{"id":3385,"date":"2021-06-12T09:00:03","date_gmt":"2021-06-12T09:00:03","guid":{"rendered":"https:\/\/healthdrum.com\/?p=3385"},"modified":"2021-10-12T15:38:49","modified_gmt":"2021-10-12T15:38:49","slug":"junk-health-plans","status":"publish","type":"post","link":"https:\/\/healthdrum.com\/blog\/junk-health-plans\/","title":{"rendered":"Junk Health Plans"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">The health insurance industry is in the business of making money &#8211; not covering your health problems. In fact generally, the more \u201caffordable\u201d, the greater the \u201cadvantage\u201d, the \u201cbetter\u201d the deal, the \u201ccheaper\u201d the plan, the less you get covered. The health insurance industry is about the only insurance industry that \u201ccovers\u201d routine care and then takes you for a fool.<\/span><\/p>\n<p><b>Health plan tactics to minimize payments.<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You pay for your routine care anyway with copays, deductibles, non-covered services and any pre-existing issues.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Plans are marketed using misleading terms.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Plans have terminology that\u2019s difficult to understand.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Plans are confusing by design.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Plans are impossible to compare.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Plans are riddled with loopholes, limits and exclusions.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Plans use endless barriers such as \u201creferrals\u201d to limit access to care.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Commonly have narrow provider networks.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Use non-medical intermediaries for \u201cauthorizations\u201d to delay, ration or deny care.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Limit testing and often recommend cheaper options, i.e. ultrasound instead of MRI to limit payouts.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Have \u201cpreferred\u201d drug lists &#8211; you get cheaper drugs so they save money.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Have cost limits for drugs.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Deny tests or treatments claiming they are experimental or unnecessary.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Subject consumers to post-claims payment reviews.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Commonly use agencies to review claims and claw back payments.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Unilaterally and systematically deny coverage.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Explanation-of-benefits or EOBs are ploys to explain why payouts were limited.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Explanations regarding provider payout \u201callowables\u201d are ploys to mislead.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Plans often discriminate against women.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Commonly, only about 50 percent of premium dollars are paid out on medical claims.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Brokers are compensated more for selling junk health plans.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Be wary of \u201cindividual\u201d, \u201cmanaged care\u201d, \u201ccobra\u201d and \u201cfixed benefit\u201d plans and medical discount cards.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Not all health plans are equal &#8211; even large insurance companies sell junk plans.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Healthcare \u201cratings\u201d are unreliable.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The health insurance company\u2019s allegiance is to their shareholders &#8211; not patients.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Visit <\/span><a href=\"https:\/\/healthdrum.com\/\"><span style=\"font-weight: 400;\">www.HEALTHdrum.com<\/span><\/a><span style=\"font-weight: 400;\"> Come join our healthcare community and discover how <\/span><b>consumer-directed, self pay care<\/b><span style=\"font-weight: 400;\"> can save you a bundle of money and put healthcare control back in your hands.\u00a0<\/span><\/p>\n<p><b>Read more.<\/b><\/p>\n<p><a href=\"https:\/\/healthdrum.com\/blog\/why-doctors-need-to-reclaim-their-profession\/\"><span style=\"font-weight: 400;\">https:\/\/healthdrum.com\/blog\/why-doctors-need-to-reclaim-their-profession\/<\/span><\/a><\/p>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">Written by HEALTHdrum<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The health insurance industry is in the business of making money &#8211; not covering your health problems. In fact generally, the more \u201caffordable\u201d, the greater the \u201cadvantage\u201d, the \u201cbetter\u201d the deal, the \u201ccheaper\u201d the plan, the less you get covered. The health insurance industry is about the only insurance industry that \u201ccovers\u201d routine care and [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":3388,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[21],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Junk Health Plans | HEALTHdrum<\/title>\n<meta name=\"description\" content=\"Junk health plans are insurance plans that over promise and under deliver.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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Subsequently, he completed fellowship training in Pediatric and Adult Reconstructive Urology at the Eastern Virginia Medical School in Norfolk, Virginia. During his time there he also undertook NIH sponsored, pioneering research on \u201cUrinary Bladder Reinnervation\u201d earning him the honor of a Masters of Surgery Diploma through the University of Otago, New Zealand. Dr Vorstman returned to Miami to become a board-certified faculty member in the department of urology, Jackson Memorial Hospital, University of Miami. Eventually, he left academic practice, moved north to Coral Springs and established Florida Urological Associates pa (www.urologyweb.com) in 1987. Dr. Vorstman is passionate about consumer-directed healthcare and helping men diagnosed with prostate cancer navigate the minefield of prostate cancer misinformation. After retiring and leaving colleagues to continue the urology practice, he became founder and CEO of a healthcare platform that connects buyers and sellers of routine, cash pay healthcare services - www.HEALTHdrum.com\/ Through this platform he also enables colleagues to reclaim their profession from health industry exploitation. Partial bibliography https:\/\/ascopost.com\/issues\/june-10-2016\/prostate-cancer-opinions-vary-on-gleason-scores-and-surgery\/ https:\/\/ascopost.com\/issues\/november-25-2020\/a-urologic-surgeon-assesses-the-current-state-of-prostate-cancer\/ https:\/\/www.medscape.com\/viewarticle\/945928 https:\/\/urologyweb.com\/robotic-deception-prostate-cancer-hoax-p-5\/ https:\/\/bvorstman.medium.com\/prostate-cancer-treatment-deception-and-lies-30e23f17b749 https:\/\/healthdrum.com\/blog\/the-gleason-6-prostate-cancer\/"}]}},"_links":{"self":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3385"}],"collection":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/comments?post=3385"}],"version-history":[{"count":8,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3385\/revisions"}],"predecessor-version":[{"id":3907,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3385\/revisions\/3907"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/media\/3388"}],"wp:attachment":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/media?parent=3385"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/categories?post=3385"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/tags?post=3385"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}