Part 2: HA (Semi-Unhealthy Client)

Break the Ice Again If Scheduled as a Follow Up Call - Follow up on personal things you talked about last time 

Recap 

I did some research for you, and just to recap, we wanted to make sure we found some nationwide PPOs with a well recognized company and of course we want to pay attention to those deductibles as well as the catastrophic coverage to protect you in a worst case event. I just sent you an email - if you have a laptop in front of you feel free to pull it up. 

Screen Share/Review Email 

ACA:

The first one you’ll see at the top is an Affordable Care Act option from the Health Insurance Marketplace, this one does have a pretty high monthly premium with a pretty high deductible. This is a public plan and an example of one of those Guaranteed Issue plans we talked about that anybody can get on, so naturally, it is a little more expensive. I don’t necessarily think these are the best fit for you, I just wanted to include it as a point of reference. 

So the ACA plans are going to typically be best suited for those who are really low income or have significant health issues. Most people in America have some sort of health history or maintenance meds, but it doesn’t mean we’re going to the hospital tomorrow for our _______, right? Client: Right, it’s not that big of a deal!

PRIVATE MARKET (HEALTH ACCESS):

So with that being said, you may be more interested in the private market, so I went ahead and looked at some of those as well and found a plan you might prefer.

This one is running through PHCS with a PPO network. Are you familiar with those guys? No problem, it actually stands for Private Healthcare Systems, also referred to as MultiPlan. They are a subsidiary of United Healthcare so the networks are similar and it is a PPO, so it will allow you nationwide coverage in all 50 states. Remind me, do you ever travel for work or vacation? Client response. Cool! Well if you ever find yourself out of town, you’ll have the peace of mind that your coverage is going with you.

In addition to that, you’ll also have the flexibility to choose your own providers and won’t need to get a referral to see a specialist or anything like that. 

Optional: I also confirmed that your doctor ____/facility is in network with them as well, so you’re fine to keep  your same providers. 

This plan is also going to offer a $0 deductible, which is nice because you won’t have to meet any crazy deductibles before your benefits kick in. They’re going to offer first dollar coverage for doctors visits, prescriptions, annual exams and all that fun stuff we may need to use throughout the yet.

Optional: Confirm price & coverage for prescriptions

COPAY QUESTION / DR VISITS: Now I do want to walk you through what to expect if you did end up needing to use a doctor's visit or something like that on this plan. So first and foremost, like I said, no copays, no deductibles. And sometimes, when I say that, people hear that everything is free all the time, and as much as I wish that was the case, I’ve yet to find any healthcare plan where everything is covered 100% of the time (laughs or agrees). But here’s how the billing process will work so you know what to expect.

So when you walk into the doctor’s office you’re just going to hand them your card and go about your day. The first benefit you’re going to receive is what’s called a provider discount. So doctor’s love it when you have insurance, right? That’s how they get paid, so anytime you’re with a well known provider, you can get in network discounts for being with a major carrier. Those discounts can usually take off somewhere from 40-70% off of the bill. 

On top of that, you’re also going to get itemized benefits from the insurance company, and those are gonna be listed throughout your brochure. With that being said, you’re getting tons of up front discounts and benefits, so your out of pocket for routine services should be very minimal if anything at all. Does that make sense? 

So that’ll take care of your routine services that pop up throughout the year, but as we discussed, we want to make sure you’re covered in case anything crazy happens like a surgery or hospital stay, things like that. So this policy is going to have up to $5 million worth of coverage to go towards catastrophic claims, so you’ve got a really high ceiling for that as well.  The biggest thing on this policy I need you to know is that there is a one year exclusion for surgical and hospitalization benefits for pre existing conditions only, which from what it sounds like is not really a huge concern for you, correct?

Cool, so are you thinking you’d prefer the ACA route or private market?

Reel It In:

“What other questions can I answer for you?”

Ok so just a couple reminders, these rates are subject to change anytime and we would of course want to allow time for processing . Once we submit an application though, you do reserve that current rate which is nice so it can’t go up on you while you’re waiting for the plan to process. And to confirm, you’re thinking _____ for your start date?

Cool, I think we can make that work just fine. It’s pretty easy for the most part, basically you’ll just fill out an application with me which entails basic demographics like your height/weight, middle name, where you wanna mail your cards to, stuff like that. 

We’re also gonna choose your start date and get a form of payment on file, although nothing comes out until your selected start date. From there we’ll schedule a call and someone from the insurance company would give you a ring. They’re basically just going to confirm all of your information, that you spoke with me and that we understand the policy and exclusions, yada yada. Does all that make sense?

So the first part takes about 5 minutes or so and we can get you scheduled with the insurance company, Do you have a few minutes to knock the first part out with me? \

***Move to Application if so*** 

If they say no (They want to look it over)

Absolutely, take as much time as you need, there is no rush on my end. This is an important decision and I want you to feel comfortable with anything we move forward with. So this stuff can be overwhelming and once you read through/review with spouse, you’ll probably have some extra questions - cause everyone does - so why don’t we set up a second phone call to make sure I get those questions answered thoroughly for you? _________________________

Ok, let’s take tonight, look it over, as of right now I have availability tomorrow at ____ and ____. Do either of those times work for you?

Cool, I’ll send you a confirmation text and calendar invite and if we need to adjust that time for whatever reason, just let me know! Have a great rest of your day, looking forward to chatting again.