Insurance

ldawngirl · October 2013

I saw a lot of you doing a WTF Wednesday about insurance - I'm in insurance (or was until yesterday!), so if anyone has questions, feel free to ask!

ky29 · October 2013

You must be one smart lady.

I'm not sure if you can help me.. but here is my question.

I'm on DH's insurance (it's a whole lot better than mine). This year it's with cigna & it's a PPO plan. It's changing to blue cross blue shield of texas (even though we are in Indiana?) for next year. There are two options. One is a PPO option (higher premium, lower dectible, slightly lower OOP max). The other is a CCP, consumer choice plan + HSA option.

When I look online here (just from googling) is shows that there's a HMO & PPO option. I need to know which one theirs is, because it doesn't break it down on the description he has. Either that, or I am just not reading into it correctly.

I ask this because, if it's an HMO, my PCP & obgyn are in different health networks. And, if I understand things correctly, on an HMO you can only go to doctors in your PCPs health network? Even though they may both cover bcbs. And I love my obgyn.. and since we are hoping to have a baby next year, this is very important to me.

If it turns out to be an HMO, can I select my obgyn as my primary care doctor? I rarely see my PCP anyway, but I do like him!

I've tried to call the 'general questions' line through his work (twice).. and all they do is read me the paper I have and it does me no good. I also tried to call the bcbs health line questions, and while she understood my question, she had no idea what the CCP was, and said that must be an option specifically for his company.

Is what I'm trying to ask making sense?

Yikes, that was really long and not just one question, ha.

BTW, the ppo plan will cost us $1300 more in premiums for the year, and the max OOP is only $300 less. So we are really leaning towards the CCP.

ldawngirl · October 2013

Wow! That is complicated! I can't help you with the HMO & PPO portion of things as that really all depends on the company. I know some HMOs that will allow you to go outside the network but others are a lot more strict. Does his company have a specific insurance staff member? Often times you can ask for the employee responsible for health insurance and they are more in the know than the general question people. It may be easier for your DH to inquire as to who that is around the office though.

For the PPO vs. CCP, I would recommend CCP for reasons you've already stated. Plus the HSA option with CCP is nice!

Sorry I wasn't more helpful! That is definitely a tough one!

ky29 · October 2013

Yeah, I have the email address to his HR person. I'll probably end up sending him an email. DH told me to try that last, because he's new and doesn't seem to know a lot about what's going on. But, no one else seems to either, ha.

DH is a plumber, and usually not in the office during normal office hours since he's usually out on a job. So it's hard for him to go in and talk to him. Plus, I don't think he really understand either, haha. But, he understands that it's important to me that I stick with that doctor.

Thanks for your help!

Insurance

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