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Choosing a Health Plan Have You Pulling Your Hair Out?

Choices

Career LR
Anywhere and Everywhere
Wed Nov 4, 2009 8:47 AM

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I have been with one Fee For Service (FFS) provider--BCBS--for 20 years and they were good to me. I had major procedures covered for my wife in 2007 and for me in 2008 with no problems.

I have been with HMOs and do not like the fact that you have to be referred by them to specialists. I will always be with FFS for the freedom of choice.

I hesitated to change because my specialists all took BCBS. But I did some research and ALL my specialists are Preferred Providers for the other insurance plan that has comparable benefits at much lower premiums.

So, contrary to my earlier posts on this subject, I AM definitely going to make the switch away from BCBS because the increases no longer can be rationalized in my mind. Also, the customer satisfaction ratings on the OPM web site show the other FFS plans in a more favorable light, also assuring me that change is OK.

Finally, I can get the new FFS plan AND a dental plan with combined premiums LESS THAN BCBS. A No Brainer to me.

Re: Choices

Retired
IRS
Wed Nov 4, 2009 10:42 AM
So what plan are you switching too Career LR ?

Re: Choices

Health Sys Analyst
DOD
Wed Nov 4, 2009 11:29 AM
My experiences are very similar to Career LR. Been with BCBS Standard for over 20 years and very pleased with them. But their premiums and co-pays are rapidly escalating. Sounds like Career LR did his homework as did I. Since I have a chronic condition that requires maintenance drugs and periodic speciality visits and procedures going solely on the "low bidder" so to speak is out of the question. After much comparison and research of nationwide FFS plans, I plan to switch to NALC's Cigna plan. I will save money, not only in premiums, but office visits and labs without sacrificing quality as their physician, hospital, and ancillary network in my area is virtually identical to BCBS.

Re: Choices

Career LR
Anywhere and Everywhere
Wed Nov 4, 2009 12:20 PM
Health: NALC

Dental: Humana

Together, quite a bit less than BCBS.

HOWEVER, each individual must make their own decisions based on their unique situation and health care needs!

Re: Choices

Employee
US
Thu Nov 5, 2009 7:59 AM
Before all you jump on the switching bandwagon out of BSBS Standard Plan you need to do a little more homework if you need to take those prescriptions. The prescription drug benefits are not equal in some of the other plans. The one thing you need to ask of the plan you are looking at it “Does it have a separate deductable or Catastrophic Deductable for prescription drugs” a lot of them do and you need to read the fine print to find out. In my review it appears to me that if you are taking a lot of prescription that BCBS Standard might still be the best for you.

HOWEVER, each individual must make their own decisions based on their unique situation and health care needs!

FEHB programs and premiums are horrid

Specialist
DFAS
Wed Nov 4, 2009 9:20 AM

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What is CDHP? What is HDHP? How can you possible tell what these insurances will pay for or how much your total out-of-pocket is going to be? And don't say an agency health benefit fair, because those are overwhelmingly overcrowded. OPM does a pretty poor job of overseeing FEHB, because the choices are just awful. We are going to have to pay more than ever, not only in premiums, but out-of-pocket and deductibles and co-pays, none of which count for the dollar threshold each other.

Re: FEHB programs and premiums are horrid

Trans Ind Analyst
DOT
Wed Nov 4, 2009 3:19 PM
The short answer is there is no easy way. Most non HDHP plans exclude a lot of things in calculating what makes up the out of pocket total. HDHP's in contrast CAN'T under IRS rules because then you could not be eligible for a HSA. If they serve your area the United Healthcare HDHP has a $3,000self/$6,000 family in network out of pocket maximum. When you consider they pass through $750 self/$1,500 family a year in premiums back to you through your HSA that makes the effective out of pocket maximum $2,250/$4,500. As long as you stay in network EVERYTHING you pay including prescription co-pays goes towards your out of pocket maximum. BCBS is only for those who want the flexibility of going out of network (and are willing to pay for that privilege).

Re: FEHB programs and premiums are horrid

Investigator
EEOC
Thu Nov 5, 2009 7:33 AM
I have used CDHPs for years. It works well for my family because we have LOW annual medical costs at this time. I prefer paying a lower premium each pay check and no co-pays ever, as does the rest of the world I would imagine, but what I get is great for $188/mo!
1) No co-pays: includes meds, ER, Dr., etc., UNTIL you've spent the $$ in the flexible spending account that the CDHP sets up for you. You don't pay into this separate; they allot you funds annually. For us this year $2400 was allotted to spend for medications, tests, up to $800 of that could be spent on eyes or dental work.
2) Preventative is covered 100%, isn't out of the $2400 pot. Annual physicals, blood work, hearing exam (kids), immunizations, bitewings, 2 dental exams, 1/ 5yrs for mammograms, etc.
3) If you don't use up the $2400, it rolls to the next year to use! If you do, then you pay $1200 before their 80-90% (plan dependent) coverage begins for all covered services.
4) Your Dr. choice &/or PPOs available.

Kidding, right?

IT Drone
DoD
Wed Nov 4, 2009 10:14 AM

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"Federal employees have an average of 21 medical plan options, in addition to an array of dental and vision plan choices. It's like standing in front of a wall of flat-screen TVs and being so overwhelmed that you either make a rash purchase or leave empty-handed. "

================================

Not all employees have the ability to choose from those multiple options. Several are "self-pay" and are stuck with one choice. NAF employees and those who work for the various NAFI agencies have been railroaded into Aetna, Aetna or Aetna. Oh, yeah--or Aetna.

Some other agencies only provide BCBS.

Choice?

Pulling my Hair out?

Consumer Safety Inspector
USDA
Wed Nov 4, 2009 11:41 AM

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If I had any hair left to pull out, I probably would have! I think she was just making fun of us bald guys... :-)

Choice

Career LR
Anywhere and Everywhere
Wed Nov 4, 2009 12:23 PM

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For me, HMO is not an option. Two "high maintenance" individuals who need freedom to choose specialists.

That also takes out high deductible plans.

That only leaves Fee-For-Service (FFS) plans, so the choices are limited to perhaps 5-6, and that's in NoVA (DC Metro).

Re: Choice

Trans Ind Analyst
DOT
Wed Nov 4, 2009 3:21 PM
I don't understand why you rule out a HDHP. In NOVA where you live both Aetna and United Healthcare offer HDHP and CDHP plans. Both have out of network benefits.

Re: Choice

Manager
DHS
Thu Nov 5, 2009 10:40 AM
Folks need to brush up on the HDHPs. They see the huge deductible then run without reading how the plans work. I have a spouse and 3 kids, all of whom go to the doctor for various ailments throughout the year and I save $1000s with Aetna's HDHP when compared to where I'd be with BCBS standard. It's not even close.

Health Care

Admin Assistant
MWR
Wed Nov 4, 2009 1:13 PM

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It will be very interesting to see how much rage people will have when Health Care Reform dies, and your commercial insurance companies continue to raise your premiums to the point you can no longer afford them!
The working middle class needs to WAKE UP.

I'll Keep BC/BS Standard

IT Retired
DOD
Wed Nov 4, 2009 3:23 PM

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Why? Because in conjunction with Medicare all co-pays, etc. are waived. Also, I have had BC/BS for 30+ years and have always been very pleased with them. Heck, even with the increases it is MUCH less than when I was paying for family. So, nope, not switching.

Re: I'll Keep BC/BS Standard

retired INS
INS (Dept. of Justice
Wed Nov 4, 2009 4:19 PM
My wife and I are covered by Medicae Part A and B.
We also have BCBS Standard option. Would we lose any major benefits by changing to Basic option? The savings on preniums would be substantial.
Total Comments: 24
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