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Great Experience With BuyAmericanInsurance, OK with IMG (Long but must read)
IMG Protection America - My Experience and Tips
Before I rate IMG Protection America, let me rate BuyAmericanInsurance as excellent. I also want to thank Mr. Narendra Khatri of BuyAmericanInsurance who took very good care of me. The service provided by BuyAmericanInsurance was more than what was expected from them.
My mom's claim of around $20K was denied by IMG (Protection America) on the basis of pre-existing condition. Following this I contacted Mr. Khatri and with his help we filed an appeal along with our Doctor's note. His continued effort and follow up with IMG led to the reversal of denial and the claim was processed and paid per the plan benefit. I didn't expect an insurance agent to fight for their customer’s rights so hard. So if you need to buy insurance, I will suggest this is the best place to buy because unlike other agents, here you get the support even after you bought it.
My mom was admitted for severe dehydration and low sodium in her body following Vomiting and Diarrhea. She has high BP as her pre-existing condition. During and after her treatment all doctors were very confident that neither her condition is chronic nor pre-existing, nor it has any relation with her pre-existing condition of high BP.
I was shocked when IMG (Protection America) denied the claim on the basis of pre-existing. I would have expected this with Indian Insurance company, but not from an American company. It was only after the appeal, note by the attending physician and the good effort by Mr. Narendra Khatri that they reversed their decision and decided to pay.
Therefore, Protection America, I will rate them OK/Good. I cannot give them better rating, as they did deny by mom's claim first on the basis of pre-existing condition that was not correct. Other than this, my experience with IMG was very good. They paid in time and directly to the providers and per the benefit. Customer service was also good and I was able to talk to the same person each time I called. This made it a lot easier.
Here are some tips from my experience. I had debated the all questions below myself and decided to buy insurance, I am glad I did it.
1) If pre-existing is not covered, why should I bother taking insurance for elderly with pre-existing conditions like BP, Heart problem, Diabetes etc? Most likely they are going to have trouble with those conditions, if any.
Answer is you never know what is going to happen to whom and when. My Mom's all pre-existing conditions were in control all the time and something happened we never heard or expected of. Beside, illness one can have accident, which has nothing to do with pre-existing condition.
2) By reading forum it seems like almost every insurance company will try to tie any treatment whether or not pre-existing with pre-existing and deny the claim.
Yes, they do that, and that's what happened to me. But if you buy American Insurance, and if your case is genuine, you can appeal and even take help of your state's insurance commissioner and most likely will get favorable result in time. For me it took just 3-4 weeks for them to reverse the decision. If you buy Indian Insurance, I can't imagine you can get the result so fast and in your favor.
3) There is a huge difference between premium of comprehensive and fixed. With the age of my parents and there duration of stay, comprehensive becomes very expensive. Shall I just take fixed?
Well, this was the most important question for me. My wife and I debated a lot on this. She wanted to take fixed and I wanted to take comprehensive. I am so glad I took comprehensive. Now when I look back, if I would have taken fixed, I don't think insurance company would have paid even half or one third of the total bills. I feel fixed is as bad as no insurance. If you just want to have insurance for namesake, take fixed. If you want to protect yourself from unexpected, then take comprehensive. Yeah, it’s so expensive, true! What we did is increased our deductible to the maximum we can afford. That brought down the premium a lot.
4) If we take high deductible like $1000 on my comprehensive, what is the use of taking insurance if first $1000 I have to pay from my pocket.
Well, I take insurance to protect myself for unexpected things like what happened to my mom. I don't see the point in taking insurance to cover your $100 office visit. I think most of us can afford that. What we worry about is, if something major happens to them. Well, that's why one need to decide what the maximum one can afford, $500 or $1000 or even $2000. See chances are very high that nothing will happen to them. That's why insurance company makes money. So your $1000 deductible doesn't mean anything, as most likely you will never have to go to doctor, but this will save you money now in premium. Only, if you get unlucky like me, the deductible comes into the picture.
5) What is the point of taking comprehensive with large deductible when I can get fixed with zero deductible and same amount of coverage?
For example, you get unlucky and go to ER. Say, your total bill comes to $5000. Assume fixed plan will pay only $2300 per their schedule and even with zero deductible but you are still liable for $2700. Whereas on the other hand, comprehensive with $1000 deductible, insurance will pay 80% of $4000 (for Protection America, first $5000 is covered at 80%) i.e. $3200 and you will be liable for $1800. Still works out better than fixed.
6) I heard that if you don’t sign any paper saying you are responsible for the medical expenses of your parents, you can get away with paying the part of payment not covered by insurance. Is it true? If yes, then why should we take insurance?
I do not know the answer of this. May be Mr. Khatri can respond to this.
Tips:
1) If your parents’ doesn’t sound good, even though they say they are fine, go with your instinct and see a doctor. Don't wait too long to see doctor, even if it sound not serious.
2) If your parents are religious and want to fast, allow fasting only if their health allows and you feel comfortable with their decision to fast.
3) If something unexpected happens, call 911 and get an ambulance, don't try to take the patient on your own to ER.
4) If you had to go to ER, call insurance ASAP to get pre-certification initiated.
5) Do not sign any thing that says you are financially responsible for medical expenses. Let the other parent sign on that.
6) Don't hesitate to tell about all pre-existing medical problems to the doctor about the patient. Don't even think that your insurance will be denied if you tell them all the past medical problem. That is required for the better diagnosis/care for the patient.
7) Talk to Dr. about your concern of pre-existing clause on insurance. Dr. will be able to tell if the condition is pre-existing or not.
8) When patient come out of hospital, get copy of all the medical records from hospital. You might need these later if you have problem with insurance as well as for further treatment back home.
9) Before they return home, get a medical confidentiality release form, authorization letters etc signed by the patient in your name. Its a good idea to let them sign few authorization letters saying they authorize you to discuss all health/insurance on your behalf. Insurance companies/hospitals wouldn’t even talk to you without these letters.
10) Before they board flighe home, If any of your parents were in hospital, get a written authorization from Doctor saying that the passenger is in good condition and able to travel back home and keep that with the passenger. Airline may deny boarding without travel authorization letter from doctor if they find out that the passenger was in hospital or had medical problem recently. Happened to me, Air India were almost ready to leave them behind if my Dr. wouldn't have faxed the letter to the airport right at that time. All we did is asked for wheel chair, and all these became a huge problem for Air India!
11) Keep the pager number of the Doctor who treated your parents, all the time with you, until they go back home. If I wouldn't had the pager number for my doctor with me at the airport, air india would have left them behind.
I took a long time to write this, just thinking that I can help a little bit this way to all my countrymen who love there parents, call them here with all good intention but have to go through this difficult insurance and medical uncertainty. Thanks.
Before I rate IMG Protection America, let me rate BuyAmericanInsurance as excellent. I also want to thank Mr. Narendra Khatri of BuyAmericanInsurance who took very good care of me. The service provided by BuyAmericanInsurance was more than what was expected from them.
My mom's claim of around $20K was denied by IMG (Protection America) on the basis of pre-existing condition. Following this I contacted Mr. Khatri and with his help we filed an appeal along with our Doctor's note. His continued effort and follow up with IMG led to the reversal of denial and the claim was processed and paid per the plan benefit. I didn't expect an insurance agent to fight for their customer’s rights so hard. So if you need to buy insurance, I will suggest this is the best place to buy because unlike other agents, here you get the support even after you bought it.
My mom was admitted for severe dehydration and low sodium in her body following Vomiting and Diarrhea. She has high BP as her pre-existing condition. During and after her treatment all doctors were very confident that neither her condition is chronic nor pre-existing, nor it has any relation with her pre-existing condition of high BP.
I was shocked when IMG (Protection America) denied the claim on the basis of pre-existing. I would have expected this with Indian Insurance company, but not from an American company. It was only after the appeal, note by the attending physician and the good effort by Mr. Narendra Khatri that they reversed their decision and decided to pay.
Therefore, Protection America, I will rate them OK/Good. I cannot give them better rating, as they did deny by mom's claim first on the basis of pre-existing condition that was not correct. Other than this, my experience with IMG was very good. They paid in time and directly to the providers and per the benefit. Customer service was also good and I was able to talk to the same person each time I called. This made it a lot easier.
Here are some tips from my experience. I had debated the all questions below myself and decided to buy insurance, I am glad I did it.
1) If pre-existing is not covered, why should I bother taking insurance for elderly with pre-existing conditions like BP, Heart problem, Diabetes etc? Most likely they are going to have trouble with those conditions, if any.
Answer is you never know what is going to happen to whom and when. My Mom's all pre-existing conditions were in control all the time and something happened we never heard or expected of. Beside, illness one can have accident, which has nothing to do with pre-existing condition.
2) By reading forum it seems like almost every insurance company will try to tie any treatment whether or not pre-existing with pre-existing and deny the claim.
Yes, they do that, and that's what happened to me. But if you buy American Insurance, and if your case is genuine, you can appeal and even take help of your state's insurance commissioner and most likely will get favorable result in time. For me it took just 3-4 weeks for them to reverse the decision. If you buy Indian Insurance, I can't imagine you can get the result so fast and in your favor.
3) There is a huge difference between premium of comprehensive and fixed. With the age of my parents and there duration of stay, comprehensive becomes very expensive. Shall I just take fixed?
Well, this was the most important question for me. My wife and I debated a lot on this. She wanted to take fixed and I wanted to take comprehensive. I am so glad I took comprehensive. Now when I look back, if I would have taken fixed, I don't think insurance company would have paid even half or one third of the total bills. I feel fixed is as bad as no insurance. If you just want to have insurance for namesake, take fixed. If you want to protect yourself from unexpected, then take comprehensive. Yeah, it’s so expensive, true! What we did is increased our deductible to the maximum we can afford. That brought down the premium a lot.
4) If we take high deductible like $1000 on my comprehensive, what is the use of taking insurance if first $1000 I have to pay from my pocket.
Well, I take insurance to protect myself for unexpected things like what happened to my mom. I don't see the point in taking insurance to cover your $100 office visit. I think most of us can afford that. What we worry about is, if something major happens to them. Well, that's why one need to decide what the maximum one can afford, $500 or $1000 or even $2000. See chances are very high that nothing will happen to them. That's why insurance company makes money. So your $1000 deductible doesn't mean anything, as most likely you will never have to go to doctor, but this will save you money now in premium. Only, if you get unlucky like me, the deductible comes into the picture.
5) What is the point of taking comprehensive with large deductible when I can get fixed with zero deductible and same amount of coverage?
For example, you get unlucky and go to ER. Say, your total bill comes to $5000. Assume fixed plan will pay only $2300 per their schedule and even with zero deductible but you are still liable for $2700. Whereas on the other hand, comprehensive with $1000 deductible, insurance will pay 80% of $4000 (for Protection America, first $5000 is covered at 80%) i.e. $3200 and you will be liable for $1800. Still works out better than fixed.
6) I heard that if you don’t sign any paper saying you are responsible for the medical expenses of your parents, you can get away with paying the part of payment not covered by insurance. Is it true? If yes, then why should we take insurance?
I do not know the answer of this. May be Mr. Khatri can respond to this.
Tips:
1) If your parents’ doesn’t sound good, even though they say they are fine, go with your instinct and see a doctor. Don't wait too long to see doctor, even if it sound not serious.
2) If your parents are religious and want to fast, allow fasting only if their health allows and you feel comfortable with their decision to fast.
3) If something unexpected happens, call 911 and get an ambulance, don't try to take the patient on your own to ER.
4) If you had to go to ER, call insurance ASAP to get pre-certification initiated.
5) Do not sign any thing that says you are financially responsible for medical expenses. Let the other parent sign on that.
6) Don't hesitate to tell about all pre-existing medical problems to the doctor about the patient. Don't even think that your insurance will be denied if you tell them all the past medical problem. That is required for the better diagnosis/care for the patient.
7) Talk to Dr. about your concern of pre-existing clause on insurance. Dr. will be able to tell if the condition is pre-existing or not.
8) When patient come out of hospital, get copy of all the medical records from hospital. You might need these later if you have problem with insurance as well as for further treatment back home.
9) Before they return home, get a medical confidentiality release form, authorization letters etc signed by the patient in your name. Its a good idea to let them sign few authorization letters saying they authorize you to discuss all health/insurance on your behalf. Insurance companies/hospitals wouldn’t even talk to you without these letters.
10) Before they board flighe home, If any of your parents were in hospital, get a written authorization from Doctor saying that the passenger is in good condition and able to travel back home and keep that with the passenger. Airline may deny boarding without travel authorization letter from doctor if they find out that the passenger was in hospital or had medical problem recently. Happened to me, Air India were almost ready to leave them behind if my Dr. wouldn't have faxed the letter to the airport right at that time. All we did is asked for wheel chair, and all these became a huge problem for Air India!
11) Keep the pager number of the Doctor who treated your parents, all the time with you, until they go back home. If I wouldn't had the pager number for my doctor with me at the airport, air india would have left them behind.
I took a long time to write this, just thinking that I can help a little bit this way to all my countrymen who love there parents, call them here with all good intention but have to go through this difficult insurance and medical uncertainty. Thanks.
All Replies (1)
Disclaimer: Please note that the experiences presented are submitted by visitors to our website. Individuals’ experiences may vary, and you should interpret each individual’s experience at your own risk. Do not make a decision solely based on an experience posted here. We do not endorse any individuals’ experiences, and we are not liable or responsible for consequences stemming from your use of the information presented within any individual’s experience.
