Health Insurance – who are you with ?

posted 2 years ago in Weddingbee
Post # 2
Member
2166 posts
Buzzing bee
  • Wedding: October 2013

My work covers part of my plan but I’m with Aetna. I like it, it’s a common insurance provider that a lot of medical offices take so it’s easy for me to find doctors. 

Post # 3
Member
514 posts
Busy bee
  • Wedding: September 2017

I am following this thread… We are also in the market for an affordable health insurance company, preferably one with a good plan for pregnancy. 

I know that Healthcare.gov opens Nov 1st, but because of the iffy climate in politics right now, I am hesitant. 

Adding: My last vision insurance company was fantastic. It was called VSP. Also, I used to work in dental (Still a licensed RDA) and had great experiences with Delta Dental. Though if you don’t forsee you will need extensive work, out of pocket for dental ends up cheaper. 

Post # 4
Member
5109 posts
Bee Keeper
  • Wedding: December 2014

gavinnizzy :  I have Health/Dental/Vision through my work, so I didn’t choose it, but I have Humana for health insurance and Guardian for Dental/Vision. I’ve never used the vision, but it’s otherwise been pretty good, particularly for preventative care stuff. I haven’t had any issues finding network providers. 

Post # 5
Member
7773 posts
Bumble Beekeeper

Also following. We have health insurance with United Healthcare through DH’s work but it is incredibly shitty. I’ve had several different health insurance plans over the years through my different employers and none have even come close to touching the level of shittiness that we now have through United Healthcare. We each have a $2000 deductible and a $6000 annual out of pocket maximum (so really $12k out of pocket for the both of us)…if we have a kid that will turn into an $18k out of pocket. Its kind of like…what is the fucking point in having health insurance if we could have to pay $18k in a year conceivably? I had a high deductibele plan in the past but it came with an HSA account that my employer contributed to each year, so that made it worthwhile. This plan has nada. Also infertility treatments are 100% not included.

To add insult to injury, Darling Husband was hospitalized last month to the tune of $19k and United Healthcare DENIED THE CLAIM saying his stay was “medically unnecessary”  (even though the doctors literally told us that if we left the hospital before they approved it, we would be going “against medical advice” and our insurance may not cover the stay!). So we are now in a heinous appeals process that will probably last a full year. I am so done.So yeah…I want to look into other health insurance options too. I have heard really awful things about Obamacare (though I still think it’s better than nothing!) – would love to hear people’s experiences.

Post # 6
Member
7773 posts
Bumble Beekeeper

This might be common knowledge for most of you, but it wasn’t for me. I just spent a few min reading the info on healthcare.gov and if you already have health insurance through your employer, you would have to pay “full price” for a plan through the ACA. Our monthly premium for the cheapest “full price” ACA plan would be $690….and this plan has even higher deductible/out of pocket max than our United Healthcare (employer sponsored) one does now. yell why is healthcare in America so fucked???

Post # 7
Member
11617 posts
Sugar Beekeeper
  • Wedding: June 2015

 I’m on highmark blue cross/bs now, and it’s interesting because I had a less expensive plan I purchased on the Obamacare exchanges with same company and now I’m on a premium plan with same company that is privately purchased.

I paid for the Obamacare insurance in full as I didn’t qualify for subsidies, and it was a lot cheaper than the private insurance. The Obamacare plan was better re copays and deductibles, though, for doctor visits and X-rays etc. The premium private plan is better for prescriptions. 

I’m very happy with them, and was happy with plan through marketplace and happy with private plan now.

the exchanges give you a breakdown of what each tiered plan offers and so you can shop for the expenses you are most likely to incur. The experiences will vary from state to state, since the exchanges were supposed to be run federally but republicans objected to that and sued over it. Now the states that didn’t agree with the law have a lot of leeway to sabotage it, and they have or did, though a lot of them eventually came around because they realized it was helping people (they were denying the Medicaid expansion, e.g., so people who didn’t make enough to qualify for Obamacare were getting screwed)

Re different insurers, IME, United is the worst. I had them before Obamacare and they denied everything even things they approved before the event. Now you just have to fight them forever, but at least they have to eventually pay something if it was covered and you know your rights under the Obamacare law.

Fiance also covered Obamacare law extensively so I like to throw in that it is a lot more than the marketplace; it’s a law the regulates insurance companies so they are more accountable pexpletive with whom they contract.

the most important things obamacare does that impact everyone – not just people who buy through the marketplace -is make insurance companies actually pay for things they’re supposed to cover, which is pertinent to  Tiffanybruiser’sDH’s situation. 

Obamacare law also makes insurance companies have to cover preexisting conditions, which is how they used to get out of covering things that they could say you had before. 

Obamacare made pregnancy a thing that has to be covered by x amount of insurers (pregnancy coverage was super hard to get with a normal plan before), gave women well woman visits and affordable birth control. It shocks me that women think pregnancy is just a thing that is covered, when a mere seven years ago, it was not. 

And of course the kids can stay on parents’ insurance thing until they’re 26 is via Obamacare law. 

 

 

tiffanybruiser :  sorry, tried to tag you above re your DH’s bill, but I’m on a mobile. I hope you guys get that sorted, that is so wrong. 

Post # 8
Member
266 posts
Helper bee
  • Wedding: June 2017

I too have Aetna, but unlike PP, I have had nothing but problems with them since they became my insurance provider a little over a year ago. My company used another local insurance provider previously, and I never had a single issue or denial with them. But since we were forced to switch to Aetna, I have had to fight tooth and nail for them to pay for ANYTHING. We are required to have an annual wellness exam (including pap smear for women) that is completely covered by insurance in order to get a reduced price on our health insurance cost every year. This year, Aetna refused to pay the lab bill for my pap smear because apparently my phsician used a lab that is not in the Aetna network… like I had ANY control over where the physician sends his labs. They also said the lab was charging more than what they thought was a fair price. Again, NOTHING I HAD CONTROL OVER. So I ended up going to my benefits department and one of our benefits representatives argued with Aetna for weeks about the bill before they finally decided to write it off.  Insurance denials are a big reason why healthcare facilities in America are failing.

Post # 9
Member
4936 posts
Honey bee

I have Anthem. I would recommend Aetna if you can get it. That and Cigna were the best I’d ever had. Mine is good but if you can find coverage with the other two I’d look into it. Of course you gotta look closely at coverage, deductible, premium, etc. 

Post # 10
Member
4936 posts
Honey bee

For vision I liked VSP

Post # 11
Member
4936 posts
Honey bee

Although the comment above mine makes me think twice about my recommendation. I’ve had issues with billing with mine too. Could be the medical group issue too. 

I would just take a weekend day and pore over the details. It seems coverage has changed enough in the last few years that my recommendations are no longer valid. 

Post # 13
Member
24 posts
Newbee

For what it’s worth, I work at a doctor’s office and many of us agree that United sucks.

However, you have to consider the plan, not just the company.  My husband and I are both covered under the same insurance company, but each through our own employer.  Our plans are completely different.  Mine cost more in premiums (not sure if this is due to a true difference in the premiums or a difference in how much our employers subsidize us), but has a lower deductible and covers more.  His costs less in premiums, but covers much less and the deductible is higher.  Our plans differ in terms of “preferred” system, so he gets his care at one area hospital system, whereas I get my care at another.

MissMayhem’s experience is not uncommon – as a consumer you do have to make sure that the lab your physician’s office is using is a preferred lab or else you may not be covered.  At many offices I’ve been to as a patient, I’ve had to sign something to that effect (ie, “We use Quest Labs.  Please check with your insurance company to confirm they cover Quest Labs.  We are not responsible for lab charges that are not covered by your insurance).  It’s a question not a lot of people know they need to ask, but you really do.  It’s not an Aetna thing – most insurance companies have preferred labs.

Post # 14
Member
9815 posts
Buzzing Beekeeper
  • Wedding: September 2013

tiffanybruiser :  that’s crazy…do they not have family caps on your out of pocket?  Our max out of pocket is $4k for individual but for family it is $8k.  So since I carry all our insurance (DH, me, 2 kids) our OOP max for everyone would still cap at $8k once we hit it.

I am on a plan through work so I get no choice.  I have Humana and have had them 2 years I htink now…going on 3.  Before I’ve had Cigna and BCBS.  They are all about the same IMO.  And they all suck smile  JK…our plans have all been about the same just different carriers.  I never had an issue with BCBS but I never really had anything other than a few preventive visit type things.  With cigna and humana I gave birth under each and each time one of them screwed something up and took multiple, dozens of phone calls to fix.

Post # 15
Member
1903 posts
Buzzing bee
  • Wedding: October 2017

I’m with Blue Cross Blue Shield through work, but we are switching to Aetna as a company next year.

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