I've spent all day doing research for all of you who don't have the time. Here's why:
A lady called me today to offer an insurance plan with a too good to be true price. I fell for it. It was to cost $139.95 a month with a registration fee of a similar amount. The rate was "promotional" but would never be raised as long as we continued making our monthly payment. She said the company New Health Choice PPO was non-profit, in business since 1935. A PPO, 80/20 with hospital benefits, vision and dental.
I gave her my family's info and the credit card to charge. Then we moved on to the recorded confirmation part where she read off statements that I had to either agree to or repeat after her. When she got to the part that the charges were non-refundable and this is not an insurance policy I asked her to give me some time as I had a few questions to research and I'll call her later. She said no problem and gave me her number 888-858-8180 and an extension number, telling me to leave her a message and she'd call right back.
I googled the company name and found info right here on usacomplaints.com that indicated this was no good. So I called, left a message, and she called right back. I asked several questions: 1- Will your company be able to provide me with a certificate of coverage? Answer-YES. (This is a lie. This plan is not an insurance policy so no coverage exists and therefore no certificate can be issued.) 2- Will my doctor be paid the 80% of his fees? She answered YES!
New Health Choice would not pay directly, but the doctor would be paid through Blue Cross or whatever network "popped up" when my membership card was swiped. This made no sense to me, so I proceeded with question 3- Can I see the plan details in writing or on some website? Answer - Sure. As soon as my fees are paid and membership processed I will receive within 24 hours an email with a temporary membership number and some info, and a welcome packet in the mail a short time later.
I told her that in this day and age I expected any reputable company to have a website with detailed information about their product or service. She became agitated and told me "You know what, I'll hold on to your application and when the promotion is over I'll send you pamphlets to review and then you'll pay 4-500 dollars for the same plan! I started saying that I wouldn't mind paying this much for legitimate health insurance but she didn't listen, just went on ranting and insulting me, saying that I was ignorant and several other unsavory things before slamming the phone down.
By now I knew this was a scam but I needed more info on the company in order to post the story. So I called the number again and tried several extension numbers. Not one of them were answered - they all went to voice mail. Apparently, that's how they screen calls to avoid difficulties. I couldn't find much online, either, so eventually I left a message and my call was returned by someone who claimed to be a supervisor. Only he wasn't sure which company I had called about.
During our conversation he mentioned New Health Choice PPO, Good Health, PPO Next, NBC Health and I believe one more which I missed. He repeated the same crap about 80/20 coverage, payments to the Dr. Through blue cross, etc. Then I asked for a website where I could review the details. At first he said it was for members only, to which I replied that I understand I wouldn't be able to log in but I would want to, at least, see the home page.
Finally he gave me the address as being NBCHealth.com.
I checked it out. Found that it was not as they told me, and figured out that it could not possibly pay. Here's what it says in handbook B, page 4, paragraph 5 under the heading Physician office visit 30% savings guarantee:
"Members must pay the contracted rate in full at the time of billing for the services. The guarantee only applies to network doctor office visits that have been paid in full with a total billed amount of less than $500.00 per visit. There is a maximum of 12 medical encounters per calendar year."
It goes on to say that if a member does not receive a 30% savings on the total physicians' usual billed charges, the member will be reimbursed the difference after following a whole set of instructions, as specified.
Let's do the math. 30% of 500 is 150. That's the maximum savings they will guarantee, limited to 12 times a year and only with in-network providers. They pay nothing to the physician, or to any other provider for that matter. There is an accidental death and dismemberment policy attached to the plan, but that's not available in NY. The whole thing stinks. It seems unlikely that anybody will ever benefit by buying this plan. What's certain is that their salespeople are liars and crooks who are scamming people. Beware!
0 comments