Cinergy

Posted: Sat Feb 09, 2008 08:01 pm Post Subject:

Surgery Benefit:
This benefit will pay the cost for medically necessary surgeries up to an Unlimited Annual Maximum for any covered person that undergoes a surgical procedure with anesthesia due to a covered accident or illness. Coverage is 80% of the federal Medicare allowable schedule .

Posted: Sat Feb 09, 2008 08:02 pm Post Subject:

Also can yo give me the link where you found that so that I can read more into it.Thanks My sister drives a school bus and she got insurance through the county but could not afford to put her husband on there also.

Posted: Mon Feb 11, 2008 07:21 am Post Subject:

Hummingbird:

This is how I read what was posted. First, the surgery has to be medically necessary and for a covered illness. The unlimited annual maximum would seem to mean that there is not a maximum benefit for surgeries. As for the 80% of the Medicare schedule; this is an assumption…. Medicare has a schedule that it will pay for all procedures…. which is fine for someone that has Medicare but not so good for others.

Lets say you need knee replacement, when they bill the surgery there is a procedure code that goes with the surgery. (There is a procedure code that goes with every procedure). Medicare has a schedule for each procedure code. Lets say that for knee replacement its $5,000.00. Lets say the provider bills $8,000.00. Medicare only allows the 5K and pays their portion. The Medicare patient is responsible for there % of the 5K that Medicare did not cover and the 3K is written off by the provider.

In your case, this insurance company pays 80% of the 5K, you are responsible for the other 20%. As you are not on Medicare, the provider can then bill you for the 3K. They are never real clear on this.

A couple things struck me when I look at what was posted and a few things to think about.

1 How healthy is the person that is going to be covered for this plan? Have they in the past been admitted to the hospital numerous times. If you look at the benifit, its $1,000.00 per. That's about 1 day in the hospital, and that is also most likely based on the same Medicare schedule. Also, the surgery above most likely only covers the surgery. If it is major surgery there is going to be a hospital stay and would fall under an admission or in hospital.

2 Is the plan only going to be used for a few office visits a year. If so, that seems fine, but it would seem that it would still be subject to the Medicare schedule.

3. Diagnostic testing. Sure they put x-rays and labs, but what about CT scans, EKG, MRI.... I had 4 CT's and 1 MRI this year which ranged between $700 - $2000 each. That $100.00 won't go real far. If the scans are for an accident, that would seem fine, but what other services are being done after an accident that would eat up the listed 5K.

These are all assumptions based on the information that was posted, but I would bet I am pretty close.

Posted: Mon Feb 11, 2008 07:15 pm Post Subject:

Emergency Room / Urgent Care Visits:
Pays the first $100 per visit for emergency care for a covered illness or accident for one visit per year.
My hospital bill for the ER was over 500.00 so that is just a small amount for that.
Accident Medical Benefit:
Pays up to $5,000 per year for charges incurred due to injuries received in a Covered Accident. Covered charges are subject to a $100 Policy Year deductible. )
Does that go along with the other? These are all confusing to me and I'm beginning to think that why they speak geek,so I can't understand what kind of policy I would be buying till I tried to us it and found out it is almost worthless!They make it sound so good on tv then you see all this fine print on the bottom of the screen that passes so fast you would have to be a speed reader to read it. Thanks for trying to explain all that to me.

Posted: Mon Feb 11, 2008 11:40 pm Post Subject:

Staw far away from the Cinergy plan.

When you seee:

"Uniquely designed as an alternative to higher-priced major medical plans"

Run away and run away fast.

Same thing with "medical discount plans." See below:

Before you pay any money, ask the company for a list of providers who participate in its plan. Call the providers and ask about the services and discounts they're offering.


If the plan doesn't provide a list of providers promptly, consider taking your business elsewhere.


Investigate the details of any plan carefully. Read the fine print, paying special attention to the refund policy. If a plan doesn't readily provide information and answers before you buy, it isn't likely to be responsive once they have your money.


If your usual medical or dental providers don't participate, see whether other doctors in your area accept the plan and will give you the discount the plan promoters promise. Some legitimate plans offer a “get acquainted” or “initial consultation” visit so you can meet a practitioner who participates in the plan before you commit to becoming a member.

Posted: Mon Feb 11, 2008 11:58 pm Post Subject:

Great advice, you could also ask you local doctors and hospitals for plans that they recommend.

Posted: Sat Jul 18, 2009 03:58 am Post Subject: Cinergy health

I read a lot of complaints on Cinergy: misquotes, NO follow-through, some have been fighting with them for at least six months. So far I have read very few good reports.

Posted: Sat Jul 18, 2009 06:38 am Post Subject:

I read a lot of complaints on Cinergy: misquotes, NO follow-through, some have been fighting with them for at least six months. So far I have read very few good reports.

Posted: Fri Jul 24, 2009 02:11 pm Post Subject:

This is a medcial reimbursement company much like Aflac and Colonial
their ads are deseptive to say the least they do not offer comprehensive Health Insurance lin the sense of Anthem PHP or Aetna.
Be bvery careful with these types of plan good to supplement your comprehensive plan but not health Insurnace coverage.

Posted: Sat Jul 25, 2009 05:16 am Post Subject:

Hello Guest, you have pointed it out very correctly that plans offered by Cinergy would fail to replace proper health plans offered by the health insurance companies. The plans that Cinergy offers are mainly discount plans and limited benefit health plans but not comprehensive health insurance.