Value Health for diabetics
originally posted: 11/22/2006 reposted: 2/18/2011 This post has not been recently reviewed or revised by the author and may be out of date. If in doubt, please send a new question or ask for an update.
Q: My questions regarding Value Health Plan: 1) I am diabetic and I know the 12month waiting period in calculating the fee for classic ($25.00) semi-annual do I pay 6 X $25.00 X $15.00 admin. fee + $5.00 = $245.00 or 6 X $25.00 = $150 + $15.00 + $5.00 = $170.00. I am confused about the $15.00 admin. fee for each month particularly if you choose the semi-annual payment or the annual payment. Please clarify. 2) The 12month waiting period means that no coverage for anything related to my diabetes, but if I get my teeth cleaned or regular eye exam there will be some coverage yes/no, just needed clarification, so I can feel more comfortable to apply to this plan.
A: Value Health is currently the best (and one of the only) low cost insurance that allows insulin-controlled diabetics. It is a limited benefit insurance offered through FreedomBenefits.net. Because this product is new to the market, these types of questions are common. The administrator replies that new rate calculation materials are being printed to address the areas that caused you confusion. 1) The $5 and $15 fee are charged every month regardless of payment method. So, in your case, the six month premium is 6 x $45 = $270. While I agree that the combined $20 per month administrative charge is high in relation to the premium, it is slightly less than average for all group type health insurance policies across the board. And, of course, the total premium is significantly less than anything else available to insulin dependent diabetics. 2) Only expenses related to diabetes are excluded. The big risk of a pre-ex limitation is that if you happen to be hospitalized on an emergency basis, often the cause is not determined until after admission, and therefore benefits are not pre-determined.
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