just explained I do not want a limited plan and even the Premier choice whatever had limitations to the maximum coverage. The problem with your analysis, and people today is they treat health insurance like something for someone else to pay for their responsibilities to pay for medical care; not the governments or taxpayers, not other organizations like insurance companies. If we treated our auto insurance the same way we would send the $29 oil change cost and the $100 tire replacement cost to State Farm or Allstate and our auto insurance coverage would be through the roof like the cost of health insurance.
Insurance companies are there to handle risk of unforeseen medical coverage and going for a yearly checkup is not unforeseen; it should happen every year and if you can’t afford it there are clinics all across this great nation that provide these for free and NOT the government mandating everyone goes every year and you don’t have to pay.
Get rid of the co-pays, get rid of the 80/20 and put everyone on the tax-savings plan (there go those Obamacare recipients as they don’t pay taxes) and once you get to $6, 500 out of pocket then the insurers, or reinsurers cover the risk of the rest. My premium for a plan like this with $5, 000 individual and $10, 000 family out of pocket cost $309 a month back in 2009. Today it’s $2024 a month for only family of 3 with $13, 500 deductible and $37, 000 out of pocket and that was in Illinois. In North Carolina, where we moved same plan only without our son and same deductible but a $52, 000 out of pocket risk and it’s $2075! A month!
I am going to a catastrophic. I will pay less than $24, 000 a year to rip off insurance companies and pay my doctors and buy something like an AFLAC unlimited plan for about $167 a month per person so if we have that heart attack or get cancer then we’re covered and the insurance companies floating these limited plans, yes US Health has 100% coverage of the benefit but the benefit is limited to $125, 000 for a heart attack which will cost over $400, 000 today for 3 days of IU at a decent hospital.
So when you compare your plans to others put the whole piece together and include the premiums and worst-case scenario. If you buy a limited plan you are rolling the dice with bankruptcy should something catastrophic happen.
How long have been working for US HEALTH lol. Your a joke! There is no negotiated rate and your example is bogus and misleading. Most Drs Will never accept these types of plans anyway.and the insurer has to file its own claim for the Mickey mouse benefit to get paid. The part that you leave out is if a person gets hospitalized for something serious they are screwed. This plan is a discount plan with indemnity benefits and its underwritten to make it sound legit. The persistency is hoping that people never use it.
You sound like an agent from a competitor. USHEALTH has the best products and services nar nine. A few posts with your opinions are designed to discredit a great company. Go ahead and call me or email me. My phone number and email are in this webpage and submit form. I will debate you with facts not opinions. USHAGENT.com/benlee.
Call me or submit form I will email you policies’ full brochures with coverage. My number and form ate in webpage USHagent.com/benlee
If you knew what you were talking about you would know that every health insurance company talks about negotiated rates. The negotiated rate is between the doctor and or facility and the network provider, not the insurance companies. The insurance companies have no idea what the negotiated rate will be because it is directly handled between the two parties-network provider and doctor. Also, the negotiated rate can change from doctor to doctor as well as state to state which is why they give an average or percentage. Maybe you should actually work for an insurance company before displaying your so called wisdom and then maybe, just maybe you'll sound more intelligible and actually get your point across because I read this and think, "Someone who just wants to vent about something they don't understand."
Not meant for you Rey, I walked away from my computer for a minute.
If you're expecting this insurance to be anything but catastrophic coverage, you are in for a surprise. It's being sold as an Obamacare work around. If you have a pre-existing condition you may be declined or will pay a significant monthly surcharge. My wife and I are both healthy but $820 a month for this kind of weak lame coverage is nothing but a rip off of our hard earned dollars. The deductibles are high ($12, 000 for us) and the copays low on just about every kind of claim submitted and all we ever get is a letter explaining why what we submit (very few very small claims) gets declined or isn't covered. Drug coverage is a joke so we use Canadadrugs.com. Fortunately, I'll be on medicare in 7 months and my wife in a year. At that time, our combined monthly premiums will be 60% less than we pay for worthless USHealth Advisors policy and our out of pocket costs will be near zero. And then we can actually go to the doctor; have tests and exams done if we need them without creating a financial hardship. If you're considering buying a policy from USHealth Advisors, do your homework well and know what it is but mostly what it is not.
First off there are no plans that offer $12, 000 deductible. The plans offer NO Copays, Look at any private insurance company and look at their prescription coverage and they are all jokes. Remember these plans are to help people that are HEALTHY save money on the health insurance they never use. If you are in and out of the Dr's office for anything and everything then your agent shouldn't have sold you these plans. I have one and very rarely use it but when I do I have yet to pay any out of pocket visits. I even got a check in the mail for my physical because I didn't use the full benefit allowed on my plan. Not sure any other companies pay back if you don't use the full amount. So do your homework and make sure your agent isn't a scum bag.
I wish I would have read this prior to purchasing this non sense ridiculous insurance that covers nothing. Useless. I never go out of my way to complain but people should know what they're getting themselves into. I am canceling after 4 no months and not having anything covered.
Stop going to the wrong agents then. Go to one that actually looks out for the clients and not their pockets
I just terminated my discussion with a US Health Group agent. This is a sales driven con operation, my error in getting involved in a discussion with them. Luckily I was able to contact my bank prior to them ACH-ing funds from my account. I would advise all buyers to stay away from these sharks, the double speak and confusion would make a cell phone salesman blush. Oh, did I mention the $40.00 per head "application" fee that was never mentioned by the agent, thankfully they did not get this money from me. Shame on me for getting involved in a scam like this. If your gut tells you
something is fishing, then act upon it! BB in Dallas Texas
It's not $40 "per head"...it is a $40 application fee for the policy as a whole...not per person.
Just spoke with an "independent agent" recommending USHealthGroup Premier Choice. The comment of 64212 above sounded just like what this agent was pushing. I told her I need to see the info on "no deduductible" etc, etc and asked her to email me all info. I am looking for a company that will cover me not just in the US but also overseas while I am studying abroad.
This complaint above is absolutely true and was probably written by an agent who understands exactly what the scam is. Everything in his post is factually correct. I am an agent myself for over 25 years and was recruited heavily to perpetuate this fraud. I declined to associate myself with the US Health Advisors LIES to the public. What they are selling is rubbish
I just passed state exam and went in yesterday for first "training" session. I questioned a few things I heard. Leaving wondering if this was a "great" company to work for? After reading this, now I'm really doubting my career choice. They lied to me at first interview. I spent all the money to get approved to take state exam, fingerprinting, state exam fee, plus background check. I'd like to hear more from you.
The initial complaint exposing US Health Advisors is 100% factual. I was heavily mislead into working for them for almost a year. Their practices are very unethical and misleading. They will train you to hammer down the "no deductible" and are very shady when it comes to explaining the ins and outs of how the plan actually works. If agents were to be thorough with potential clients with the pros and cons of "premier choice", then no potential client would ever purchase the plan. Now that you are licensed I would suggest finding a recordable company within the health or life industry to work for. I jumped ship and am now actually able to help protect families through life insurance and I finally am able to sleep well at night knowing that I can back up my product with 100% confidence and transparency. I hope this helps!
The Agents that sell plans like this are either being deceived, do not do their homework, or simply greedy. The give honest agents a bad name. Health insurance today is so complicated. We don't need unscrupulous deceptive plans to add to the pain that the public already feels.
@fit4u, don't waste all that effort and licensing. There are plenty of reputable firms out there needing brokers and there are tons of marketing firms to get you leads on health and life insurance in your state.
This type of complaints are unverified. Anonymous postings could be from competitors. Call or email me in your submitted form with your application number, I will follow up for you. My telephone and submit form are in webpage USHagent.com/benlee
This is not 100% true like you say. They do have wellness benefits and and children immunizations. Yes you get 3 dr visits with a $75 benefit on the LOWEST Plan. The other plans you get $100 benefit. They also have plans with deductibles which is what I have. I live in LA and have their secure advantage plan and haven't had any issues. Trump got rid of the tax penalty and you will not be penalized for not having an ACA plan. Maybe if your plan was sold correctly to you and not to pad the agents pocket then maybe you would change your mind
I got this insurance it sounded GREAT had it for 6 months cancelled it the second of the month and they charged my premium the same day. They then told me I wasn't eligible for a refund. There trying to steal money I don't HAVE! The insurance commissioner will hear about this company and their fraud if not resolved soon.
This type of complaints are unverified. Anonymous postings could be from competitors. Call or email me in your submitted form with your application number, I will follow up for you. My telephone andsubmit form are in webpage USHagent.com/benlee
and was it resolved or did you just need to vent at someone else's expense
I'm absolutely not an anonymous competitor, and this is by far the worst health insurance coverage I've ever had and it isn't even close. To think I've paid $700/month in premiums for 3 years, and then to compare it to what that company has actually covered for me, is truly remarkable. I bet the profit margin on one person like me is like 95%. I already know that my complaining won't matter, and that these companies are designed to just take advantage of unassuming people and then blow them off and expect them to go away when they complain. Every single time I've tried to call, it's totally confusing who I'm talking to or if I'm talking to the right person, it's inevitable I'll end up on hold for ten minutes or transferred to the wrong "department."
When they wouldn't cover my son's yearly physical he needed for sports, the nurse at the pediatrician's office told me this is by far the worst company they have to deal with, and she absolutely hates having to call them because they are so unreasonable. That's just a drop in the bucket compared to what they've done, too. This coverage is an absolute scam, and they know it too.
I've gotten to where I don't even like saying I have insurance when I go to a doctor, because it'll just muddy up the waters, make everything take longer, and they won't pay anything anyway. But at the same time they are more than happy to take my money every month.