Discount Plans are not insurance. Instead, they are opportunities to get health care at greatly reduced prices, for a low monthly membership fee. Monthly fees can be under $10/month and the reduced prices can be as low as $20 for a basic dental cleaning.
How can this be? The large membership company has theoretically negotiated lower price schedules with the health care providers in return for the potential increase in business the provider will receive from the company's membership. Everybody wins.
Is this too good to be true? Nope, it may be a good deal for you.
Originally popularized as dental discount plans, these discount alternatives have expanded to include medical coverage and vision care. Some offer chiropractic care, and big discounts on vitamins as well as prescription drugs.
It's true that the market is rampant with scam artists nationwide, because unlike insurance companies, discount plans aren't required to be licensed (and therefore monitored) in every state. However, Florida has led the field in legitimizing these discount plans, and serves as a nice touchstone to confirm a plan as being dependable and not a fly-by-night.
Florida Regulates DMPOs
In Florida, several discount providers have been issued state licenses. These include the market leaders AmeriPlan and Careington, as well as well-known traditional insurers like UnitedHealthGroup.
Overseen by the Office of Insurance Regulation, a part of Florida's Financial Services Commission, Discount Medical Plan Organizations (DMPOs) must comply with a variety of requirements, including keeping a current list of available providers available to the public.
List of Licensed DMPOs
The 45 DMPOs currently licensed and in good standing in Florida are:
20/20 EYECARE PLAN, INC
ACCESS ONE CONSUMER HEALTH, INC.
AFFINION BENEFITS GROUP, LLC
AFFORDABLE FAMILY HEALTH SERVICES, INC.
ALLIANCE HEALTHCARD OF FLORIDA, INC.
AMERICAN DENTAL CARE PARTNERS, LTD.
AMERICAN MEDICAL INTERNATIONAL GYNECOLOGY OBSTETRIC SURGERY, INC.
AMERIPLAN CORPORATION DBA BENEFIT PLANS OF AMERICA
ASSOCIATION HEALTH CARE MANAGEMENT, INC. D/B/A FAMILY CARE DBA FAMILY CARE
ASSURED OPTIONS SYSTEM, INC. (D/B/A MEDMORE)
ATLANTIC DENTAL, INC.
AVIA DENTAL PLAN
BENEFIT SERVICES OF AMERICA, INC.
BEST CARE MEDICAL PLAN, INC.
CAPELLA GROUP, INC. (THE) DBA CARE ENTREE
CAREINGTON INTERNATIONAL CORPORATION
CHCS SERVICES, INC.
CINERGY HEALTH, INC.
COLONY SPRINGS MEDICAL CENTER DBA CSMC PRO SALUD PLAN
COVERDELL & COMPANY, INC.
CREATIVE BENEFIT DESIGN, INC.
DENTAL NETWORK OF AMERICA, INC.
ENVISION MEDICAL SOLUTIONS, INC.
FLORIDA HEALTH SOLUTION, CORP.
GROUP DENTAL SERVICES OF MARYLAND
HEALTH CHOICE NETWORK, INC. DBA CARENET
INTERNATIONAL ASSOCIATION OF BENEFITS
MANATEE COUNTY RURAL HEALTH SERVICES, INC. DBA GULF COAST DISCOUNT MEDICAL PLAN ORGANIZATION
MEDISAVER MEDICAL DISCOUNT CARD, INC.
NATIONAL BENEFIT ADVISORY ASSOCIATION
NEWBN, INC. DBA NEW BENEFITS, LTD
ORGANIZACION GAMMA, INC. D/B/A MEDICAL PASS
PATRIOT HEALTH FLORIDA, INC.
PRO-MED HEALTH NETWORK
PROMEDICAL PLAN PHC, INC. DBA PROMEDICAL PLAN PHC, INC.
PROTECTIVE MARKETING ENTERPRISES, INC.
SOLSTICE BENEFITS, INC.
SUNSHINE MEDICAL NETWORK II, INC.
UNITED HEALTHCARE SERVICES, INC. DBA UNITED HEALTH
UNITED HEALTHCARE SERVICES, INC. DBA UNITED HEALTHCARE SERVICES OF MINNESOTA, INC.
USA FOR HEALTH CARE, INC.
VANTAGE AMERICA SOLUTIONS, INC.
What do you get with a DMPO?
Well, if you are a Sam's Club Business or Advantage member, then you can get the following through Sam's affiliation with United Health for $14.95/month (it's free if you are a Sam's Club Plus member):
Medical Care Discount of 5-30%
primary care, specialists, lab tests, XRays, hospital care
LASIK Eye Surgery Discount of 15% or 5% off promotional rates
Dental Care Discount of 10-35%
checkups, XRays, fillings, orthodontics, cosmetic dentistry
Alternative Medicine Discount of 20%
Acupuncture, Chiropratic care, massage therapy
Wellness Discount of 10 - 60%
Weight managament, smoking cessation, fitness club memberships
Long-Term Care Services Discount of 5-30%
Assisting living facilities, home health care, adult day care, durable med equipment
Hearing Care Discount of 10-20%
Infertility Discount of 5-20%
in-vitro fertilization, reproductive endocrinology
Behavioral Health Discount of 5-30%
counseling, psychology, addiction treatment
Careington Offers the Most Variety
Careington is a national organization that shares a reputation with AmeriPlan of being the two largest DMPOs in the country. At Careington, members not only get discounts similar to the Sam's Club offering but they also enjoy access to a real, live nurse at the 24/7 Nurse Access Line as well as a 24/7 Counseling Line (with Master's Degree level counselors on staff). Careington offers vision discounts, vitamin discounts, and even funeral help and pet insurance.
For $29.95/month, Careington provides discounts on dental, vision, pharmacy, alternative health, vitamins, hearing aids, physicians, hospitals, 24/7 Nurse Line, LASIK, Teeth Whitening, Mail Order Pharmacy, Online Drug Store, and Diabetic Supplies. For $11.95/month, you can get a basic dental and vision plan. With $15.95/month, you receive all their discounts except those covering physicians and hospitals.
AmeriPlan Isn't Web Friendly
AmeriPlan does not cover the range of services of either Careington or the Sam's Club option. AmeriPlan is limited to dental, vision, prescriptions, chiropratic, and medical. However, it promises bigger discounts: up to 80% off dental services, for example, and more coverage, too: oral surgeons, periodontists, etc. are included in their plan. (One page of the site touted some upcoming wellness services.)
Their website is harder to navigate, though, and the actual membership prices were not shown (instead, you were requested to allow their agents to contact you by email or phone).
When is a DMPO Good for You?
Who would want these discount plans? Of course, for those 60+ million Americans who have no health insurance, or not enough coverage, these plans help to fill the gap. However, these plans also help those with adequate insurance coverage.
There is no rule that you can't have coverage through your employer and not have a discount plan, as well. For those with coverage, these discount plans help cover deductibles as well as non-covered items such as preexisting conditions or your child's braces.
How to choose a good discount plan?
1. Check the Florida licensure list -- these are reputable plans and many are nationwide.
2. Ask for their materials. Make sure that the company is happy to provide you with all its marketing materials, including current provider information for your area, for free and without any commitment on your part.
3. Call the providers they list. Are they truly recognizing these discounts? Are the providers happy with the plan provider? Ask for the person responsible for the medical or dental office's billing - don't stop at the receptionist. The money person there will know the skinny.
4. Check with your state's Secretary of State's office. Has this company registered to do business in your state? The fees here are not huge, but fly by nights seldom bother to complete the paperwork and pay the money here.
5. Surf the web for testimonials and reviews. For example, CinergyHealth is a small Florida plan provider that seems to have a good local reputation and a happy following.