Recommend a good health insurance policy

[Premchand1976]

May I offer a tip with Maritime’s ADmed? Make sure and get the gold package, not the silver and not the bronze. I feel cheated a bit by Maritime and I am actually considering switching to Guardian. When that time comes, I shall discuss same with Premchand.

Thanks for the support

[Premchand1976]

They said you have to remove yourself from one? I can understand that you can't claim on both for the same issue, but why remove one set of coverage?

This is not true at all. If you have multiple plan, the primary one bears the first reimbursement ( 80% ), the remaining 20% is transferred to the secondary plan and you are paid 80% off the remaining 20% brought over. Done it lots of times for clients with company and personal plans and hassle free too.

Somebody not guiding y'all right at all.

Ask the company directly.

[bronze_mercury]

They said you have to remove yourself from one? I can understand that you can't claim on both for the same issue, but why remove one set of coverage?

because i cannot have both personal health from home and group health in work and claim from both cause they cover the same thing. ended up saving by removing myself from the personal health from home.

[bronze_mercury]

They said you have to remove yourself from one? I can understand that you can't claim on both for the same issue, but why remove one set of coverage?

This is not true at all. If you have multiple plan, the primary one bears the first reimbursement ( 80% ), the remaining 20% is transferred to the secondary plan and you are paid 80% off the remaining 20% brought over. Done it lots of times for clients with company and personal plans and hassle free too.

Somebody not guiding y'all right at all.

Ask the company directly.

the agent reffered me to account executive from group sales in westmooring branch. thats what the guy said that it is a clash of coverage. the agent told me initially that yes i can have both insurance no problem. but now i am told otherwise and have to remove myself from the individual provisor which i took for home with my wife. and work covers us with group health. else i would have gladly kept payiing the premium for both me and my wife for the individual plan and also add her as a dependant on the group plan under me.

[jose123]

What were the issues with Maritime.
With Guardian the experience was one of nontruths being offered to the customer. In other words was a major betrayal.

If I remember correctly , this was resolved and it wasn't a matter or betrayal. Your agent misled you, you did not read your contract as well.....don't blame the company for the unethical agent. The manager did in fact resolve the issue as I remembered.

Feel free to shop around tho.....provisor works for me to this day and I've had lots of admed come across the last 2 years.......I doubt they all would be misled......and continue to stay on after being misled.

Insurance isn't for everyone I guess ?????

We're back to this dude? It wasn't the agent who mislead. It was a Team Leader from you customer service who said I was not covered when I was. He said that he read my policy and I was not covered. You and others said I was. If it wasn't for me asking other people and contacting you I would have been mislead. I consider that a betrayal because next thing there is an emergency and that same Team Leader tells the hospital I'm not covered leave me on the sidewalk when they call to get confirmation of coverage.
Without your intervention I would not have got the claim. I am not renewing with Guardian. I chose to move to another provider for the untruth.
Anyway, as you say insurance may not be for everyone. Just the same as after sales service is not for every Trini company.

[jose123]

They said you have to remove yourself from one? I can understand that you can't claim on both for the same issue, but why remove one set of coverage?

This is not true at all. If you have multiple plan, the primary one bears the first reimbursement ( 80% ), the remaining 20% is transferred to the secondary plan and you are paid 80% off the remaining 20% brought over. Done it lots of times for clients with company and personal plans and hassle free too.

Somebody not guiding y'all right at all.

Ask the company directly.

the agent reffered me to account executive from group sales in westmooring branch. thats what the guy said that it is a clash of coverage. the agent told me initially that yes i can have both insurance no problem. but now i am told otherwise and have to remove myself from the individual provisor which i took for home with my wife. and work covers us with group health. else i would have gladly kept payiing the premium for both me and my wife for the individual plan and also add her as a dependant on the group plan under me.

This is what I'm saying. Seems like different people at Guardian have different opinions and are giving different answers to the same question.

[Premchand1976]

I understand fully what you're saying. Thankfully for every one of my clients thus far, I've never had such issues with them....all their claims are covered and paid , even the precertification ones as well.

Hope it works out for us all, at the end of the day, it's a valuable asset having medical insurance knowing the state of the local medical facilities.

[bronze_mercury]

They said you have to remove yourself from one? I can understand that you can't claim on both for the same issue, but why remove one set of coverage?

This is not true at all. If you have multiple plan, the primary one bears the first reimbursement ( 80% ), the remaining 20% is transferred to the secondary plan and you are paid 80% off the remaining 20% brought over. Done it lots of times for clients with company and personal plans and hassle free too.

Somebody not guiding y'all right at all.

Ask the company directly.

the agent reffered me to account executive from group sales in westmooring branch. thats what the guy said that it is a clash of coverage. the agent told me initially that yes i can have both insurance no problem. but now i am told otherwise and have to remove myself from the individual provisor which i took for home with my wife. and work covers us with group health. else i would have gladly kept payiing the premium for both me and my wife for the individual plan and also add her as a dependant on the group plan under me.

This is what I'm saying. Seems like different people at Guardian have different opinions and are giving different answers to the same question.

i checked the admed from maritime is seems good for major and emergency medical things only as they have set prices.
guardian medical you can claim all the small and major stuff. you either stick to the list and get your discount up front or, go anywhere else and pay full price go thru the fill out forms etc etc and wait for your cheque.
dunno much about sagicor one.
but admed price fluctuates depending on package. bronze,silver, gold,
guardian is the best priced.

[jose123]

They said you have to remove yourself from one? I can understand that you can't claim on both for the same issue, but why remove one set of coverage?

This is not true at all. If you have multiple plan, the primary one bears the first reimbursement ( 80% ), the remaining 20% is transferred to the secondary plan and you are paid 80% off the remaining 20% brought over. Done it lots of times for clients with company and personal plans and hassle free too.

Somebody not guiding y'all right at all.

Ask the company directly.

the agent reffered me to account executive from group sales in westmooring branch. thats what the guy said that it is a clash of coverage. the agent told me initially that yes i can have both insurance no problem. but now i am told otherwise and have to remove myself from the individual provisor which i took for home with my wife. and work covers us with group health. else i would have gladly kept payiing the premium for both me and my wife for the individual plan and also add her as a dependant on the group plan under me.

This is what I'm saying. Seems like different people at Guardian have different opinions and are giving different answers to the same question.

i checked the admed from maritime is seems good for major and emergency medical things only as they have set prices.
guardian medical you can claim all the small and major stuff. you either stick to the list and get your discount up front or, go anywhere else and pay full price go thru the fill out forms etc etc and wait for your cheque.
dunno much about sagicor one.
but admed price fluctuates depending on package. bronze,silver, gold,
guardian is the best priced.

Yes. Guardian has the best quote and coverage. In theory. I once had an agent like Premchand. In fact he was my emergency contact long before he was selling insurance.
I'm now going with the Provisor because the coverage adds to the group from my workplace and has international coverage on major and accident for travel purposes.

[The_Honourable]

Premchand, have two questions on Guardian:

1. For critical illness, is there some 30 day rule where if someone is diagnosed with X, that person have to wait 30 days before submitting a claim? or is it once diagnosed, that person have within 30 days to submit a claim?

2. What's the difference between the The Individual Personal Investor product and the Life Evolution Series - Investor product? Which one I can withdraw portions if needed without penalties or fees? Can I switch from one to the other?

[Premchand1976]

Premchand, have two questions on Guardian:

1. For critical illness, is there some 30 day rule where if someone is diagnosed with X, that person have to wait 30 days before submitting a claim? or is it once diagnosed, that person have within 30 days to submit a claim?

2. What's the difference between the The Individual Personal Investor product and the Life Evolution Series - Investor product? Which one I can withdraw portions if needed without penalties or fees? Can I switch from one to the other?

There is a 30 day survival period on the Rejuvenator ( critical Illness ) plan. Should you die within the 30 days , only the death benefit ( if any ) is paid. If you survive the 30 days , the critical illness is paid and terminated and the rest of the policy benefits continue. If you were to die any time after that 30 day period , your beneficiaries are paid the death benefit . The policy can be a double payout . One for critical illness and one for life insurance ( death benefit ).

The definition of a claim under critical illness is also important. I am reviewing a competitor's client's policy right now and the definition of their claim for heart attack is .......WOW.

The ipi is a unregistered annuity, has front loaded charges and penalties for the first 5 years, then zero thereafter ( the fund is set up for medium to long term investing ) the investor has no penalties / surrender / withdrawal charges after the 1st 12 months ( lumpsums have no penalties for withdrawals ) our charges are up front and from.principal funds only and not back end ( principal plus interest )

[The_Honourable]

Premchand, have two questions on Guardian:

1. For critical illness, is there some 30 day rule where if someone is diagnosed with X, that person have to wait 30 days before submitting a claim? or is it once diagnosed, that person have within 30 days to submit a claim?

2. What's the difference between the The Individual Personal Investor product and the Life Evolution Series - Investor product? Which one I can withdraw portions if needed without penalties or fees? Can I switch from one to the other?

There is a 30 day survival period on the Rejuvenator ( critical Illness ) plan. Should you die within the 30 days , only the death benefit ( if any ) is paid. If you survive the 30 days , the critical illness is paid and terminated and the rest of the policy benefits continue. If you were to die any time after that 30 day period , your beneficiaries are paid the death benefit . The policy can be a double payout . One for critical illness and one for life insurance ( death benefit ).

The definition of a claim under critical illness is also important. I am reviewing a competitor's client's policy right now and the definition of their claim for heart attack is .......WOW.

The ipi is a unregistered annuity, has front loaded charges and penalties for the first 5 years, then zero thereafter ( the fund is set up for medium to long term investing ) the investor has no penalties / surrender / withdrawal charges after the 1st 12 months ( lumpsums have no penalties for withdrawals ) our charges are up front and from.principal funds only and not back end ( principal plus interest )

Kudos for breaking it down. Thank you for the information Premchand, will pm you as i need some advice.

[nightcrawler]

Does provisor cover dental and optical? How long after you sign up can you make a claim?

[Premchand1976]

Does provisor cover dental and optical? How long after you sign up can you make a claim?

See sample schedule attached

[Premchand1976]

Premchand, have two questions on Guardian:

1. For critical illness, is there some 30 day rule where if someone is diagnosed with X, that person have to wait 30 days before submitting a claim? or is it once diagnosed, that person have within 30 days to submit a claim?

2. What's the difference between the The Individual Personal Investor product and the Life Evolution Series - Investor product? Which one I can withdraw portions if needed without penalties or fees? Can I switch from one to the other?

There is a 30 day survival period on the Rejuvenator ( critical Illness ) plan. Should you die within the 30 days , only the death benefit ( if any ) is paid. If you survive the 30 days , the critical illness is paid and terminated and the rest of the policy benefits continue. If you were to die any time after that 30 day period , your beneficiaries are paid the death benefit . The policy can be a double payout . One for critical illness and one for life insurance ( death benefit ).

The definition of a claim under critical illness is also important. I am reviewing a competitor's client's policy right now and the definition of their claim for heart attack is .......WOW.

The ipi is a unregistered annuity, has front loaded charges and penalties for the first 5 years, then zero thereafter ( the fund is set up for medium to long term investing ) the investor has no penalties / surrender / withdrawal charges after the 1st 12 months ( lumpsums have no penalties for withdrawals ) our charges are up front and from.principal funds only and not back end ( principal plus interest )

Kudos for breaking it down. Thank you for the information Premchand, will pm you as i need some advice.

No probs man

[Mms]

I have AdMed...I bought the gold package since i was told was the best one..
My husband had to have surgery in he sum of 113,000.00.
With the gold package it was under category c amount of payable 170,000.
You know they put it in category b which only paid 70,000 and I had to foot the rest....
I'm mad at this cause here I'm thinking that his spinal surgery would have been covered ....smh

[Premchand1976]

Arguably, Guardian still has the best plan, benefit and cost.

[nightcrawler]

Arguably, Guardian still has the best plan, benefit and cost.

What's the name of that guardian plan?

[redmanjp]

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.

how much does the Individual plan cost and what is covered? e.g. doctor's fees, blood test, etc. ?

[fokhan_96]

You said 75% for orthodontic treatment. Does this mean if my cost is $20000 then $15000 is covered and i only have to pay $5000?

[Premchand1976]

Arguably, Guardian still has the best plan, benefit and cost.

What's the name of that guardian plan?

Lifecare Quantum / Provisor

Under dental, remember whatever is not covered under the benefit limit, may be covered under the major medical limit ( surgery related )

[pugboy]

What’s the cost of the provisor plan ?

[Premchand1976]

Premiums are now banded, inbox your details, I can send a 99.9% confirmed premium

[1kingmed]

How does pan american paligmed stack up in the scope of things?

[Premchand1976]

Send me your email address and I will forward our schedule of benefits and rates for you to compare

[mitsutt]

Arguably, Guardian still has the best plan, benefit and cost.

What's the name of that guardian plan?

Lifecare Quantum / Provisor

Under dental, remember whatever is not covered under the benefit limit, may be covered under the major medical limit ( surgery related )

Corrections
Dental and vision limits are fixed dollar amounts , anything in excess of it you have to cover yourself.
The investor has charges for year 1 and 2 and also a bid offer .

[Premchand1976]

Arguably, Guardian still has the best plan, benefit and cost.

What's the name of that guardian plan?

Lifecare Quantum / Provisor

Under dental, remember whatever is not covered under the benefit limit, may be covered under the major medical limit ( surgery related )

Corrections
Dental and vision limits are fixed dollar amounts , anything in excess of it you have to cover yourself.
The investor has charges for year 1 and 2 and also a bid offer .

Surgery under dental is covered under the major medical.

Anything surgery related under any of the benefit classification that exceeds the states limit falls under the major medical benefit of the plan ( 250k,500k , 1M )

Investor ???? Yes it has charges year one and two......front end charges, not back end ( where the charges are taken from capital AND interest earned )

[diamondtip01]

I saw Venture Credit Union is offering Sagicor Goup Ins healh plans with monthly payments. Seems quite similar to sagicor annually one. Anyone knows about it or tired it