By Coleen Elkins, Managing General Agent
RV Insurance Benefits
In July of 2018 RV Insurance Benefits introduced a health plan offered to the RV Community through Family Motor Coach Association (FMCA).
We have received many comments and stories from happy RVing clients regarding how their benefits have worked for them wherever they may be and saved them money over their prior health insurance plan.
This is one of those testimonials from a client wintering in Florida.
I would like to share my recent experience with my FMCA Health Plan which saved me approximately $9300. My wife and I are Full-time RVers and have the FMCA Health Plan. While traveling in Florida I had a kidney stone. I went to the Emergency Room at the local hospital and they confirmed I had a 3mm - 4mm stone lodged in my ureter. At that time I was told I needed to be admitted to see the urologist the next day. In the process of being admitted I became septic. Once I was stabilized in the Emergency Room I was admitted to the Medical ICU. The urologist came in and told me I needed to have a stent (a tube from his kidney to bladder) put in to allow the urine to bypass the stone. After my surgery the doctor informed my wife and I in 2 weeks they would remove the stone at the hospital then 4 days later the stent would be removed in his office. A week before the kidney stone was scheduled to be removed I received an email and phone call stating I would need to pay $10,917 within 2 days prior to the surgery or it would be canceled. At that time I asked for a cash price and was told they did not negotiate cash pricing. After processing what I had just been told I called back again and spoke to a different account representative. She told me the cash price would be $25,000 and they would give a 35% discount ($16,250).
First thing I did was call Karis Group (the concierge service benefit of my FMCA Health Plan) to help find a doctor/facility who would help me to maximize my health plan benefits with the least amount I would have to pay out of pocket. In speaking with Karis Group the representative said she would call me back as soon as she had the information for. I received her call and she gave me the doctors/facilities in the area with contact information and pricing. It was followed up with an email containing all of the details we had spoke about on the phone.
I called Coleen Elkins of RV Insurance Benefits and explained what was happening and she asked me to contact Dave in Management at New Era who underwrites my health plan. I told him I had already contacted Karis Group. Dave asked me to contact FMMA (Free Market Medical Association) as well to see if they had anyone in the Florida area who could help me. I spoke with FMMA and was given contact information of places I could call to see if they would be able to help me. Later in the day Dave called back and gave me the name of Dr. Lee Gross. I called Dr. Gross’s office and spoke with Anne his Office Manager. After emailing her all of the information she returned my call and told me DeSoto Memorial Hospital offered a bundled price to have my kidney stone/stent removed. First I had an appointment with Dr. Gross and they set up the appointment for me to see the urologist, Dr. Matthew Ercolani. Dr. Gross and his staff are awesome. I am not one who likes doctors or hospitals but was very happy with Dr. Gross. He is a DPC (Direct Primary Care) physician. I pay a monthly fee to him and have access to his services at any time.
My appointment with Dr. Ercolani went very well. After speaking with Dr. Ercolani he felt I had passed the kidney stone. He ordered a CT Scan to confirm the stone was not in my ureter. The results, NO STONE! My appointment was scheduled at Dr. Ercolani’s office to have the stent removed but he was unable to remove my stent that had been in place for 4 1/2 weeks. He asked me to come to the surgical center the next day for IV Sedation to remove it. The next day my stent was removed with no issues.
I am very disheartened by the lack of compassion in our health care system. The original doctor I saw has never called to check on me or ask why I never had the stent removed. The reply I received when I canceled the appointment was ok, thank you for letting us know. The experience I had with Dr. Gross and Dr. Ercolani has helped me to realize there still are great doctors who genuinely care about their patients.
I also had a few other options were available to me, Surgical Center of Oklahoma (Dr. Smith, Kelly and Teresa) and Texas Free Market Medical (Sean). I opted to stay in Florida instead of traveling to Oklahoma or Texas.
Thanks to the help of Karis, Dave, FMMA, Dr. Gross and Dr. Ercolani I would have paid $10,917 instead of $1600 which I am able to be reimbursed by the FMCA Health Plan underwritten by New Era/Philadelphia American. I am very blessed!