Health Care Discount Plans
(Note: These tips pertain to the industry cited above and do not necessarily track our experience with the company in whose report they appear. In particular, industry complaints referenced below are typical of the industry as a whole, but not necessarily every company in the industry.)
People often look for ways to cut their health care expenses. Insurance is one way. Health care discount plans may be another way, if you do your homework in checking out the companies and the plans.
Participants typically pay an annual or monthly fee and are led to believe that they will receive large discounts on medical services and prescriptions from thousands of participating doctors or other providers. Do not buy over the telephone or Internet without reading the actual contract. Do not even give credit card or checking account information until you have checked everything out, even if the company says you can get a refund if you are not satisfied.
How do you determine if the companies deliver what they tell you? First, read the agreement to see what is actually offered. Asking the company how the plan works is not a substitute for reading the agreement. If a company will not allow you to receive a copy of the agreement to review first, you can shop for another company. Look for the sections that state exactly how much the discounts will be. If the plan says that you can save up to 80%, look for the minimum amount you will save, also. By the way, you may be able to arrange a discount on your own by paying cash. Check with your providers about that possibility.
Ask to see a list of participating providers in your area. Check with several of them to be sure that they do participate. Ask those local providers how big a discount they give members. Very importantly, check with your existing doctors, pharmacies, and other health care providers to determine if they participate in the plan and what discount they offer. You can also ask your providers what discount plans they participate in and then contact those companies for information.
Discount plans are not the same as insurance and are not regulated by the state of Texas. If you are not sure if the plan is insurance, call the Texas Department of Insurance at 800-252-3439 to check. If you call from out of state, call, 512-463-6169.
If the company checks out, compare what it offers to other discount plans that check out. These plans are not all the same. Then compare them to insurance plans. You may need one or both types of coverage to receive the protection you want at prices you can afford.