Complaint Review: Assurant Health Major Medical Policy

I do not sell insurance.... in fact I am retired and we have employer-provided medical insurance that is really excellent. But the rules for private insurance are very different than the rules for group insurance. One example: group insurance cannot exclude pre-existing conditions [i.e. high blood pressure, asthma], while private insurance policies CAN, and WILL, exclude pre-existing conditions. And if you later develop diabetes, you become UNINSURABLE for a new policy in the private medical insurance world.

The sole exception is only when you first turn 65 and you buy a private Medicare Supplimental Policy: pre-existing conditions must be covered. But thenafter, if you want to switch to another private Medicare Supplimental Policy you will find that private Medicare Supplimental policies CAN, and WILL, exclude pre-existing conditions.

I suggest you read the Jan '08 CR, and note carefully the comment about "policy death spiral".

I was looking for something else and saw your comments....I'm a broker in San Antonio Texas , I sell alot of Assurant here and carry the policy personally for my family. There seems to be a little truth in what you wrote in that there is a co pay of 15 dollars in their policies but it is for generic meds/drugs not office co pays. The co-pay available was never 15 for doctors office visits it is currently 35. The co-pay for brand name is 25 subject to a seperate 500 deductible. The reason I carry Assurant as an agent is because even though it is expensive relative to other carriers there are less exclusions and the policy is written cleaner in my opinion. I have over twenty years of expirience reading policies. I know it hurts to pay so much to recieve so little .... maybe this will help.....

This is what I do I carry a 5000 deductible w/50/50 co ins to 7000 which is 8500 out of pocket in net work 9500 out. I pair that w/ a 10,000 accident. So as it would happen if there where an accident my bill would be 100 dollars! It happened last year 1 of my three broke her arm the bill was 5300 and I paid 100. If we have doctors visits they are in network for around 60 as opposed to a 35 dollar copay.
By opting to for go doctors visit coverage my premium is approximately 100 dollars a month less therefor I have limited my liability to major illness to about 8500 per year.(most likely there will not be more than two major illness in the same year, in the same immediate family)the premiums I save over lower deuctibles will recoup any difference in deductible eventually but in most cases immediately. I pay around 280 for the whole family 42s/35ns/3kids but it will be slightly higher up north

Insurance is highly regulated in my state and yours. Insurance Companies do exactly what the policy states to the letter, in my expirience. Good Luck.

First, $400 per month is very inexpensive for health insurance. Usually the policies that have co-pays that small ($15) are over $1000 per month for family. I have never had Assurant, but basically you got the insurance that is for a catastrophic illness that could wipe you out financially. Actually almost worth $400 per month.

What you usually get for those policies is this. A very high deductible, but certain coverages once that deductible is met. Worth it if you become hospitalized.

Since Assurant is located in a state other than your own, they are not governed by the laws of your state, but by the laws of their state. Because of this, many insurance companies that sell out of state base their operations in the states with the least amount of laws they have to abide by.

Go on the web and search for your states department of insurance (may be department of financial affairs) and find out which insurance companies are governed by the laws of your state. Call them for quotes. There are certain guidelines they must abide by for your state. Assurant may be registered to sell in W.Va., but that doesn't mean they are governed by W.Va. That claim is probably somewhere in your insurance paperwork.

I live in FL and insurance companies governed by Florida have laws they must adhere to in regards to pre-existing conditions, cancellations, raising premiums, etc.

One more thing. Even though you didn't see any savings, your doctor, lab, etc. can only bill you for the contracted amounts they have with Assurant. That is one positive in having this type of insurance. Assurant will tell you the contracted amount in their Explanation of Benefits you should be receiving after each appointment/procedure. The doctor/lab/hospital, etc., cannot bill you for more than that amount or they are in violation of their contract with Assurant. However, you must make sure you go to providers that Assurant has contracts with.