Question about Guardian Health Insurance I am New to private health insurance

[SuperMan9999]

Never had health insurance, I see Eastern Credit Union offers "group health insurance" From Guardian for $400 a month

https://ecunewexperience.com/wp-content ... ochure.pdf

What does Co Insurance 80% - 20% mean? does this mean if a surgery is $100,000 then I only pay $20,000 and guardian covers $80k?

It says Pre-existing conditions are NOT covered but then goes onto say during the first 12 months does this mean if you have a pre existing condition you can take the insurance then wait 12 months and they will then cover the surgery?

Turning 40 in 3 months and wondering if this is a wise move for $400 a month, the idea of waiting YEARS for a potential life saving surgery in Mt Hope if that day ever comes is terrifying not to mention the amount of people there when you go the chaos etc
When I walked into St Augustine Private Hospital everything was so clean, nice and quiet the contrast was just no words to describe the difference between there and Mt Hope.

Thinking of doing this health insurance plus a health savings account with $300 every month but probably not with the credit union itself as I heard credit unions take a long time to give you money when you want to withdraw. Not sure if anyone else has experience with Eastern, I don't want to have a special account saving money for medical emergency the 20% out of pocket cost and when I request it they take months etc if that was the case probably better save it in the bank again don't have experience with how this works beyond hearsay so trying to get input from folks here.

Is private really worth the cost should something catastrophic happen?

[Gladiator]

I can answer a couple of your questions... the 80/20 is correct. GL will pay up to 80% and the rest is your cost.

If you have a pre existing condition it wont be covered even after 12 months.

Insurance is a must these days so its wise to keep it for the $400 a month. You will save a lot of money and as soon as you hit 40 its all down hill medically.

Never had health insurance, I see Eastern Credit Union offers "group health insurance" From Guardian for $400 a month

https://ecunewexperience.com/wp-content ... ochure.pdf

What does Co Insurance 80% - 20% mean? does this mean if a surgery is $100,000 then I only pay $20,000 and guardian covers $80k?

It says Pre-existing conditions are NOT covered but then goes onto say during the first 12 months does this mean if you have a pre existing condition you can take the insurance then wait 12 months and they will then cover the surgery?

Turning 40 in 3 months and wondering if this is a wise move for $400 a month

[SuperMan9999]

I can answer a couple of your questions... the 80/20 is correct. GL will pay up to 80% and the rest is your cost.

If you have a pre existing condition it wont be covered even after 12 months.

Insurance is a must these days so its wise to keep it for the $400 a month. You will save a lot of money and as soon as you hit 40 its all down hill medically.

Never had health insurance, I see Eastern Credit Union offers "group health insurance" From Guardian for $400 a month

https://ecunewexperience.com/wp-content ... ochure.pdf

What does Co Insurance 80% - 20% mean? does this mean if a surgery is $100,000 then I only pay $20,000 and guardian covers $80k?

It says Pre-existing conditions are NOT covered but then goes onto say during the first 12 months does this mean if you have a pre existing condition you can take the insurance then wait 12 months and they will then cover the surgery?

Turning 40 in 3 months and wondering if this is a wise move for $400 a month

Hi thanks

I noticed you said UP TO 80%, so this means let's say a surgery costs $100K there is no guarantee they would pay $80K? they could pay 40K only? any idea what determines this?

One other thing say a surgery costs $50K does that mean I have to have the $50K upfront to pay in full and then the insurance reimburses me the 80%? or is it I only need to have 20% upfront and I swipe their card and they will handle the 80%?

someone told me it has specific health facilities that covered under guardian where you won't have to pay the 80% hoping St Augustine Private is one of them as that's my preferred place to go if needed.

[timelapse]

I can answer a couple of your questions... the 80/20 is correct. GL will pay up to 80% and the rest is your cost.

If you have a pre existing condition it wont be covered even after 12 months.

Insurance is a must these days so its wise to keep it for the $400 a month. You will save a lot of money and as soon as you hit 40 its all down hill medically.

Never had health insurance, I see Eastern Credit Union offers "group health insurance" From Guardian for $400 a month

https://ecunewexperience.com/wp-content ... ochure.pdf

What does Co Insurance 80% - 20% mean? does this mean if a surgery is $100,000 then I only pay $20,000 and guardian covers $80k?

It says Pre-existing conditions are NOT covered but then goes onto say during the first 12 months does this mean if you have a pre existing condition you can take the insurance then wait 12 months and they will then cover the surgery?

Turning 40 in 3 months and wondering if this is a wise move for $400 a month

Hi thanks

I noticed you said UP TO 80%, so this means let's say a surgery costs $100K there is no guarantee they would pay $80K? they could pay 40K only? any idea what determines this?

One other thing say a surgery costs $50K does that mean I have to have the $50K upfront to pay in full and then the insurance reimburses me the 80%? or is it I only need to have 20% upfront and I swipe their card and they will handle the 80%?

someone told me it has specific health facilities that covered under guardian where you won't have to pay the 80% hoping St Augustine Private is one of them as that's my preferred place to go if needed.

From my experience with a similar product from Maritime, there are certain approved ranges for different types of health issues which I have clearly stated in my policy. For example the maximum range of a minor surgery like tonsils might be lets say 15 k where something more serious like heart issue might be 80 k. These are random figures I used

[SuperMan9999]

^ Ok thanks for the input

I will sign up next month along with a savings plan to have something for emergency I think this is a good investment.

[nervewrecker]

I notice a new wave of them popping up. Can't get a job elsewhere so they do a lil course on selling insurance. Love to use the term "God forbid" and anything happen is "check your policy, that not covered" or worst yet it wasn't filed or some nonsense like that.

Pardner of mine get a message from one and said she got the number from me. I never heard of that person in my life.

Most of who I see pop up on social media selling insurance are a set of known crooks scanning whatsapp groups and Facebook for contact numbers and common friends. They love to do research to see where you work to target you.

[pugboy]

you should sign up one time because nowadays ppl fall sick when you least expect it esp after 40.
I can tell you this first hand.

Also that price is a good price, once you cross 45 or so it will be double.

Guardian seems to have a lot of the market share on these group health plans
Sagicor and Tatil used to but I feel they get licks and had enough.

Recently with their new owners and mgmt Guardian has been tightening down a lot with the stipulations for their coverage.

In USA it is really bad, for larger claims the insurance companies will want you to submit quotation from doctor/surgeon and often flatly deny. It is a big problem over there.
It is only a matter of time before local insurers start doing the same.

tbh I think a lot of these group plans are abused esp the company employee ones
many companies offer next to nothing coverage for an employee's family with few limits
so somebody with a few chirren who get sick can easily sink the plan and peter ends up paying for paul

yet if somebody goes and takes out standalone insurance they will get real hell to have their spouse/kids fall under their plan.

btw you should also take out a critical illness plan.

^ Ok thanks for the input

I will sign up next month along with a savings plan to have something for emergency I think this is a good investment.

[paid_influencer]

i check all them plans and them MC always have some out saying that if u have mental illness the plan void but mental illness is illness just like any other and I think that discriminatory and fack them

[nervewrecker]

Ocd is classed as mental illness eh

[88sins]

OP, I just have 2 pieces of advice for you.

Thing one, make sure you read that contract VERY carefully.
Item two, make sure your plan is truly 80/20, and not 80% of whatever they feel is a reasonable cost according to them.


Because that 80% of what they think is fair and reasonable can and will shaft you if you are in need of specialist care from the best and most experienced and qualified medical professionals. For example.
Say develop a serious medical condition, and you need a very experienced specialist surgeon because your case is rather difficult and complicated, and after consultation the surgeon says his fee is $300k. You thinking ok, you insured, so you good to go. You then go to the insurance company, who then informs you that their fair and reasonable cost for surgeon's fees for your procedure is $100k, so they paying only $80k, and you hadda figure out where and how to make up the difference. This kinda thing actually happens more often than people think.

Approach with caution, and be sure what you agreeing to is what you want.

[Gladiator]

I can answer a couple of your questions... the 80/20 is correct. GL will pay up to 80% and the rest is your cost.

If you have a pre existing condition it wont be covered even after 12 months.

Insurance is a must these days so its wise to keep it for the $400 a month. You will save a lot of money and as soon as you hit 40 its all down hill medically.

Never had health insurance, I see Eastern Credit Union offers "group health insurance" From Guardian for $400 a month

https://ecunewexperience.com/wp-content ... ochure.pdf

What does Co Insurance 80% - 20% mean? does this mean if a surgery is $100,000 then I only pay $20,000 and guardian covers $80k?

It says Pre-existing conditions are NOT covered but then goes onto say during the first 12 months does this mean if you have a pre existing condition you can take the insurance then wait 12 months and they will then cover the surgery?

Turning 40 in 3 months and wondering if this is a wise move for $400 a month

Hi thanks

I noticed you said UP TO 80%, so this means let's say a surgery costs $100K there is no guarantee they would pay $80K? they could pay 40K only? any idea what determines this?

One other thing say a surgery costs $50K does that mean I have to have the $50K upfront to pay in full and then the insurance reimburses me the 80%? or is it I only need to have 20% upfront and I swipe their card and they will handle the 80%?

someone told me it has specific health facilities that covered under guardian where you won't have to pay the 80% hoping St Augustine Private is one of them as that's my preferred place to go if needed.

For major issues you have to get "pre-approval" they will decide on how much of the 80% they will cover. There is usually a schedule that will tell you how much of each illness will be covered also.

Once you have the pre-approval you would not have to put out the money out of pocket.

They also have a list of participating facilities. You also have to check that list for participating doctors since they operate separately from the hospital.

[SuperMan9999]

you should sign up one time because nowadays ppl fall sick when you least expect it esp after 40.
I can tell you this first hand.

Also that price is a good price, once you cross 45 or so it will be double.

Hi there are you saying that if I sign up now for $400 a month I will pay this until I dead?

Or are you saying that if I START at 46 year old they will shaft me for $800 a month?

What kind of prices are we looking at here? as I age from 40 into 60?