United Healthcare PPO or EPO - do you have it?

[Neesy228]

I'm looking at medical benefits for a new job and the company offers a variety of United Healthcare PPO's and EPO's (they refer to them as medium and premium) as the most available, and affordable, option. I don't have any past experience with them, so I'm hoping to get some feedback...

Do you have this plan? Does it work well for your family? Do you have complaints? How much do you end up paying OOP for standard medical care - like if you go to the doctor and have bloodwork done, or if you have to take your kid to the ER for something etc?

I would really appreciate any info you could offer. It would really help me work through which plan is the best option. Thanks so much!

 

[uk_wildcat]

We have United Healthcare and the plan we have is called Choice Plus. It was the highest plan my dh's employer offered. Our individual deductible is $500/family is $1000. Out of pocket max is $3000 individual and $6000 family. Our copay for regular doctor visits is $10, $50 for specialists and I think it is $150 for ER visits (but may be $50). I think most things are covered at 80% before deductible is met.
Honestly, I don't really care for this coverage. We had Anthem at my dh's previous employer and I hardly ever paid anything out of pocket other than copays. We didn't have deductibles.

 

[Friendofpluto]

Most employers in order to keep cost down have switched to United. We had no choice this year. From the medical field side, they are not my favorite insurance provider.

 

[Tinker Pam]

Also from the medical side.
My least favorite to deal with as well.

 

[prncess674]

I too have United ChoicePlus and have overall been satisfied. My main concern is access to doctors anywhere in the country that are in network. UHC has a huge network and the negotiated rates seems to be very reasonable, so my portion is pretty small. I travel all over the country for work and have seen doctors from California to New York, so a large network was tops on my list. Many smaller employers only offer in state HMOs and everything out of state is considered out of network.

The days of copays rather than % coverage are coming to an end. So I wouldn't necessarily say one is better than the other simply because of copays.

 

[MichiganKris]

I don't think you can say generally that it is good or bad, it depends on the individual policy. My husband and I both have United Health Care, called the same thing with the same deductibles, however, we work at different companies. I pay much less then he does for the same tests at the same doctors office. My premium is also less than his, unfortunately, my policy is written to discourage adding spouses that are insured at another company, so if I add him to my policy I have to pay a lot more than we would save.

 

[kkandaj]

My husband and children are covered through my husband's UHC plan. We have a $600 deductible per person, then they cover at 90%. Specialists are covered at 80%. Once a person reaches $1500 OOP, they pay at 100% for that person. When the family hits $3000, they pay at 100%. I don't remember the costs for the ER services. DS has life threatening food allergies, so if I really need ER service, I don't really care the cost.

We haven't had any issues with them not covering things we need. DH's yearly exam/blood work is paid at 100%, along with all well checks/shots for our kids.

I do miss the days of paying a $25 co-pay. DS has lots of medical bills, so we reach his $1500 about half way through the year.

 

[Golf4food]

Our company switched to UHC this year. We have the top plan available for the three of us and have so far put up about $1,500 out of pocket already because it is a coinsurance plan now so until you meet the deductible you pay the full cost OOP. I think we'll hit the deductible now the baby had ear tubes put in recently, so that should help a bit. We had to switch one doctor that was not on the new plan, which sucked. I have no other reason to dislike them so far, but I can't say we love them. We were perfectly happy with Aetna in past years.

 

[puffkin]

We had it for several years through my husbands company and it was HORRIBLE. My husband is diabetic and we had so many problems getting his supplies. They would cover his testing strips (which are outrageously expensive). We called on 3 seperate occassions to get it resolved. and 2 of the 3 reps had NO IDEA what diabetic testing strips were or how to help. Considering Diabetes is incredibly common, this is just unreal to me. The last rep was a bit more helpful but said they would only cover 30 for 3 months. Umm.....that means he could only test his sugar once every 3 days!

ANother issue we had was for his insulin pump. He uses Pod devices. On our past insurance we could get them through the manufacturer...Insulet. They cost about $800 for a 3 months supply. United Healthcare wouldnt' deal with INsulet (it took HOURS on the phone to figure all this out as no one knew what an insulin pump was or how to help us figure out our coverage ) so we had to go through a 3rd party vendor that they did deal with. The 3rd party vendor marked up the exact same pods by 100% What a complete scam and you can see why the healthcare system is the way it is.

We are much happier with Highmark (my companies plan) the last few years and this year his company switched to Independence Blue Cross because they had so many complaints about United Healthcare. We so far have no complaints and our premiums and OOP costs are lower, as are our deductibles. We have tons of medical bills every year with DH's diabetes and I am pregnant this year but so far everything has been smooth. And, they deal directly with Insulet as well so no crazy middle men for DH's pods!

 

[DEA]

We had it for several years through my husbands company and it was HORRIBLE. My husband is diabetic and we had so many problems getting his supplies. They would cover his testing strips (which are outrageously expensive). We called on 3 seperate occassions to get it resolved. and 2 of the 3 reps had NO IDEA what diabetic testing strips were or how to help. Considering Diabetes is incredibly common, this is just unreal to me. The last rep was a bit more helpful but said they would only cover 30 for 3 months. Umm.....that means he could only test his sugar once every 3 days!

ANother issue we had was for his insulin pump. He uses Pod devices. On our past insurance we could get them through the manufacturer...Insulet. They cost about $800 for a 3 months supply. United Healthcare wouldnt' deal with INsulet (it took HOURS on the phone to figure all this out as no one knew what an insulin pump was or how to help us figure out our coverage ) so we had to go through a 3rd party vendor that they did deal with. The 3rd party vendor marked up the exact same pods by 100% What a complete scam and you can see why the healthcare system is the way it is.

We are much happier with Highmark (my companies plan) the last few years and this year his company switched to Independence Blue Cross because they had so many complaints about United Healthcare. We so far have no complaints and our premiums and OOP costs are lower, as are our deductibles. We have tons of medical bills every year with DH's diabetes and I am pregnant this year but so far everything has been smooth. And, they deal directly with Insulet as well so no crazy middle men for DH's pods!

Hi there. I am in the same boat as your husband (Diabetic, using the OmniPod), and I have UHC health insurance. They did move the FreeStyle test strips (the kind that work in the OmniPod PDM) up to a higher tier, and forced me to go through mail order to get them, but they are covering them with the (higher) copay according to my Dr.'s prescription. The Pods themselves had to go through EdgePark, because UHC does not have a direct relationship with Insulet (like BCBS had back when I had them, and like your new company does).

The bigger thing was that all the Pod stuff goes into the Durable Medical bin. That used to be a problem because with the Pods and my CGM stuff (which all go under Durable Medical, even though most of the stuff has to be replaced every 3-5 days) would hit the Durable Medical cap fairly quickly. Health Care reform got rid of that problem, otherwise I am sure I would have had to pay OOP to keep up a reasonable standard of care.

There are parts of my specific plan that I don't like, including the fact that some of my favorite practitioners are not in the UHC network, but they do seem to handle things well once they get the necessary certificates of medical necessity on file.

 

[texaskathy]

We have choice plus too. Pretty good compared to others I have heard about!

KB

 

[heartsy77]

Good to know all this! My DH can carry us as of 5/1 on this insurance, through his employer Gannet News. My only concern is my DD 13 is growth hormone injections and right now we have no copay for them!