Health insurance carriers

You should have separate choices for "other PPO" and "HMO".

My insurance is with Principal Network (PPO). I rate them as average. I used to be with BlueCross EPO (exclusive PPO). I was more satisfied.

 

DH and i have separate (long story, financial reasons) PPOs with BCBS of NC.

both are "employer" sponsored... and i put quotes around that because technically my school is not my employer but they do provide a somewhat crappy and rather expensive but existent health plan.

DH's plan is awesome. mine, not so much.

have had a decent experience overall- coverage almost everywhere, we haven't been presented with invalid reasons for claim rejection, etc etc. i did have a hard time getting my hundred bucks back when i bought contact lenses, it took 3 submissions of my claim form and a few phone calls to the administrators but the check came quickly once they got it processed. they also fought with my opthalmologist when i was overcharged and pushed my refund through for me.

so overlal pretty good. i've dealt with worse plans.

 

I think you need more choices. The common one in the Boston are are (I'm sure I'm missing some)

1. Blue cross, Blue shield
2. Harvard Piligrim (Fiancee)
3. Tufts (Me)

 

Group Health Coop of Puget Sound. I am a member and a Doctor. Consumer owned Cooperative since 1947. Yes it can look like an insurance company at time but it's heart is generally in the right place and does a fairly good job.

 

Employer supplied Anthem BC/BS. Really a very healthy program.

edited to add I have to pay 10% of premium

 

I have Blue Cross. I've been here in WA too short a time to have an opinion yet. In ND I had Blue Cross / Blue Shield. For many years they were absolutely dreadful, but there wasn't much alternative. Then at some point they changed. I think they were taken over by another company who kept their name, and lately I'd rate them as acceptable.

At first I had State Farm, who I like very much. Then a brand new HMO came along and I joined them. They were great. I forget the name. This was maybe in the 70's or the 80's. But they went bankrupt and all their members were grandfathered in to BC/BS. I considered going back to State Farm, but I disliked the fact that State Farm had specific dollar amounts for each, listed, covered condition, whereas BC/BS covered percentages, without a list or set dollar amounts. BC/BS also had agreements with hospitals to limit costs to certain amounts. It seemed like a more inclusive kind of arrangement. But they usually refused to pay for anything. By the time I said "Enough of this!!!" and wanted to go back to State Farm, they had quit selling health insurance, and I was stuck with BC/BS.

Nowadays I'm lucky enough to be able to pay the outrageous premiums and the deductibles and co-pays. So I don't much care. But all these years, in sum, I've paid in many times more than I've gotten back, and I'd have been much better off putting my premiums into a bank account and paying my own doctor and hospital bills. Even in the single year I had my prostate operation my total premiums were far more than the insurance company paid out. I think I should buy stock in some insurance companies.

 

I've got a POS plan through Saint Mary's. For those unfamiliar, it's basically a combination of HMO and PPO. I'm covered for most things, but I get better coverage when going to someone in the network.

 

DW (copyright Galaxee ) and I have Medica, employer sponsored. It's under the United Healthcare umbrella. United pays their CEO $125,000,000.00 per year and whines that the doctors charge too much!
You have very little choice in doctors and need special dispensation to see any specialist, and the doctor better have a damn good reason or it's denied. :angry:

Then there's the aleged drug coverage. One perscription DW needs is not on their "approved" list (must not get enough kick back from that drug company), they said there is a different pill that will do the same thing, only DW is alergic to it! So this one we have to pay out of our pocket. I guess they feel our doctor has an MD while they have an MBA, that's one more letter in their degree so they out rank our Dr.

Canada, England, and most of Eruope is looking better all along!

 

Hmmmm. I don't care how good that type of plan is; they really need to change the name. :lol: