Recommend a good health insurance policy

[teems1]

Got myself a life evolution rejuvenator increasing benefit option from guardian life.Dont have the policy in front of me now but it is supposed to cover most illness,at the time of inception,will pay most of the medical bills.

What you have is CI (critical illness) coverage. That insurance is for if you get things like cancer.

He wants regular health coverage, for dental, vision etc.

[shake d livin wake d dead]

yup something simple as he said^

thanks for all the info thus far.

[Swisha]

bump

any updates on which health insurance is worth it?

apparently Guardian Life is terminating my group health plan and offering individual plans instead so I think I may need to shop around. they also cut vision and dental benefits...

[redmanjp]

Got myself a life evolution rejuvenator increasing benefit option from guardian life.Dont have the policy in front of me now but it is supposed to cover most illness,at the time of inception,will pay most of the medical bills.

What you have is CI (critical illness) coverage. That insurance is for if you get things like cancer.

He wants regular health coverage, for dental, vision etc.

what if u have regular coverage & then get cancer- can u switch to CI?

[A172]

took CI & regular coverage with guardian

think was 3500 for the yr regular and 440/mth CI

[pugboy]

Eat properly, live a good lifestyle and exercise well to reduce chances of diabetes and cardiovascular issues.

[brams112]

Got myself a life evolution rejuvenator increasing benefit option from guardian life.Dont have the policy in front of me now but it is supposed to cover most illness,at the time of inception,will pay most of the medical bills.

What you have is CI (critical illness) coverage. That insurance is for if you get things like cancer.

He wants regular health coverage, for dental, vision etc.

Yeah you are quite right,that is what I have,i discovered you have to get an experienced agent to draw up the plan opie is looking for,most agents now a days only want to sell you what they have,not what you want.

[Chemical]

My Wife and I have this Best Doctors Medical. Covers the kids too. Don't have a clue how much it costs as her company pays for it as part of her package.

http://www.bestdoctors.com/bd/trinidad/ ... sGuide.pdf

[Dreamygirl]

Hello.Can anyone recommend an insurance company with a reasonable health plan .IM looking at medical,dental and vision.

[MG Man]

Try Sagicor

[cherrypopper]

Maritime has this admed thing I believe

[88sins]

they all have reasonable health plans
until you file your first major claim. thats when you start to see all the loopholes in your contract.

you're looking for coverage for an individual or for a family with dependents?

[Dreamygirl]

Looking for me and my mum.

[88sins]

check sagicor first then algico group. doh waste time with maritime admed

[Dreamygirl]

Ok np

[neexis]

+1 for Sagicor.

Guardian is increasingly becoming more like US insurance companies with its restrictions

[ganeshlalchan]

The thing with sagicor as compared to all others is that you pay your premium annually. So that means you forking out a lump sum payment. The upside is that they have the best coverage compared to the others. Admed is monthly but their coverage is for mostly employees in a business or company according to an agent I spoke to.

[Premchand1976]

Guardian Provisor is unmatchable. Sagicor plan is a copy of ours and their provider list is quarter of ours.

We do the comparison and whilst our rates " may " be a hit higher , our benefit limits and reasonable and customary limits are higher. This means we cover more of each and every benefit so it costs you less out of pocket.

OP, check inbox

[ganeshlalchan]

Guardian Provisor is unmatchable. Sagicor plan is a copy of ours and their provider list is quarter of ours.

We do the comparison and whilst our rates " may " be a hit higher , our benefit limits and reasonable and customary limits are higher. This means we cover more of each and every benefit so it costs you less out of pocket.

OP, check inbox

How much dental and vision is covered for the year?

[neexis]

Guardian Provisor is unmatchable. Sagicor plan is a copy of ours and their provider list is quarter of ours.

Provisor is problematic and now marred by this "pre-certification" drama. So when you go to a provider, they will tell you they can only do a few hundred dollars worth of treatment that day.. anything more and they must get approval from Guardian... which can take a few days. So you have to make an appt to get pre-certified, then another to actually get your treatment... assuming you want to use their card. Once I had a provider call me back saying I owed them because Guardian said I reached my limit when I know I did not.

I'll take the option of paying up front and let the insurance company reimburse me later and have the option of going to any doctor I want without being penalized for going out of network.

Do your research with whichever company you choose... and ask them specifically what these plans DON'T cover.

[88sins]

Guardian Provisor is unmatchable. Sagicor plan is a copy of ours and their provider list is quarter of ours.

We do the comparison and whilst our rates " may " be a hit higher , our benefit limits and reasonable and customary limits are higher. This means we cover more of each and every benefit so it costs you less out of pocket.

OP, check inbox

since you are a Guardian General rep/agent that likes to tout the superiority of the institution perhaps you can explain one thing for me.
Guardian has the idea that they an their reps can submit a triplicate form that's clearly labeled a medical examination request form and that providers should provide services to this that present these forms. Nowhere on this form states hat Guardian group will be responsible for payment. And if the provider does provide service is ketchass to get paid from Guardian. Why is this?
and don't get me started on your "Guardian Provisor is unmatchable" BS. My company has upwards of TT$20000.00 in unsettled claims made to the Guardian Provisor subsidiary of the Guardian Group dating as far back as 2003. All claims were submitted within 30 days, they would pay some, often less than half, and ignore the rest. then maybe pay on one or two a year later. it got so bad I discontinued accepting the Provisor card an your clients now pay cash. and its no just me. I can list at least 9 other institutions with the same issues.

Guardian deals with their individual clients better than their service providers, but Guardian can't even stand in the same room as Sagicor.

[Premchand1976]

Guardian Provisor is unmatchable. Sagicor plan is a copy of ours and their provider list is quarter of ours.

We do the comparison and whilst our rates " may " be a hit higher , our benefit limits and reasonable and customary limits are higher. This means we cover more of each and every benefit so it costs you less out of pocket.

OP, check inbox

How much dental and vision is covered for the year?

FOR Individuals

dental - 1500 - 2500 for regular cleaning etc and 75% off the cost for orthodontic services.
Vision - 1200 - 1600
contact lenses - 400 - 600

For groups : same as above and increased limits can be purchased by group.

[Premchand1976]

88sins, I cannot say why you have this much in unsettled claims, maybe incomplete forms, maybe lost claim forms, maybe inconsistencies with claim form and receipts. It can be for any number of reasons. Groups are indeed a bit more difficult to handle UNLESS the agent services properly. I myself have issues with individual clients because they simply refuse to fill the form out properly. Example, the omit the illness dates and expect me to know this and fill for them ??????

With respect to the triplicate form, up to two days ago, I personally took my sons to a doctor in san juan, and we signed same and paid our 20%. The only reason the provider will have headache to be paid is if they submit invoices late, if the invoices are irregular in prices, example, if I visited the doctor for the flu and the doctor's fee that is being claimed for by the provider seems higher than that of a normal GP visit fee.

We have had numerous issues with providers, we have been late in processing payments etc, we have even cut ties with large eyewear companies in chaguanas simply because they seem to raise their process conveniently when they see a lifecare card flashed in their eyes etc etc. At the end of the day, we want clients to benefit and be comfortable, we want them to get a true discount from vendors and we try to curb the instances of exhorbitant prices but we can only control it within parametres.

The issue of the form not stating anything about Guardian's Liability / promise to pay is non important. ANy client I send with this form to any doctor / lab NEVER was asked to pay the bill. NEVER. the form itself is proof that the vendor is guaranteed payment.

The medical plan forms as well is a promise once signed an submitted, that payment is guaranteed for their services rendered to Guardian's clientele.

We have already looked at Sagicor's panel and ours still gives a much wider variety to choose from ( which could mean, your doctor, lab, dentist etc would be on the panel, and therefore you will be liable for 20% instead of 30% or more )

Every plan has advantages and disadvantages, I have experienced cerain surprises when claiming for my wife's second pregnancy but all in all....I am satisfied with the service.

Hope this helps.

[88sins]

All forms filled out properly by sp & client, & submitted within 15 days of attendance. Even the Manager had no reason why the claims weren't settled & remain unsettled to this day.

The issue of the form not stating anything about Guardian's Liability / promise to pay is non important.
.

keep telling yourself that kaka & thinking Joe Public out here chupid

We have already looked at Sagicor's panel and ours still gives a much wider variety to choose from ( which could mean, your doctor, lab, dentist etc would be on the panel, and therefore you will be liable for 20% instead of 30% or more )

I call this as BS. My wife's had a procedure done, cost was TT$19000.00, Sagicor sent me a chq for TT$18300.00
Time before we were with Glife. Submitted a claim for $12000.00 & only got back $8000.00

Say what you will, I speak from my experience.

[Premchand1976]

And likewise sir, I speak from my 13 years experience with the company and with very few instances of major concern.

At the end of the day one is free to choose the insurer the prefer.

Sorry for your hassles with Guardian though. Good luck with Sagicor.

[Premchand1976]

It would be nice though if we can see a copy if the payment slips you say you got from both companies.

If you in fact submitted a claim for 19k and got back 18k then I personally will stop selling guardian medical plan and even buy sagicor for myself because it will be proven their plan is better for us ALL

until then, I hear what you say.....but.....I don't believe a word of it.

[pete]

I'm with British American 2500 vision 15000 for maternity and delivery. Dental was like 4000 I think.

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[88sins]

Believe what you wish Prem. I can tell you why it is the way it is, & the why is the reason for the substantial difference between the two companies. But will give you the chance to divulge it. I know why. And if you dont say I will. But be careful. Cuz if your beloved GLife discovers you divulge one of their most guarded secrets is loss wuk for u.


I put forward an actual example of my experience. Thats that. I never asked you or anyone else if they believed it.
I even make a profit if anyone on my insurance policy files a major claim. Least profit i ever made was just over $2000, most was almost $5000

What you believe is your business.

If you want something to talk about why dont you start by telling ppl here how Glife comes up with their figures of what should be their maximum payout on surgical procedures. Lets see what ppl think.

[pete]

How do you make a profit on health insurance claims? Overinvoicing aka fraud?

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[88sins]

If you dont want to say thats fine and understandable. Nobody could hold it against you. You want to keep your job. Nuttn wrong there. Besides that, you seem to me to be just an agent, so you may not even be aware of what goes on above your head within that institution.

But i dont work for sagicor or guardian life, & never signed any nondisclosure agreement document. So I have no legal obligation to keep anyones policies or practices secret.

But you have a nice evening anyway