June 19, 2006 by bob.

Q. I notice you suggest finding a plan that does not include a rider on health conditions. Why is this?

A. Pretty simple actually. What is the ONE thing you want your plan to do?

Pay your claim.

If the plan only pays for some claims, and not for others, why have the policy?

Riders are a way for carriers to offer more affordable coverage and avoid risk. There is nothing wrong with choosing an affordable plan, but if it hangs you out to dry you don’t need it.

Consider two plans. One has full coverage including your hypertension, the other has a rider. The full coverage plan is similar in benefits but is 10% more than the one with the rider.

Here are some things to consider.

The rider plan will not cover your hypertension meds.

The rider plan will not cover your hypertension related doctor visits.

If you have a high deductible plan, expenses for your ridered condition do not accumulate toward the deductible.

If you have a stroke, or heart attack, your ridered plan may not pay for your medical bills.

Is that enough reason?

Would you buy an auto insurance plan that covers you if you have an accident in any month that does not have an “R” in it? Or would you rather have a 12 month policy, even if it cost a bit more?

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June 19, 2006 by bob.

Q. I am talking to another agent who represents some of the same carriers you have. He says his plan has more doctors in their network and he says his plan is better than the one you suggest. Why don’t you push the same plan he is offering?

A. The answer is simple. Although the rates and benefits are similar between the two plans, the difference is you will have full coverage under the plan I have suggested. With that other plan, which I can offer, you will not be covered for hypertension. That means your medication, doctor visits and anything related to hypertension will be denied.

So why is the other plan better for you?

It isn’t.

But the other plan is better for the agent. Assuming he earns the same commission I do on both plans, he makes twice as much if you buy the other plan but you get less coverage.

Now who wins?

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