Grrr! Health Insurance!!!

[debster913]

Hi, all--
Got the benefits packet from work yesterday (open enrollment is next week Sept. 11-14), and I am so pissed. (Can I say "pissed" here? ) Anyway, I've been covered under Blue Cross Power Care Advocate (a PPO). The silliest thing about this plan is I have to call and "pre-notify" before seeing anyone besides my GP. Yeah, imagine how many times I had to call to let them know I was going to see my cardio and listen to them butcher his last name...that's why we call him Dr. V. Anyway, the best part is that my surgery was completely paid for. The worst parts: paying $35 per co-pay to see the doctor AND paying $897 a month for my husband and me to have this plan.

Now...Mike, my hubby, has his own health insurance, and because his open enrollment is later than mine, I have to sign up for BC PCA. For myself, it's close to $700 a month. Ridiculous!!! AND Kaiser and BC HMO cost nothing per month.

I really think my school district is making it hard to afford the PPO plan because they don't want to pay for it, leaving us (eventually) to choose between Blue Cross HMO or Kaiser. Obviously, I need the PPO plan b/c my cardio doesn't accept the HMO (he did graciously take me two years ago when I was accidentally put on the HMO plan and could not get switched to the PPO), but the HMO gives me a lot of crap about needing to see the cardiologist. When I had my first TEE, they sent me a letter wanting to know why I had it done before they paid for it (yeah, because I was bored! ), and didn't want to cover my cardio visits.

I'm so frustrated I'm thinking about going to another school district next year that has better insurance offerings. Grrrr!!!! Anyone else have this problem?

Debi (debster913)

 

[Guest]

Debi,

Can't say I've had the same problem as you....

Yet, I know the frustration of trying to figure out which is best. I've always gone with PPOs because I like the "freedoms" they involve, albeit at a higher cost. But, like you, none of my doctors are in any HMOs ... so, an HMO wouldn't do me any good anyway.

Just out of curiosity ... why not just go under your husband's health insurance?



Cort, "Mr MC" / "Mr Road Trip", 32swm/pig valve/pacemaker
MC:family.IL.guide.future = http://www.chevyasylum.com/cort/
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"There's things goin' on make me mad down to the core" ... Charlie Daniels ... 'Simple Man'

 

[Ross]

My wifes PPO has a deductible that is so high that it's impossible to reach to it without having a catastrophy. She's stuck paying premiums for insurance she can't even use unless she should somehow end up in the hospital for a few days. It sucks. Your paying for something that isn't even going to get used short of catastrophic coverage, but after she got caught without any insurance last year and the hospital bill flushed us completely off the map, we have no choice.

 

[MarkG]

My company offers a high deductable plan with an HSA/FSA attached to it. I have to pay 100% up to a deductable, but after that it is all paid for as long as I go in-network. With the medications I take and the Dr visites I have, I hit the deductabe after 6 months. If you figure what I paid with my PPO before and what I pay now, I actually saved $$$ over the year. This is the second year and I think it is the best. Now other folks that don't utilized the insureace much are not very happy about it, but it works great for me.