Best health insurance?

The illegal immigrant story got me thinking---if you have had different health insurance over the years, which have you found to be the best? And if you love your insurance company (as much as one could love their insurance company), which one is it?

I have had Oxford for nearly 10 years. I was very happy most of the time. But co-pays were raised again, and my hospital coverage was changed. I got burned very badly this year with medical costs as a result of some major illnesses, hospital stays, and changes to my coverage, which I did not learn about until bills started coming in.

I am thinking of switching companies at the end of this year, but I don't know if other plans are any better, or if the whole industry is bad. I know my company also has BCBS, but not sure what else they have. COuld also look into what insurance DH's company offers.

TIA!

Re: Best health insurance?

Oxford and BCBS both have great network of doctors and hospitals. But it sounds more like the actual plan structure. The lower the copays/deductibles the higher the premium is going to be. Health insurance is constantly increasing and in the rough times we're having employers have been cutting back on medical insurance premiums. In some cases employers are putting high network deductibles or passing on more premium to their employees...some are even doing both.

My suggestion would be to see if there is a flex spending plan at your employer instead of switching carriers...it seems more likely to make an impact.

Re: Best health insurance?

best will be relative to your needs but generally speaking, the best plans are those that cover the most and have a very high or not catastrophic cap.

before I had my son I had a GHI plan that I loved.

no deductible, out of network benes paid 80/20 and I could go anywhere I wanted.

I paid out of pocket a nice chunk of change for single coverage (about 3k a year) but it was great.

I switched to my husbands plan, which is a High DD plan that covers EVERYTHING once the dd is met (for our family it's $6k). it saves us about $1k a year over the family plan my GHI offered.

ETA: every insurance company will have coverage specially designed for your "group".

my group is the FEHB (federal employee health benefits) and our details are specific to that group. Postal GHI had the same benefits but a lower out of pocket premium b/c of the way it was negotiated. it all comes down to the specific group plans that the insurance company offers through your (or your husbands employer)

basically our yearly cap out of pocket no matter what is 6k and that is something we can live with. we keep our account funded with that amount and we only spend what we need, saving us and his job and the ins. company over time a lot of money.

this, for now, works for us.

Message edited 10/5/2011 11:24:05 AM.

Re: Best health insurance?

Back in the day I was under my stepmother's plan. It was an HMO (haha old school) with Humana and it was great. Sure I had to get referrals but that was easy compared to the copays etc.

I got my first job at 16. At that point they said "grow up" and I was responsbile for all my own doctor appts and bills. They'd pay the premium. Having a flat copay was easy. Just $10-$20 (cant remember) and no matter what I needed it was done.

Those days are long gone.

Now I can't say I have had a favorite. I like my CDHD (high deductible) program right now. I pay NO copays at all. Everything goes through my insurance and applies to my deductible first. I have an HSA that pays for medical first then my FSA for anything afterwards. So far I have about $40 left in my plan for my FSA and about $500 left in my HSA. Carrier: Aetna.

Oxford was cheaper and smoother when my husband had it for him and AJ. But when we moved to TX he had to drop his insurance and got added to mine.

Employee = cheap (in some places just employee was free for me)
Employee + family = somewhat affordable and doable
Employee + spouse + family = UGh.. Nearly impossible!

Re: Best health insurance?

Tell me if this sounds like a deal, or if I am paying too much.

My premium, in addition to what my company pays, is over 1k per month for the family plan. I have $25 co-pay for regular doctor visits (ped and our GP). All specialists (which I tend to see a lot of) are $40 co-pays. Out of network drs, which I have one because it is my spinal surgeon that I have seen since I was 13 and knows my history, I have a 2k deductible on co-pays, and after that, they pay a portion of the visit. (maybe 70%?)

My hospital stays used to be a $500 co pay. Now I think it is a 1k deductible.

Emergency room visits are a $100 co-pay.

Is this a good plan or a rip off? Would it make more sense to switch?

Re: Best health insurance?

I'm pretty happy with Cigna but in the end it's not so much the insurance.

The company contracts what it will & will not cover & how much it will pay.

Re: Best health insurance?

you pay 12k a year and that is your coverage?

I would definitely comparison shop. look at what your dh's company has to offer as well.

Re: Best health insurance?

I have been happy with most of the insurance companies I have had.

BCBS
Oxford
United Healthcare

And I'm sure I had soemone else along the way.

I can't blame the co-pay and deductibles on the actual carriers because that is all the company you work for. The changes in copays is usually a way for the company to keep the benefits and keep costs down.

Re: Best health insurance?

Re: Best health insurance?

Message edited 10/5/2011 2:34:43 PM.

Re: Best health insurance?

Again, depends on the plan...

I had Aetna when I was under my parents. They were good at the time.

I've had United which was AWESOME at the time.

Then I had Empire BCBS which was good on that plan.

Then I changed jobs and had Empire BCBS but our company plan was HORRIBLE.

Then our company changed to Aetna, and it was horrible. $50 copays! Ridiculous

Then I got married and changed to United, my husband's company. He works for a much bigger, public media company vs my small private company. So naturally his benefits are WAY better than mine. I don't have co-pays but I do get bills every time I go to the Dr so I guess it evens out.