Open Enrollment at work

[Napria]

If this is not appropriate to post here please let me know and I'll remove it.

Can you all give me your positive/negative experiences with the following:

Blue Cross Blue Shield HMO
United Healthcare HMO
Kaiser HMO

There are also High Deductible and HRA plans being offered, but in our situation I feel more comfortable with an HMO.

The thing is, the HMO Plan benefits for UHC & BCBS are identical according to the decision guide, but BCBS is $140/mo less than UHC. I'm skeptical about this, and the only thing I can come up with is its a ploy to low-ball and get everyone to sign up for BCBS, then next year drop the UHC choice, saying that no one signed up for it. Then with no competition they can raise their rates back up and lower the benefits.

Kaiser is the one thing throwing me off. Their rates will be closer to BCBS, but with Kaiser there will be no deductible and no coinsurance, effectively making them cheaper in the long run. But I had Kaiser in the past and if you don't like what Kaiser says regarding care, you're out of luck. I'm wondering if they've changed?

 

[havaneselover]

It's really next to impossible to say without seeing complete plan comparisons (copays, coinsurance, etc.).

We just went through this at work. We're a small business with offices in two states. Because of the second location we could only get our coverage through Anthem even though there was another company with better coverage cheaper : ( So lower price doesn't necessarily mean inferior product.

 

[Judique]

If this is not appropriate to post here please let me know and I'll remove it.

Can you all give me your positive/negative experiences with the following:

Blue Cross Blue Shield HMO
United Healthcare HMO
Kaiser HMO

There are also High Deductible and HRA plans being offered, but in our situation I feel more comfortable with an HMO.

The thing is, the HMO Plan benefits for UHC & BCBS are identical according to the decision guide, but BCBS is $140/mo less than UHC. I'm skeptical about this, and the only thing I can come up with is its a ploy to low-ball and get everyone to sign up for BCBS, then next year drop the UHC choice, saying that no one signed up for it. Then with no competition they can raise their rates back up and lower the benefits.

Kaiser is the one thing throwing me off. Their rates will be closer to BCBS, but with Kaiser there will be no deductible and no coinsurance, effectively making them cheaper in the long run. But I had Kaiser in the past and if you don't like what Kaiser says regarding care, you're out of luck. I'm wondering if they've changed?

1. Kaiser hasn't changed.
2. United is more expensive because of less subscribers and yes, they will probably disappear as one of your choices.
3. BCBS has remained fairly consistent for us. All healthcare is expensive in my opinion.

 

[erinmarie2224]

I've had both United and BCBS and have had very positive experiences with both. I've also been the decision maker for my company in benefit offerings. Your company's rates are based on claims of the employees (and the cost % your employer cover). Hopefully with a good benefits broker your rates shouldn't go up too much if they drop United.

This might seem obvious but you should check with your current doctor and hospitals to make sure they take the cheaper plan. Then you can evaluate if the cost savings is worth the hassle of finding new doctors.

 

[barkley]

just keep in mind that while someone might have the identical plan-depending on where they live it can be an entirely different experience.

my suggestion-for the non Kaiser plans see if you can go on their websites and pull up providers WHERE YOU LIVE. with an hmo the primary care provider is the gate keeper to all services, and if you don't have allot of service providers in your region it can be a pain to get a referral (getting an out of network referral isn't impossible but it can take time you don't need to waste). you also want to see what medical groups in your area are affiliated b/c you might not have an initial choice of who you get assigned to (our initial experience had all the preferred groups/providers with LONG wait lists to get affiliated so the hmo just did a random initial assignment and you had to get on a wait list for months/years to get in with the doctor/group you wanted).

if you have a current primary care physician that you like/trust-ask them if they are affiliate w/any of the plans-and if more than 1, which they would recommend for their patient care/coverage (my former doctor warned me away from one b/c the other one was notorious for delaying approvals as a cost saving mechanism).

 

[angwill]

BCBS is what I have and the cost is very high with huge deductible. The service I get is very good and I only had one issue once. I have heard Kaiser is hard to deal with and does things that make it hard on the user easier one them. If you have health issues and HMO is harder to work with than a PPO due to needing referrals for everything.

 

[jedijill]

I have experience with Kaiser. Here in Denver, you go to their doctors/facilities. It's ok but hard to get to a specialist. The mental health coverage is terrible. For example, there are only 2 or 3 offices for the whole Denver metro that have mental health services. Very hard to get in to see a therapist or you have to drive an hour to get to an appointment.

On the other hand, Kaiser HMO can save you serious money over paying OOP with other plans. I had an employee who's daughter had major back surgery, his wife had cancer, and he had a heart attack and I believe he paid less than $1000 OOP for all 3 major events (over 3 years).

Jill in CO

 

[tvguy]

It's really next to impossible to say without seeing complete plan comparisons (copays, coinsurance, etc.).

We just went through this at work. We're a small business with offices in two states. Because of the second location we could only get our coverage through Anthem even though there was another company with better coverage cheaper : ( So lower price doesn't necessarily mean inferior product.

I agree completely. Each of these providers has tailored their plan to your employers wishes. So your coverage and costs can vary wildly from people who work for the company across the street with the same insurance carrier.

 

[Marionnette]

just keep in mind that while someone might have the identical plan-depending on where they live it can be an entirely different experience.

my suggestion-for the non Kaiser plans see if you can go on their websites and pull up providers WHERE YOU LIVE. with an hmo the primary care provider is the gate keeper to all services, and if you don't have allot of service providers in your region it can be a pain to get a referral (getting an out of network referral isn't impossible but it can take time you don't need to waste). you also want to see what medical groups in your area are affiliated b/c you might not have an initial choice of who you get assigned to (our initial experience had all the preferred groups/providers with LONG wait lists to get affiliated so the hmo just did a random initial assignment and you had to get on a wait list for months/years to get in with the doctor/group you wanted).

if you have a current primary care physician that you like/trust-ask them if they are affiliate w/any of the plans-and if more than 1, which they would recommend for their patient care/coverage (my former doctor warned me away from one b/c the other one was notorious for delaying approvals as a cost saving mechanism).

Definitely check to see which doctors are on each insurance plan's panel. But in addition to that, call the offices of the doctors you think you will use and ask them if they intend to remain on that insurance company's panel in 2015. The last thing that you want to do is choose an insurance based on the healthcare provider and then learn that they have dropped out.

Another problem with HMOs is that your primary may not be capitated to the specialist that you may want to use. I needed physical therapy a few years ago and I couldn't go to the location closest to my home (the one that was recommended by my orthopedic surgeon) because my primary wasn't capitated to that location. I ended up driving half an hour away from my home twice a week for PT instead of only traveling 10 minutes.

I have no experience with the Kaiser, but have dealt with United Health and BC/BS. Of the two, BC/BS was the least problematic but also the most expensive. Since Aetna is dropping our insurance plan after this year thanks to the ACA, we're now in the market for health insurance (again) and we're leaning toward BC/BS for ourselves.

 

[DebbieB]

My company has the choice of BCBS and UHC. Everything is exactly the same except for provider lists. I had UHC in the past and had some difficulty with claims. When my company offered BCBS I switched, probably 8 to 10 years ago and have been very happy with them. Problem is there is a war going on here in Pittsburgh between Allegheny Health Network (BCBS) and UPMC (U of Pitt Med Center, they have their own plan). If I continue with BCBS, I will not have access to UPMC doctors & hospitals. If I switch to United, I will have access to both, they are neutral in the this war. Seems like a no brainer but I hate that UPMC has put us in this position, they have instigated this war in my opinion. I feel I have no choice but to switch to UHC so that I can still access my UPMC doctor & facilities. Hope for the best.

 

[msmayor]

While its fine to get opinions of others' experience with various plans, you really shouldn't factor that in to your decision because the best plan for you is based on how YOU and your family consume health care. Someone could tell you that they have great coverage and experience with BCBS, but if they use their benefits in a different way than you do, it could be the worst plan for you.

I used to enroll employees in medical and they would always ask me which plan was the best or cheapest. I told them I couldn't answer, because only they could find that answer based on how they would use their plan.

 

[MrsJackSparrow4Life]

Does your company's open enrollment website have an insurance calculator?

We always have 3 different plan options to choose from and our company provides a calculator that you input your usual medical needs and it tells you which plan would work best for those needs. I would suggest looking to see if your company has something similar.

 

[ruadisneyfan2]

BCBS is what I have and the cost is very high with huge deductible. The service I get is very good and I only had one issue once. I have heard Kaiser is hard to deal with and does things that make it hard on the user easier one them. If you have health issues and HMO is harder to work with than a PPO due to needing referrals for everything.

I agree and love my PPO but I think all of OP's choices are HMOs.

 

[Napria]

Thanks for all the feedback.

I live in the metro Atlanta area and am currently on a (non-HMO) BCBS plan. Prior to this year I had UHC (HMO). All my doctors and hospitals are on both plans. Both plans have the majority of the physicians in this area on their rosters. The two plans are completely identical in benefits/coverage. So much so that our decision guide lists both plans over the benefit headings for each benefit section.

There was a mess last year here when the HMO was yanked away from us and replaced with only one provider (BCBS) and only three choices, all HRAs. UHC and Cigna were dropped from our list of choices.

Because of all that went on last year and the benefits being absolutely identical, I'm rather suspicious of BCBS' rates being $140/month cheaper. But $140/month would be the equivalent of a major raise and hard to pass up.