My husband’s job doesn’t offer medical insurance. He found this website: http://www.formulatedmedicalplan.com/. They are offering what sounds like a good deal for him, me, one of his brothers, the brother’s wife, and her two kids (by her ex-husband).
My husband just now dumped this in my lap. The company is asking us to commit today in order to lock in the rates/premium. I have no idea if this company’s services are worth what they charge. Any info and advice welcome. (I’ll be researching them online, but while I’m doing that, I thought I’d ask here.)
Caveat: I don’t know anything about this company, but…
High-pressure sales tactics are a red-flag to me. It tells me they don’t want you to do your research before committing. It also doesn’t really make sense that they’d raise their rates on a random Tuesday in January. Rate increases are typically once a year, on Jan. 1.
And… telemedicine? There is so much that a doctor is just not going to be able to do without directly observing your symptoms. This means that the quality care available to you will be extremely limited. A rash could be dry skin/eczema or it could be the first symptom of a life-threatening allergic reaction. I don’t see how a doctor would be able to diagnose that over the phone without actually seeing it, live and in-person. How would you do blood labs? I would think this would run the risk of you not getting care/diagnosis you really needed, because the phone-doctor makes a blind diagnosis and treatment, and you think you’re done because you “saw the doctor,” and don’t get further face-to-face treatment until you’ve got a (now very expensive) emergency on your hands.
Color me skeptical. I would not want a doctor to guess at my diagnosis based on my limited ability to describe symptoms accurately. I’m not a doctor. I may not notice something because I don’t have the training to know it’s important.
I tried to google them and came up with nothing either damning or praiseworthy–that means they’re probably too new to have a reputation.
This is not something reputable insurers do–the rate is the rate, based on actuarial tables and years of research. Things that matter are age, marital status, medical history–NOT whether you sign on the dotted line today or next week. And naturally, you should never commit to something without the ability to do your research. Nor should you trust a company that attempts to deprive you of that ability.
IMO? Just wait. Healthcare is supposed to be mandatory (even if you have a pre-existing condition) and affordable next year. By then, there will likely be a veritable buffet of reputable health insurers who provide more transparency than these assholes. They may be trying to lock you into a stupid-high rate now. Or maybe they’re legit, but you can’t know that. Frankly, it’s just not worth the risk.
Simply think of it this way: if they’re significantly cheaper than buying your own insurance from a reputable provider right now, there’s a reason for that.
Which could mean they’re not regulated. Insurance companies are highly regulated by the department of insurance in each state. If this is a for-profit medical… thingy (I don’t even know what to call it), then there’s no way to know whether they’ll do ANYTHING with the money you send them.
After reading their Terms and Conditions page, this sounds like the medical version of AAA. It is not insurance! You pay them to get access to discounts for certain procedures at certain medical providers (none of which are guaranteed). And if you use their discount too much, they’ll likely drop you like a hot potato. Some relevant bits that should discourage you from wanting to join:
“CAREINGTON/Formulated reserves the right to terminate plan members from its plan for any reason, including non-payment.”
“You are obligated to pay for all health care services at the time of your appointment. Savings are based upon the provider’s normal fees.”
“This plan is not a health insurance policy.”
“This plan does not make payments directly to providers of medical services.”
“This plan provides discounts at certain healthcare providers for medical services.”
“This plan does not discount all procedures.”
“It is the member’s responsibility to verify that the provider is a participant in the plan.”
“The plan member is obligated to pay for all healthcare services but will receive a discount from those healthcare providers who have contracted with the discount medical plan organization.”
“The program and its administrators have no liability for providing or guaranteeing service or the quality of service rendered.”
From their FAQ page (red coloring mine):
"Q - Can I physically go to a doctor face to face?
"Yes, however please know that face to face doctor appointments are not part of this program. Seven out of ten face to face doctor appointments are not necessary! While the care was necessary, the time, travel and cost of the visit could be avoided.
"Q - Can I get a prescription?
"It is up to the doctor to recommend the best treatment. Please know that our doctors do not issue prescriptions for substances controlled by the DEA.
"Q - Is this program insurance?
“No. This is not insurance, nor is it intended to replace insurance. This is a Nationwide Discount Medical Program. An alternative to expensive and wasteful traditional insurance.”
Yes, that expensive and wasteful insurance that can actually prescribe and pay for controlled substances when your health condition requires them. :rolleyes:
I recognized and was skeptical of the “must buy now!” sales tactic of the sales rep. However, I thought this was medical insurance, based on what (little) my husband told me about it. I’ve had time to look into the company and found out they are not selling health insurance but a “discount card” program for health care services.
Not much info about the company is on line, but based on what I did find about “discount card” programs (thanks, Better Business Bureau!) we’re going to pass on FMP’s offer.
Once again, thanks for sharing y’all’s observations and advice.
I’d love to know where they got their stat that seven out of ten doctor’s visits are unnecessary. My doc won’t prescribe an anti-biotic over the phone (and apparently the telephone doctors can’t anyway), and that’s a good thing, because she can’t tell without seeing me and maybe running some labs whether it’s a cold, pneumonia, the flu, or something else entirely.
I can’t think of a time where it was really critical for me to receive healthcare, where it would have been remotely adequate to do it over the phone. And regular doctors don’t tend to charge if all you need is a quick question answered that can be done via phone.
Sounds like you’re making the right decision. For the benefit of others who google this company and the Dope comes up as the only resource, I found this “scam watch” regarding discount medical card scams on the Delaware state insurance website (bolding mine):
"Some discount health care cards may provide valuable, money-saving benefits for people without health insurance. But unscrupulous marketers offer discount health cards claiming they are health insurance when, in fact, they are not insurance. You still must pay the medical bills yourself. To the extent they provide any benefits at all, discount medical health cards simply offer lower prices on services that accept these discounts. Many cards thus can cost you far more money than they’re worth.
“In these tough economic times, the number of deceptive or fraudulent medical discount cards is growing at an alarming rate. To lure unwary customers, ads for bogus cards can make it seem they’re selling real health insurance. They often make grossly inflated promises about savings and benefits and incorrectly represent that they are accepted by many doctors and other health care providers. Though legislation is pending, discount medical health cards are not currently regulated by the Department of Insurance, which means there are fewer consumer protections. While the DOI does investigate consumer complaints regarding the unfair marketing of these cards and their mismarketing has been prosecuted, the absence of licensing and regulatory authority means you have to be extra vigilant.”
Missed the edit window, but here’s an even better resource: CNN news story on medical discount (not insurance) companies:
"The Federal Trade Commission and at least eight states have taken action against more than two dozen health cards for offering discounts services that don’t exist.
" ‘Medical discount cards are spreading like kudzu,’ said Jim Quiggle, a spokesman for the Coalition Against Insurance Fraud. ‘There’s a tremendous amount of fraud and deception in these plans because they’re not well regulated.’
" ‘Medical discount cards are awful,’ said Nancy Metcalf, senior program editor with Consumer Reports. ‘They’re absolute ripoffs. I would stay away from them completely.’ "
I can’t find where they say they cover hospital stays, which is what really would bankrupt you. It is like AAA where you’re buying “insurance” for towing instead of engine replacement, (but at least you’re getting something of definate value, a number to call anywhere in the country when the gremlins get you.
FWIW, traditional insurance companies are pushing telemedicine too, my company even has a kiosk at the site for virtual doctor visits if you don’t want to use your own computer. Maybe OK for when your prozac runs out and you just need a renewal, the doctor can just ask you remotely if you’re feeling OK or if the medicine is making your toes turn blue or you feel like offing yourself. but I personally have never used it and never intend to.
I don’t think that’s true. My insurance raises the rates anytime it damn well pleases - sometimes more than once a year, and so far never on January 1. I just get a letter informing me that my premium rates are going up. And yes, this is real health insurance, from a large national insurance company.
Nowadays, rate increases are regulated. There’s even a tool you can use to see if your company is considering a rate increase anytime soon.
Which makes telemedicine even more of a scam, because I don’t know of a doctor that wouldn’t also do that over the phone, for no extra charge, assuming you were already a patient and had seen that doctor in person regularly/recently enough that s/he can know that nothing significant has changed. Soo… you get a “discount” on something that normally wouldn’t cost you anything anyway. :dubious:
All telemedicine is not a bad thing, where I live they have a 24 hr ‘call a nurse’ program that has been very helpful. Yes, often the advice is go to: your Doctor, Urgent Care, Hospital. But it’s great for questions about medication interaction, etc. Also if you’re not sure if you need to see the doctor. They were invaluable to me when I was caregiving for a bedridden loved one in my home.
And just recently when I was hospitalized the specialist that was actually calling the shots on my care, changing up the meds and doses, ordering all the tests, and seeing all of the results, wasn’t even in the hospital. It was Easter weekend. That was all possible because of telemedicine.
I would agree that this is a scammy trick, that the OP found, but please don’t turn people from actual beneficial ‘telemedicine’.
I think Ask a Nurse hotlines are different though. Asking a basic question that doesn’t involve making a diagnosis is different than doing medicine over the phone. And honestly, I’m unfamiliar with any that cost extra money. Ask a Nurse is often included in employee benefits package, but it’s not something that costs money per call. And as far as I know, they’re not “public” lines that anyone can call, only if you’re a part of that insurance plan.
As an added benefit to real insurance, I think it’s useful and reasonable. As a substitute, as with this discount program, I think it’s a scam.
If you need insurance but you don’t have access to it through an employer you should call a couple of carriers and ask about emergency only coverage or other similar products. Many insurance companies carry a low end product that covers you up to $10,000 (or $50,000 or whatever number they have landed upon) should you end up in the emergency room but doesn’t pay for regular doctor visits and the like. While this wouldn’t be a perfect solution to your problem it would provide a buffer that would hopefully prevent you from going bankrupt in the event of a medical emergency for a pittance.
If there is no such plan offered in your area or that doesn’t work for you then you might want to look into an HSA plan with a crazy high deductible to bring your monthly costs down. That way if you end up having a $15,000 deductible and you end up in the hospital you will owe 100% of that $15,000 but generally not a penny more than that as long as your coverage is accepted by that facility.