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Review 5/21/2009
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As you review Cinergy's policy understand one very important point - it was stated in William's response - and this point is crucial to understanding how dangerous their plans are:
They pay 80% of the MEDICARE Allowable rate.
Meaning, if you have a surgery that costs $50,000 and the MEDICARE Allowable rate is 40% ($20,000) - Cinergy will pay you $16,000 to cover your $50,000 surgery expense.
That means you will be responsible for the remaining $34,000 of your surgery expense.
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Business's response - by William W.on 5/26/2009
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We appreciate your example, and while the math is correct, the scenario unfairly misrepresents the intentions and coverages of the Cinergy Health limited medical benefit insurance plans. Our limited medical benefit insurance plans are designed with the intention of delivering meaningful and defined health insurance coverage at rates that are more affordable than those associated with major medical insurance. We further attempt to minimize our members’ potential out-of-pocket liabilities, by encouraging our members to seek care from any of the hundreds of thousands of participating doctors and hospitals, which are contracted under reduced fees for patients within these plans.
As a consumer, one of the primary reasons for being insured is to avoid the full billed charges that uninsured patients are typically billed. We offer limited medical benefit insurance plans, and we understand that our health plans may not be suitable for everyone. Therefore, we ask that every healthcare consumer make a thorough personal assessment to determine if a limited medical plan is sufficient to meet their own healthcare needs. As with most things it is often a trade-off between cost and the extent of coverage you get. Unfortunately for many, the choice is difficult because of the rapidly increasing cost of major medical health insurance.
I hope this helps in your assessment of Cinergy Health, and if you have any further questions or would like to discuss this, then please call us at (800) 847-1148 and ask to speak with the Chief Compliance Officer (x105), or email us at info@cinergyhealth.com.
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