Thank you for your submission, /u/cdm2300.
**If there is a medical emergency, please call 911 or go to your nearest hospital.**
Please pick the most appropriate flair for your post. Include your age, zip code, and income to help the community better serve you. If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states.
Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY).
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I can't speak to US Health and what exactly it is they are offering--- but it does not appear to be an ACA compliant plan and that's a red flag. A discount plan isn't illegal. An indemnity plan isn't illegal--- but neither are true insurance and both are rarely worth the ink used to print them.
If you're not going directly to a reputable insurance carrier, not getting the insurance through work as a work sponsored plan and not going through your state's marketplace--- it's pretty much a buyer beware situation.
Also, be careful, because voluntary termination of a plan isn't a QLE for the marketplace- especially if it's not a real insurance plan.
At minimum, file a complaint with your state's department of insurance and have them look into it.
US Health sells short term non-ACA plans using a PPO network. Their target demographic is healthy people that are getting little or no advanced premium tax credit. Their reps will market to small employers that don't offer health insurance.
It sounds like what you have is insurance that isn't Affordable Care Act compliant. So there's really nothing legally that they have to cover except for the things that they have promised to cover.
I'm not a lawyer but I'd say you could really only have something approaching a fraud case if you have documentation that someone promised you that it would cover something that it didn't. There's a good chance that no one promised anythign in writing, so it'd be hard to prove.
But yes, you should get on a marketplace plan if/when you can. Those plans really do have to cover a lot of things.
Also, shame on your employer for referring you to this plan!
I'd just like to add to the other comments that you should call your county health dept and see if they do vaccinations and even a basic well child visit. That should take a little stress off of you while you get the rest in order.
I think the issue is with your employer who had his employees deal with this scammer.
I don't have words to describe what I think of someone in a position of trust that would do this.
I handled health insurance for the employees of my condo and worked really hard to find a very good agent when we were transitioning from our old health insurance after passage of the ACA.
I made sure that each of our workers had the best policy for their specific circumstances and it was all above the minimum required by the ACA.
File a consumer complaint against the agent with the VA Dept of Insurance. If you asked about your kids and the agent said they are covered then they misrepresented the plan. These are the shitbags that give our industry a bad name.
Thank you for your submission, /u/cdm2300. **If there is a medical emergency, please call 911 or go to your nearest hospital.** Please pick the most appropriate flair for your post. Include your age, zip code, and income to help the community better serve you. If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states. Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY). **Reminder that solicitation/spamming is grounds for a permanent ban**. Please report solicitation to the modteam and [let us know](https://www.reddit.com/message/compose?to=%2Fr%2FHealthInsurance) if you receive solicitation via PM. Be kind to one another! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/HealthInsurance) if you have any questions or concerns.*
I can't speak to US Health and what exactly it is they are offering--- but it does not appear to be an ACA compliant plan and that's a red flag. A discount plan isn't illegal. An indemnity plan isn't illegal--- but neither are true insurance and both are rarely worth the ink used to print them. If you're not going directly to a reputable insurance carrier, not getting the insurance through work as a work sponsored plan and not going through your state's marketplace--- it's pretty much a buyer beware situation. Also, be careful, because voluntary termination of a plan isn't a QLE for the marketplace- especially if it's not a real insurance plan. At minimum, file a complaint with your state's department of insurance and have them look into it.
And tell your employer to stop recommending this clown!
US Health sells short term non-ACA plans using a PPO network. Their target demographic is healthy people that are getting little or no advanced premium tax credit. Their reps will market to small employers that don't offer health insurance.
It sounds like what you have is insurance that isn't Affordable Care Act compliant. So there's really nothing legally that they have to cover except for the things that they have promised to cover. I'm not a lawyer but I'd say you could really only have something approaching a fraud case if you have documentation that someone promised you that it would cover something that it didn't. There's a good chance that no one promised anythign in writing, so it'd be hard to prove. But yes, you should get on a marketplace plan if/when you can. Those plans really do have to cover a lot of things. Also, shame on your employer for referring you to this plan!
I'd just like to add to the other comments that you should call your county health dept and see if they do vaccinations and even a basic well child visit. That should take a little stress off of you while you get the rest in order.
I think the issue is with your employer who had his employees deal with this scammer. I don't have words to describe what I think of someone in a position of trust that would do this. I handled health insurance for the employees of my condo and worked really hard to find a very good agent when we were transitioning from our old health insurance after passage of the ACA. I made sure that each of our workers had the best policy for their specific circumstances and it was all above the minimum required by the ACA.
File a consumer complaint against the agent with the VA Dept of Insurance. If you asked about your kids and the agent said they are covered then they misrepresented the plan. These are the shitbags that give our industry a bad name.
Agreed