Federal Health Insurance (flat fee, dermatologist, contractor)

[Carlingtonian]

I have Compass Rose, which is only open to DoD, State, and IC employees. I'm about to go to a job at an agency outside of those agencies. Does anyone know if I'll get to keep my Compass Rose, or will I have to choose from some new provider once I'm at the new place?

Thanks for any info.

[Bigfoot424]

Originally Posted by Carlingtonian

I have Compass Rose, which is only open to DoD, State, and IC employees. I'm about to go to a job at an agency outside of those agencies. Does anyone know if I'll get to keep my Compass Rose, or will I have to choose from some new provider once I'm at the new place?

Thanks for any info.

Don't have an answer on this but I don't think it was one of my options under DOJ. You going to where we talked about on DM in the past?

[mlv311]

Pretty sure you won't have it as an option if you work outside of those specific agencies.

[Carlingtonian]

Originally Posted by Bigfoot424

Don't have an answer on this but I don't think it was one of my options under DOJ. You going to where we talked about on DM in the past?

Nope--different place. The complete opposite direction geographically and in subject matter from the one you're thinking of.

Originally Posted by mlv311

Pretty sure you won't have it as an option if you work outside of those specific agencies.

Right, but I work for DoD now, so I was hoping I'd be grandfathered in if I didn't bother to change it. Guess I could always call CR.

[mdcrim]

I've never heard of Compass Rose insurance and we've had a federal employee in the family for years. If you do need to switch plans, we've had MD IPA for years and it has been fabulous. It's one of the more expensive plans but our experience with a family member with a chronic illness has made it worthwhile for us- their coverage is amazing.

[Carlingtonian]

Originally Posted by mdcrim

I've never heard of Compass Rose insurance and we've had a federal employee in the family for years. If you do need to switch plans, we've had MD IPA for years and it has been fabulous. It's one of the more expensive plans but our experience with a family member with a chronic illness has made it worthwhile for us- their coverage is amazing.

Thanks. Apparently Compass Rose was known as GEHA till a few years ago, not to be confused with the other GEHA. It's a PPO and uses the UHC network.

[mormegil27]

Question for the OP - I currently have Compass Rose as well, and have been generally happy until this year. This year they switched their claims to a company called UMR. The new company has been slow to process claims, one provider even sent something to collections, which was reversed after many calls to insurance.

Then I had to have a test and UMR claims they won't pay for it because it is "genetic testing". I looked up the bill codes and it has nothing to do with genetic testing - without getting into details, the test is really straight forward and is quite common. I'm currently under appeal because it is ridiculous. The testing company is trying to charge me $600, which is typical since the negotiated insurance rates are often way below the private market rate charged when people don't have insurance. I had to deal with this refuse-to-pay for trumped-up reason BS all the time with Aetna when I was a contractor in a small negotiating pool, but thought I'd left it behind with Fed healthcare.

So would you drop Compass Rose given these difficulties? Or have you had such good experiences that you'd give it another go? I'm looking for a similar PPO, was thinking of trying the Cigna network with NALC. I'm tempted to just go over to Kaiser, but we would have to change all our doctors.

[Carlingtonian]

Originally Posted by mormegil27

Question for the OP - I currently have Compass Rose as well, and have been generally happy until this year. This year they switched their claims to a company called UMR. The new company has been slow to process claims, one provider even sent something to collections, which was reversed after many calls to insurance.

Then I had to have a test and UMR claims they won't pay for it because it is "genetic testing". I looked up the bill codes and it has nothing to do with genetic testing - without getting into details, the test is really straight forward and is quite common. I'm currently under appeal because it is ridiculous. The testing company is trying to charge me $600, which is typical since the negotiated insurance rates are often way below the private market rate charged when people don't have insurance. I had to deal with this refuse-to-pay for trumped-up reason BS all the time with Aetna when I was a contractor in a small negotiating pool, but thought I'd left it behind with Fed healthcare.

So would you drop Compass Rose given these difficulties? Or have you had such good experiences that you'd give it another go? I'm looking for a similar PPO, was thinking of trying the Cigna network with NALC. I'm tempted to just go over to Kaiser, but we would have to change all our doctors.

I haven't actually used Compass Rose that much, so I don't have much to go on. In fact, the only real reason I chose them 3 years ago was that 1. they're a FFS/PPO, and 2. they had a specific cap on ER expenses, rather than a percentage. I haven't been to a doctor (other than a dermatologist) since 2010, so the only claims I've seen from CR are when my dentist filed on my medical insurance as well as my dental for cleanings.

Sorry to hear about the difficulties you've had. That is indeed cause for concern.

If there are any Feds here who are super-happy with their health insurance, I'm sure Mormegil27 and I would be eager to hear about your experience.

[airjay75]

Originally Posted by Carlingtonian

Thanks. Apparently Compass Rose was known as GEHA till a few years ago, not to be confused with the other GEHA. It's a PPO and uses the UHC network.

If you can't keep Compass Rose and were interested in one of the three GEHA plans, they also use the UHC network in DC, MD, and VA, as well as a a number of other states. In some states, they use other networks. I have the GEHA HDHP plan and have been happy, but I also have not had to use it for anything significant.

[spleuchan]

I had BCBS basic for a few years and was overall happy with it. Had one issue where BCBS didn't pay for something. I disputed it with OPM and lost (although I still to this day don't understand why it wasn't covered). Switched about 4 years ago to GEHA Std and have been happy with that. Claims with GEHA are very quick, much quicker than BCBS. In 4 years, I've only had one issue where they didn't pay for something. I called them and they showed me exactly where in their book they say they don't cover that. I was going to switch back to BCBS, but one of the changes the following year to their program was to eliminate that exclusion. One thing that i like with GEHA is although it uses United Healthcare, Quest Diagnostics is included, along with Labcorp. I don't want to mess with the off chance one of my drs send my blood to one of those two and I'm not covered with them. These labs will submit bills for say $900, with an insurance allowable of $30. Its crazy.

GEHA Std is more than $2,000 cheaper than Compass Rose, so that is worth it to me to have the risk of an expensive hospital stay. If a hospital flat fee copay vs % is important to you, I'd go with BCBS basic.