What is your health insurance?

ariesallover · October 6th, 2008, 05:26 PM

Someone I love, X, is in the process of searching for health insurance. Into his 30s, he is blessed with health, but knows it's time to take precautions. He will be paying out of pocket for it, so cost is a consideration, of course.

My health insurance is Personal Choice from Blue Cross/Blue Shield. I love it. I have been blessed with this plan. No pesky referrals. Decent copays. Semi-painful deductibles, but all things are relative to the cost of medical needs and health insurance overall. I recommend it. I believe X was quoted $240 a month for it.

I realize that different insurers are popular in different parts of the country, so I'm curious about the East Coast of the US, though I welcome any input, especially any stories of surprises (good or bad) you had with your coverage, whether you pay out of pocket, get it through work, or are insured through a spouse, COBRA, etc.

I've heard a lot of people complain about Aetna - is it really that bad?

I have had my insurance for so long that I am rusty in the shopping-for-insurance department. Can you think of questions that he should ask that maybe the ordinary person wouldn't think to ask (especially if you work in the insurance industry)?

msdeb · October 6th, 2008, 05:34 PM

i have Health Net. i've never had a problem with them, and i've been with them for 15 yrs (Ish). however, we now have Healthnet thru hubs work, and the deductibles went up. pfffft.

i too have heard plenty of bad things about Aetna.

ariesallover · October 6th, 2008, 05:36 PM

^Thank you, that will go into my Google hitlist.

Now I'm wondering if I should bother to ask Aetna for quote lol.

BoogsBun · October 6th, 2008, 05:57 PM

We have insurance through my husband's job. It's Blue Advantage PPO, and it's in the BCBS family tree.

It's $155 per paycheck for family coverage. Our deductible is $500 per year, 80/20 in-network, office visits are $20, ER visits are $75.

We also put money into a medical savings plan at his job ($35 per paycheck). It comes with it's own debit card, so we can pay bills with that, instead of paying out-of-pocket and jumping through hoops to get reimbursed.

ariesallover · October 6th, 2008, 06:10 PM

Quote:

Originally Posted by BoogsBun

We also put money into a medical savings plan at his job ($35 per paycheck). It comes with it's own debit card, so we can pay bills with that, instead of paying out-of-pocket and jumping through hoops to get reimbursed.

Heh. I never heard of anything like this - it's fantastic. I have to shell out entirely for some stuff and then wait for a check. Otherwise most of my office visits are $15, including specialists.

dolem · October 6th, 2008, 06:16 PM

Quote:

Originally Posted by msdebagain

i too have heard plenty of bad things about Aetna.

What have you heard that is so bad? I was switched to Aetna not too long ago through my job. Before that I had Blue Cross/Blue Shield. So far I have had nothing to complain about, however I've been pretty healthy in the past year+. I do have a birth coming up, so we'll see how everything goes with that.

I've heard horror stories of people trying to find private health insurance - or at least when they have to find it themselves rather than it being provided through their job.

ariesallover · October 6th, 2008, 06:31 PM

Quote:

Originally Posted by dolem

I've heard horror stories of people trying to find private health insurance - or at least when they have to find it themselves rather than it being provided through their job.

It's an utter bitch, particularly when you're chronically ill with medical bills every week. Thankfully I've been on the same plan for quite a while.

Quote:

Originally Posted by dolem

What have you heard that is so bad? I was switched to Aetna not too long ago through my job. Before that I had Blue Cross/Blue Shield. So far I have had nothing to complain about, however I've been pretty healthy in the past year+. I do have a birth coming up, so we'll see how everything goes with that.

The big ticket things (a big injury, not just a sprained ankle; major surgery with a prolonged hospital stay or aftercare; you get the idea) not being covered or adequately covered with the appeals process not being terribly effective. Now, perhaps I'm wrongly biased because the folks telling tales didn't have a leg to stand on (*groan* - terrible, I know), so I'll own that.

L1049 · October 6th, 2008, 07:08 PM

I have nothing to add to the insurance discussion, but I have something to suggest. You may want to check out Ripoff Report: By Consumers, For Consumers for reports on various insurance companies or any company/person for that matter.

Jexxifer · October 6th, 2008, 09:03 PM

I manage the insurance billing department for a large home health company, and from my personal experience United Healthcare (UHC) and Cigna are the worst as far as paying claims. Aetna is much better than it was in the past.
The Blue Cross/Blue Shield plans vary from state to state, some better than others, so it really depends where you are.
Kaiser Permanente is also a good option if your friend doesn't mind having an HMO and if it is in your area. They tend to have resonably priced plans for individuals/self insured.

msdeb · October 6th, 2008, 09:48 PM

Quote:

Originally Posted by dolem

What have you heard that is so bad? I was switched to Aetna not too long ago through my job. Before that I had Blue Cross/Blue Shield. So far I have had nothing to complain about, however I've been pretty healthy in the past year+. I do have a birth coming up, so we'll see how everything goes with that.

I've heard horror stories of people trying to find private health insurance - or at least when they have to find it themselves rather than it being provided through their job.

my friend has Aetna and has been trying for over 6 mo to get approval for her kidney surgery, they send her to different specialists and outside doctors trying to find reasons not to do it. i just see the shit she's had to go thru. and about a year ago, MSNBC did a special on Aetna and someone else (Kaiser?) for slow approval of procedures. But in that same report i remember that they said that Aetna supports Health Care Reform. just my personal story.

McJag · October 6th, 2008, 10:06 PM

I have Aetna,but my company just lets them run it & makes the rules. We just switched from Blue Cross at the first of the year. I do not notice any difference,but wouldn't really. I get great care,no matter what. Good to have a big corporation making the rules!