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Old 07-19-2006, 01:48 PM   #1
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Default help me pick a health insurance plan

I have 3 options to choose from:



BlueCare
BlueCare
Blue Care

POS
POS
Basic




Copay Doctor
20
30
20 / 30 (Specialist)
Hospital Stay
500
500/4days (6k max)
$1500 Deductible ($4500 max family)
Out Patient
200
500
ER Copay
100
150
100
Drugs
10-20-30
10-20-30
10-20-30

Here is the cost and your contribution for each plan:
BlueCare
BlueCare
Blue Care
POS
POS
Basic

202.93 234.45 204.71
(50.54) (82.06) (52.32)




and I have NO idea what any of this means, or what i should pick...


help.
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Old 07-19-2006, 01:50 PM   #2
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bah, that didn't paste well... hang on...
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Old 07-19-2006, 01:52 PM   #3
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here:
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Old 07-19-2006, 01:59 PM   #4
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something about that makes no sense

the second blue care is shittier coverage but costs more?
is that for family or something??
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Old 07-19-2006, 01:59 PM   #5
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those aren't spectacular plans, but they are better than nothing. Blue care basic will help you if you are in the hospital for a long period of time. if you don't plan on kidney failure, i would go with the Blue care POS on the left. if you have a history of health problems get the one on the far right. it's kinda like car insurance. you never want to have to use it but the minimums will often cover the minor, daily usage.
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Old 07-19-2006, 02:05 PM   #6
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the first thing to check is whether your primary doctor is covered...
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Old 07-19-2006, 03:19 PM   #7
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i had anthem at my old job too, so i'd assume the doctor lists are the same....

i haven't gone to the doctor in like 6 years... but i have made a couple runs to the hospital for cutting fingers off.

i don't really care about the money... whats 30 bucks a month? i just don't know what any of it means...
is the expensive plan better? they have all different options... i dont know wtf is up
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Old 07-19-2006, 03:39 PM   #8
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not sure if this is what you don't know but i'll explain anyway

the top numbers are not monthly figures, they are per use
20 or 30 every doctor visit
500 bucks for a hospital stay
200 bucks for outpatient surgery/operations/procedures
100 bucks for the ER
10/20/30 is the prescription co pay depending on what tier the drug is on
10 = generic
20 = brand name
30 = special brand name, usually new drugs etc
every insurance company has diffrent ways to determine their tier systems
usually the more premium you pay the lower your copays are
so it doesn't make sense that the more expensive POS plan has higher co-pays

you also need to see if there is a basic limit, my job got really shitty insruance this year so they have deductible limits like car insurance
they don't cover rx until you spend 250 out of pocket
and they don't cover doctor visit till you spend 500 out of pocket
and then after you reach the out of pocket limit you still have the copays...
yea, my insurance sucks ass
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Old 07-19-2006, 03:43 PM   #9
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"Tell me what to buy" "Tell me what TV to have" "Tell me what to drive" "Choose my health care"
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Old 07-19-2006, 03:46 PM   #10
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Quote:
Originally Posted by Celerity
"Tell me what to buy" "Tell me what TV to have" "Tell me what to drive" "Choose my health care"
yah yah...

sorry, but i don't have a "wife" to discuss stuff with... and well, this is the easiest place to talk about things for me.
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Old 07-19-2006, 03:49 PM   #11
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Quote:
Originally Posted by pissedoffsol
yah yah...

sorry, but i don't have a "wife" to discuss stuff with... and well, this is the easiest place to talk about things for me.
werd...i would rather consult random guys i know from the net than ask a gf/wife about any major decision making.
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Old 07-19-2006, 03:50 PM   #12
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Call your hr department
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Old 07-19-2006, 03:52 PM   #13
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Quote:
Originally Posted by reckedracing
the top numbers are not monthly figures, they are per use
ok, so that's what I need to pay each time i go... got it.

Quote:
500 bucks for a hospital stay
ok, so that means i pay 500 total?

but what about this one?
500/4days (6k max)

does that mean i have to pay 500 a day? or is it 500 for 4 days, another 500 for 4 more days, up until i'd been there for 15 days? (4x15 = 6000) what happens after 15 days? It's all out of pocket?
what if i go in a coma for a month? I'm fucked?

Yes Steve, I'm going to blame Bush if i go in a coma

Quote:
so it doesn't make sense that the more expensive POS plan has higher co-pays
I know.. and thats why it doesn't make sense....
what does POS stand for anyway?

Quote:
you also need to see if there is a basic limit
you got a screen shot of what i got. I get the forms tomorrow. I have no other info than that, and i need to pick a plan by friday so i can get on the books for august 1st. so i need to figure this crap out.
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Old 07-19-2006, 03:53 PM   #14
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Quote:
Originally Posted by get_nick
werd...i would rather consult random guys i know from the net than ask a gf/wife about any major decision making.
ok, but i dont HAVE one at all... if i did, sure, i'd talk it over with her... but i don't, and i live alone... so here we are.
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Old 07-19-2006, 03:54 PM   #15
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Quote:
Originally Posted by Jeef
Call your hr department
lol

there is no hr department. lol

there are 4 people here, 3 if you don't count me.

the payroll and insurance lady is my boss's wife, who stays at home with the kids and runs payroll twice a month....
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Old 07-19-2006, 03:56 PM   #16
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You're so liberal, that if you do go into a Coma, Bush is more than likely actually to blame.
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Old 07-19-2006, 03:57 PM   #17
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i don't have one either. so i'm in the same boat. i just don't have any major decisions like you do.

here you go brian, Individual Health Plans > POS Plans
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Old 07-19-2006, 04:20 PM   #18
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Quote:
ok, so that means i pay 500 total?

but what about this one?
500/4days (6k max)

does that mean i have to pay 500 a day? or is it 500 for 4 days, another 500 for 4 more days, up until i'd been there for 15 days? (4x15 = 6000) what happens after 15 days? It's all out of pocket?
what if i go in a coma for a month? I'm fucked?
ok, i think 500/4 days = you pay 500 bucks a day for the first 4 days, then the rest of your current stay is covered
but if you have to go back 2 months down the road, you have to pay another 4 days, and it keeps going that way till your 6K limit is reached
i am assuming this is how it works, definately double check in the books when you get them...
whats the name of the company... most insurance companies have decent websites and then can prob answer your questions better than the "health and payroll" lady

also make sure she has you down for the right dependants/deductions so you don't get fucked at the end of the year...

Quote:
werd...i would rather consult random guys i know from the net than ask a gf/wife about any major decision making
especially things like hemroids, and glazed donuts
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Old 07-19-2006, 04:38 PM   #19
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Group Health
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Old 07-19-2006, 05:12 PM   #20
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Quote:
Originally Posted by reckedracing
ok, so wtf is the difference then?


Quote:
BlueCare BlueCare is a health maintenance organization (HMO) plan. That means benefits for covered medical care are only available when members use any of the nearly 4,000 physicians, hospitals and other health professionals that are part of the plan network. Members pay a fixed copayment when receiving covered services, and claim forms are submitted on their behalf. While a Primary Care Physician is recommended, referrals are never required to see specialists.

BlueCare POS BlueCare POS is a point-of-service (POS) health plan. That means members can receive the highest level of benefits when they use any of the nearly 4,000 physicians, hospitals and other health care professionals in the BlueCare network. Members pay a fixed copayment when they receive in-network covered services, and claim forms are submitted on their behalf. Members can also receive care from providers that are not part of the network, however deductible, coinsurance and charges above the maximum allowable amounts will be applied to claims for covered services.
POS lets me go to whomever, as long as i pay for it.
how is that different from an hmo?

wtf.
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Old 07-19-2006, 05:16 PM   #21
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lol, no idea what the real diffrences are, i think its all in the numbers ie: prices, costs and coverages

you can't compare the blue care HMO cause its not one of the ones offered to you according to your list...
i believe POS = no referal required... not sure though
Quote:

While a Primary Care Physician is recommended, referrals are never required to see specialists.
or maybe not....
hmmm
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Old 07-19-2006, 08:42 PM   #22
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I'd like to chime in here, Just asked my wife who works for anthem. She said take the Bluecare POS with the out of pocket 202 / (50.54) , she said it's a better plan
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Old 07-19-2006, 09:44 PM   #23
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care to explain why? i don't get what half of it means...

i don't mind higher copays... i RARELY go to the doctor... but if i do get sick, i want to be covered.
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Old 07-19-2006, 11:50 PM   #24
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In the Similar Threads found at the bottom:

Enemy of the State

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Old 07-20-2006, 12:17 AM   #25
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Insurance is for women. My plan sucks, I pay 60.xx a paycheck, and have to meet a 500.00 deductible--When I went in for cancer, it was only 300.00, meaning I still have 200.00 to meet this year before they start paying 80%.
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