Cinergy health insurance plans in Pennsylvania provide limited medical benefits that are affordable alternatives to the more conventional coverage offered by big carriers such as Highmark, Keystone and Aetna. Rarely, if ever, is an individual or family denied, so applications are processed very quickly. We’ll try to help you understand some of the differences in their policies compared to other options you have.
One thing is certain. They do like to advertise their plans. They may not be on television as much as Proactiv, the George Foreman Grill or OxiClean products, but Cinergy does heavily promote their medical plans in Pennsylvania. And why not? There are no deductibles or copays. You can go to any doctor. And you’re guaranteed to be accepted regardless of what medical problems you have and you get first dollar coverage.
However, a big change in federal legislation (Affordable Care Act and establishment of State Health Exchanges) has eliminated the practice of companies charging a higher premium or denying applications for coverage. And special federal subsidies will help many households reduce their health insurance costs. This takes away an important reason why someone should buy a Cinergy product.
So…Is Pa Cinergy insurance still worth considering. Perhaps not…unless you’re uninsurable with major health problems. The policy that they traditionally market is a “limited benefit” plan and it has much lower benefits and much higher out-of-pocket expenses than a private or employer-provided policy. It pays a “per-determined amount for specific expenses.
For example, if the benefit was $100 and the cost of the treatment is $300, you pay the difference. And that amount is in addition to the premium you pay each month. If you have few or no claims each year, then these limitations will not be a big issue.
The Cinergy “Preferred” plans are NOT major medical insurance and are not intended to replace catastrophic or major medical insurance. The dental and prescription coverages do NOT make payments directly to you. They are “discount” plans that may reduce your out-of-pocket costs with certain providers. Also, Cinergy is not an insurance company like Aetna or Highmark Blue Cross Blue Shield. They are an “Agency” that puts together different plans for consumers in Pennsylvania and other states.
The Coverage
For example…the “Plan 1000”plan pays only $100 per year (per person) of emergency room (ER) charges. Two ER visits could easily leave you with a bill of more than $2,000. Daily hospital confinement benefits are also limited to only $1,000 per day (up to 30 days per year). Hospital intensive care coverage is only $2,000 per day (up to 15 days per year). The anesthesia and surgery benefits can also leave you a gaping wound in your wallet.
However, it does pay a $1,000 indemnity benefit when admitted to a hospital along with an in-hospital payment of $1,000 per day (maximum 30 days per year). The intensive care coverage is $2,000 per day with a 15-day maximum per year. Admittedly, if you are hospitalized, the payment will be very welcomed. But you will still have big gaps in covered benefits.
There are also five office visits that are covered (two can be preventive) up to $100 each. Three days per year are covered for diagnostic x-rays and testing (up to $100) and there is a surgery indemnity schedule that determines your amount of reimbursement. However, the schedule used often covers only a small portion of medical expenses.
These plans offer far less coverage than many consumers may realize. Of course, that’s not necessarily the insurer’s own fault. The difference becomes quite noticeable with lengthy hospital stays, expensive prescriptions or constant visits to a specialist. A major medical claim could potentially expose hundreds of thousands of dollars of expenses that are not covered or are only partially covered. But if you can not otherwise qualify for a policy that is within your budget, then you may not have a choice.
The Cost
The Pennsylvania Cinergy “Plan 1000” plan costs almost $6,000 for family coverage and about $3,700 for an individual. Add a $50 registration fee and it is quite apparent that unless you’re uninsurable, this plan may not be your best option. Rates and benefits can change, so a more accurate current rate may be slightly different.
If you can qualify for health insurance from one of the major carriers, that’s probably your best option. We feel that Aetna, UHC (Golden Rule), HealthAmerica, Geisinger, Highmark, Keystone or any of the Blue Cross plans are better and more affordable options. However, under certain circumstances, Cinergy may be beneficial and possibly purchasing.
Plans that have limited benefits can be very economical if you need cheap medical coverage that provides very basic coverage. It may not be the ideal solution for everyone, but it may be a better option than being uninsured or paying for a policy that you can not afford.
UPDATES:
October 2015 – Cinergy has dropped off the face of the earth. We couldn’t find an active website or any recent corporate news releases. The passage of Obamacare legislation badly damaged many carriers that sold “supplementary” and “limited benefit” plans, and it appears Cinergy was one of the casualties. If they resurface, we will let you know!
August 2016 – No changes, and obviously, these plans will never be offered again, especially since they don’t meet ACA legislation requirements. When conducting a search online, most of the referenced information involves consumer complaints to the Better Business Bureau and other sources.
