(Closed) question for everyone who has health insurance

posted 11 years ago in Wellness
Post # 3
651 posts
Busy bee
  • Wedding: May 2012

I have Aetna and so far so good.  However, my employer pays most of the premium…I only pay $30/month.  I’m not really sure how much the whole thing costs or what the difference would be if you got it on your own.  But it covers everything that I’ve needed so far (including $600 for arm implant birth control – I just had to pay the $30 copay), and everywhere I go the doctors comment that it’s a very good insurance plan.

Post # 4
1937 posts
Buzzing bee
  • Wedding: July 2010

If you have any choice in what plan you end up with, here are some points to consider:

  • How much is the premium (amount you pay every month)?
  • How much is the deductible (amount you have to pay out of pocket before the benefits take effect)?
  • Is there a maximum out of pocket amount (when you pay $xxxx, you no longer pay anything and the plan picks up the rest)?
  • If there is both a deductible and maximum out of pocket amount, is the deductible included in the maximum out of pocket amount?  Are prescriptions costs included?
  • Is there a annual/ lifetime limit (if the plan pays $xxxx, they no longer cover your expenses)?
  • Are you limited in what doctors you see (in-network vs out-of-network)?
  • Are you limited in what hospitals you can go to (in-network vs out-of-network)?
  • What is your copay for a standard office visit?  Visit to a specialist?
  • Do you need a referral to see a specialist?
  • What is the copay for medications?  
  • Are there preferred (formulary) and non-preferred (non-formulary) medications?  
  • Is there a mail-order service (often less expensive – you receive 3 months of medications all at once).
  • If you haven’t had insurance for a while, are there any rules about pre-existing conditions?

Some of these points should change with the health care bill that was passed, however they may still apply right now if you are currently looking for coverage.


Good luck!

Post # 5
7081 posts
Busy Beekeeper
  • Wedding: July 2009

It’s really hard to recommend an insurer because private plans are so different than the ones that people get through work.

My benefits are much better than what they would be if I was privately insured (even with a similar plan).  (And I still think my insurance isn’t that great!)

Post # 6
2186 posts
Buzzing bee
  • Wedding: September 2010

the costs vary depending on if its through work or personal self employed coverage.

I have BCBS FEP (which is the federal employee coverage – the “so called congressional plan” that everyone talks about in the news.) and it SUCKS for what i need it for. they cover only what they want. and since i have had both cancer and female problems AND i have auto immune disorders, they are pretty much useless. but for the run of the mill illnesses they are great and wide range of doctors.

i used to have Cigna, and i loved them. great plan. doctors are a bit more limited though.

it really does depend on your area, whats available and how much you are willing to pay for it.

Post # 7
4 posts

msmojito- check out 1800MD.com. It’s an insurance company that’s offering great service at a crazy low rate. It’s extremely convenient and I love it! Goodluck!

Post # 9
460 posts
Helper bee
  • Wedding: October 2010

Sorry if this is TMI!

When I first got benefits at my job, I signed up for the Kaiser HMO since it was the cheapest and being healthy, I really only see my gyno once a year for my prescription. Now, I don’t know how it is everywhere, and I’m not trying to down the company as a whole, but I had a HORRIBLE experience with them. First off, it took forever for me to try to schedule an appointment with them because I couldn’t speak to an actual person, it was just that really annoying phone tree. Then, when I finally went to see my OB-GYN, the first thing he said to me was, “Why don’t you want to settle down and have a family?” uh, because I am only 24 and am not married. Then, the doctor had absolutely no clue what Seasonal birth control was. You would think that a gynecologist would have some idea of the medication that directly has to do with his field. No, I don’t expect him to know every pill on the market, but I figure that one is so different than most BC pills, and has quite a bit of publicity, any doctor worth his salt would know it. So, he put me on some horrible BC that made me sick all the time and I could only go the one Kaiser pharmacy that didn’t really have work friendly hours.

Really, my overall experience is that I got what I paid for, but I would NOT recommend it to anyone. I have an Aetna PPO now, and I am much happier with it!

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