Help choosing health insurance....

I need to make a decision ASAP on what health insurance plan to go with. My husband's job offers several options. We have narrowed it down to Vytra and Oxford Liberty. (On paper, the benefits look about the same) Anyone have any experiences (good or bad) with either of these insurance companies? TIA

Re: Help choosing health insurance....

honestly, i would choose oxford over vytra. both have their pros and cons, but vytra will try every way possible to get out of paying a claim before they actually pay it, and if you have any questions, you'll be on hold for 30-45 minutes on average. oxford is good with emergency rooms (sometimes a headache with inpatient stays), but i think they just have better business practices than Vytra

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i have oxford liberty and it is great. best thing is that some of my dentists and optomologists are covered as well as my GP and ob/gyn. i have never had any problems with them.

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If there is a choice between a HMO and a PPO - (don't know if they are both the same type of plan or not) I would take the PPO as you can go out of network if you need to see a dr - if you pick an HMO you will be forced to wait for you PCP to send you to someone and can't just go when and to whom you would like to. That would make a difference in what I picked.

Are the dr's you are currently seeing in one of the plans - something to consider as well.

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Oxford. Focuses more on well being and preventitive care. I have heard positive things about it.

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I have Vytra and I really can't say I've had a problem but they aren't the quickest in handling someething for you. If I were given another insurance over Vytra I would take it.

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Re: Help choosing health insurance....

Thanks everyone for your input! I have been avoiding HMO coverage for years, but it was just getting too expensive having a PPO (HealthNet PPO is costing me $100 A WEEK for me and DH, that's $5,200 a year!!!) I have heard pretty good things about Oxford, but wasn't very familiar with Vytra's reputation.

Thanks again for all your help!

(Gotta love the LIW/LIF girls!!! )

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I had vytra for a long time,. I never had a problem...Oxford is "bigger" so to speak. My mom and DH had Oxford and had problems..BUT I would still go for the Oxford..just stay on top of any bills you might get, explanation of benefits and ask questions if you see anything weird.

Re: Help choosing health insurance....

OK, I know this stuff!!!

Oxford is usually a higher copayment for office visits and prescriptions. Also, in the event that your or your hubby injure yourselves and require physical therapy, or chiropractic care, you are responsible for a "specialty physician" copayment (up to $50 ) EVERY SINGLE VISIT AND theraputic care is managed by a company called OrthoNet, not Oxford themselves. If you need chiropractic care, Physical Therapy, or Occupational Therapy, THEY (the nurse case managers and medical team at OrthoNet) get to determine how many visits out of your plan's 90 visits per condition per lifetime that you can actually use.

For example, my brother broke his arm and had surgery a few weeks ago. When it came time to begin rehab, his Surgeon prescribed Physical Therapy 3x a week for 6 weeks. The case manager at OrthoNet granted him a total of 8 VISITS., AND he was required to pay his $40 specialty physician copayment for every one of those 8 visits. I work in a physical therapy facility, and even I know that 8 visits isn't enough for a post-surgical patient to heal and strengthen to the best of his ability. Luckily, my brother was injured at school, so the school's insurance company acts as a secondary plan, and will cover all copayments and the extra visits he needs (This won't be the case for a non-student, UNLESS you have a 2ndary insurance.)

Vytra, on the other hand, has several different types of plans. Copayments are up to $15 now (less than MOST Oxfords), and benefits vary based on the plan. Vytra is also a local company (right in Melville). For Physical and Occupational therapy, most plans offer 24-27 visits per condition (injury.) However, there are some plans that offer a 2months PER condition PER lifetime, meaning if you have a chronic back injury, you can ONLY be treated for that pain for 2 months TOTAL for as long as you have that plan, unless there is surgery, or a specific re-injury (i.e. falling off a ladder, etc.).

I work with both companies every single day, and I would GLADLY take Vytra over the Oxford. I personally HAVE Oxford, and will be switching VERY VERY soon to another company. I've had nothing but trouble with Oxford (billing errors, lack of authorization/payment for some gyno testing, etc.)

I hope this makes sense! Please FM if you have some specific q's!

Re: Help choosing health insurance....

the 90 visits and some other thinsg that are part of Oxfords program depends on which policy the employer purchases.

DH had 90..my mom had 120.

All policies are based on which options the employer purchases. I work fror Empire BCBS so I can verify that.

A smaller employer will often purchase a policy that has a $40 co pay for example while a larger one will purchase one with a $20 co pay ( SAME POLISY all the way around) only because insurance companies can offer lower rates to larger companies with more employers.

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