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Old 01-26-2007, 12:50 AM
 
61 posts, read 567,062 times
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I'm a widower, taking an early retirement...2 years before I'm eligible for Medicare. I can continue on with my current health provider for 18 months, but it would be a very expensive proposition. I've received quotes from BC/BS (among other providers) and their rates appear to be the most reasonably priced. Do any readers have personal knowledge of the services provided by BC/BS that they'd be willing to share...or, perhaps, know of other options that might be worth looking into?

Frank
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Old 01-26-2007, 05:44 AM
 
Location: South of DAYTON
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Exclamation Dr clinic-charges.?

F: Believe Chattanooga is the HQ for BC/BS and they are building massive new bldg downtown, many employees. We recently rolled into coverage and they pay your co-pay at your chosen plan level.
. We do seem to be annoied at the extra HIGH Dr office visit charges in our town clinic. Maybe he is only place for 15 miles or so, but Its like $100 every visit, then lab, shot, x-ray, asst, etc charges. Even every re-visit is about $150 over what insurance will cover. Guess coverage is really for Hospital emergency operation should need. I.M.O.
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Old 01-26-2007, 08:23 AM
 
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My husband and I are self-employed, so health ins. is a big expense for us. After some research we found BC/BS to be the best for us. We saved a bunch more by joining the farm bureau and taking advantage of their low group rate.

Good luck!
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Old 01-26-2007, 09:41 AM
 
12,765 posts, read 35,891,563 times
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Quote:
Originally Posted by akm4 View Post
My husband and I are self-employed, so health ins. is a big expense for us. After some research we found BC/BS to be the best for us. We saved a bunch more by joining the farm bureau and taking advantage of their low group rate.

Good luck!
When I had BCBS with my previous employer, they were absolutely wonderful to work with. I never had any complaints.
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Old 01-26-2007, 12:24 PM
 
61 posts, read 567,062 times
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Thank you SPLIT, akm4, and Boris. Your feedback is very helpful. I'm currently working overseas, and no one I work with has first hand knowledge of BC/BS.

On the plan I'm considering, some of the benefits...such as Emergency Room, and Outpatient Prescription Drugs...are covered "subject to deductible and coinsurance". It's obvious what a deductible means, but what exactly is meant by subject to "coinsurance"?

Frank
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Old 01-26-2007, 01:24 PM
 
Location: Chattanooga
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coinsurance is the percentage that the plan will pay after your deductible has been met. For example, if you had a $500 deductible with 80/20 coinsurance and a $3000 max out of pocket (OOP) plan, here is how it would work:

Let's say you have a medical procedure costing $12,000
you pay the first $500 of medical expenses
coinsurance kicks in and pays 80% of the remaining balance ($11,500)
you pay 20% which equals $2300
you've now paid out a total of $2800 for the year
only $200 more and you're done for the year ($3000 max OOP ensures that you don't pay above and beyond that in a calendar year)

It can vary from plan to plan, but typically office & Rx copays do not count towards your max OOP.

Hope that helps!
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Old 01-26-2007, 02:19 PM
 
61 posts, read 567,062 times
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O.K. TriDad, bear with me.

Does a plan with a 5K deductible AND a 5K maximum OOP mean that I could actually end up paying 10K each year if, let's say, I had a catastrophic illness requiring surgeries/treatments/meds for a number of years?

Conversely, does a plan with a $2,500 deductible, and an OOP coinsurance maximum of of $3,500 (INCLUDING deductible) mean that, essentially, I would only end up having to pay $1,000 per year?

The monthly premium for the first plan I mentioned is $265 p/mo. For the second plan, it's $510 p/mo.

Frank
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Old 01-26-2007, 02:28 PM
 
61 posts, read 567,062 times
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akm4 - What are the eligibility requirements for joining the farm bureau? When I retire I will, in all probability, be living in a rural area (in or around Livingston), but not doing any farming, other than growing a vegetable garden, and keeping a few chickens and rabbits.

Frank
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Old 01-26-2007, 03:09 PM
 
Location: Chattanooga
2,071 posts, read 7,230,584 times
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Quote:
Originally Posted by frbenson View Post
O.K. TriDad, bear with me.

Does a plan with a 5K deductible AND a 5K maximum OOP mean that I could actually end up paying 10K each year if, let's say, I had a catastrophic illness requiring surgeries/treatments/meds for a number of years?

Conversely, does a plan with a $2,500 deductible, and an OOP coinsurance maximum of of $3,500 (INCLUDING deductible) mean that, essentially, I would only end up having to pay $1,000 per year?

The monthly premium for the first plan I mentioned is $265 p/mo. For the second plan, it's $510 p/mo.

Frank


it depends on how the insurance company defines OOP. Sometimes they include the deductible, and other times I've seen where they don't. This is good question to ask the benefits person/insurance agent/carrier rep you're dealing with.

If you know the coinsurance for the first option you mentioned, then we'd know for sure. Also, keep in mind that these benefits are usually reset every calendar year. So come every January, the deductible and OOP get reset and you have to start paying all over again to meet them.
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Old 01-26-2007, 04:47 PM
 
61 posts, read 567,062 times
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TriDad,

The literature I have from BC/BS, notes that the coinsurance level on the first option is..."In network: covered at 100%. Out of network: covered at 60%".

So what the heck does THAT mean? I'm wondering if insurance companies are intentionally obscure with the information they provide...or if it's just that I'm particularly numb when it comes to such things.

Frank
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