health insurance question (Pittsburgh: flat fee, deductible, costs)

[Lisa_from_Debary]

The best thing a person can do for themselves is work in a company that has their own insurance...they don't pay attention to pre-existing conditions...lifetime caps are higher...

I know this is not always posible however.

The absolute BEST insurance I have ever had was United PPO...they were the easiest to deal with and had a great network of providers. AND should something come up where I needed to see a specialist who was not on the list, I could go out of network.

I found that some providers really disliked working with Blue Cross, I have HEARD although I can't personally confirm that Blue Cross will do anything NOT to pay a claim and that dealing with them in general is so complicated some providers have dropped them altogether. This is only what I have heard from different providers and when I worked in the industry...Of course my experience with them is limited to Florida's Blue Cross, it could be VERY different in other states because they are different companies.

[Hopes]

In Pittsburgh, almost all providers participate with Blue Cross, and you can go outside the network if you choose.

I have never had a problem with my bills being paid by Blue Cross in Pittsburgh either.

[Mgmtbuzz]

Hello everybody

I would like to know which medical insurance to take which cover 100% doctor visits and gynaecology and obstetrics ,lab. tests etc.These posts above show UPMC is not a good choice and very costly too.I want to take on individual basis .My husband is a student at Pittsburgh.Since we are not earning we have financial constraint too.
Please suggest.
Thanks

[Hopes]

100% coverage is going to cost you a fortune anywhere in the country.

I know many students who use obscure health insurance providers to save money.

Have your husband ask some students at school which health insurance they use.

[barneyg]

Originally Posted by Mgmtbuzz

Hello everybody

I would like to know which medical insurance to take which cover 100% doctor visits and gynaecology and obstetrics ,lab. tests etc.These posts above show UPMC is not a good choice and very costly too.I want to take on individual basis .My husband is a student at Pittsburgh.Since we are not earning we have financial constraint too.
Please suggest.
Thanks

A thing I've learned from my CMU experience (with Highmark), not sure if it's generalizable: depending on what you think you'll need in terms of coverage, it's a tradeoff between premium and out-of-pocket expenses, not just deductible. If you're pregnant or plan to (which is what I kinda get from your post, although I could be wrong), it's possible that the basic family plan for Pitt students has a lower coverage rate (such as 60% or 80%) but a maximum for the amount of out-of-pocket expenses that you will have to make, such as $1,500 or $2,000 per occurrence. You do the math, but for prenatal tests and delivery you'd probably be better off under that plan than paying a huge family premium for a 100% coverage plan. ie. under than plan you'd have a much lower premium to pay (from what I recall it's about $3,000 less), some portion of doctor visits and ultrasounds along the way, and then $1,500 at the delivery, and then some portion of pediatrician/follow-up visits after that.

[Katiana]

Always do the math. Sometimes lower premium = higher co-pays, difficulty getting prescriptions filled (not on their formulary, etc), less coverage. A medical emergency, such as a preemie baby, can send you into bankruptcy. Do not think because you live a "healthy lifestyle" that it won't happen to you. Be careful!

[Mgmtbuzz]

Originally Posted by boylocke

Don't forget Aetna, I know some people really like them!

Hi

Can you suggest me for medical insurance which would cover for maternity initial costs for planning a baby .I spoke to Highmark bcbs.It covers upto 90% with 250$ deductible .A PPO.My husband is a international student.Kindly help .I want an insurance for myself from December to 6 mnths.

Thanks a lot.

[Mgmtbuzz]

Originally Posted by barneyg

A thing I've learned from my CMU experience (with Highmark), not sure if it's generalizable: depending on what you think you'll need in terms of coverage, it's a tradeoff between premium and out-of-pocket expenses, not just deductible. If you're pregnant or plan to (which is what I kinda get from your post, although I could be wrong), it's possible that the basic family plan for Pitt students has a lower coverage rate (such as 60% or 80%) but a maximum for the amount of out-of-pocket expenses that you will have to make, such as $1,500 or $2,000 per occurrence. You do the math, but for prenatal tests and delivery you'd probably be better off under that plan than paying a huge family premium for a 100% coverage plan. ie. under than plan you'd have a much lower premium to pay (from what I recall it's about $3,000 less), some portion of doctor visits and ultrasounds along the way, and then $1,500 at the delivery, and then some portion of pediatrician/follow-up visits after that.

Thanks.I also asked Highmark bcbs.They have 250$ deductible with 90% coverage even in maternity with about 192$ monthly premium for 1 member.We dont get any college discount in any of the plans.If I dont plan for my delivery in US and need an insurance just for prenatal visits upto 6 months then which is better option.I am highly tensed for taking insurance.

[Mgmtbuzz]

Originally Posted by Hopes

100% coverage is going to cost you a fortune anywhere in the country.

I know many students who use obscure health insurance providers to save money.

Have your husband ask some students at school which health insurance they use.

Hi

Thanks for reply.My husband 's school doesnt have married students .Others use UPMC coverage for students which is just 1200$ or student health services.
How is Highmark bcbs plan DirectBlue, An Individual Comprehensive Major Medical Preferred-Provider Health Plan; $250 Deductible; Medically Underwritten.

Also I cdnt get the difference between Medically Underwritten plan and guaranteed issue.
kindly suggest.

[barneyg]

Originally Posted by Mgmtbuzz

Thanks.I also asked Highmark bcbs.They have 250$ deductible with 90% coverage even in maternity with about 192$ monthly premium for 1 member.We dont get any college discount in any of the plans.If I dont plan for my delivery in US and need an insurance just for prenatal visits upto 6 months then which is better option.I am highly tensed for taking insurance.

I honestly don't know what your better option is. I guess the only thing you have to make sure if you're mainly concerned about prenatals is how the deductible works, ie. do you pay the deductible only once for all prenatal visits in a given year, or does the deductible apply for each occurrence. Many regular (no bloodwork or ultrasound) prenatal visits will not cost you $250.