Health costs/benefits & managed care

[Guest]

Just when ya think things are going to fall into place, you're thrown a curve ball....

Our company recently announced a change in health care "costing" for 2004. Instead of a simple co-pay (such as $20) for dr's visits, etc., the plan is going to be co-insurance, where we pay a percentage (say, 20%) of the cost of the visit or service provided as the "co-pay". Anyone else have this type of insurance set up? I guess I'm a bit concerned my health care costs will skyrocket with this....

Also, the company is offering a partnership (at no cost) with ActiveHealth Management, a company that helps individuals with chronic conditions better manage their health. Apparently, we'll be partnered with a Nurse Care Manager who will act as a "personal health coach" to help us better understand our condition, our treatment options, ways to stay healthy, & ways to work with our doctors.... Not sure if this is a good thing or not. The brochure indicates that it will be confidential, etc., but I don't know.... Anyone else in this type of program? Any comments/thoughts are appreciated...

Awaiting my follow-up check-up next week....

Peace...always,
Cort S, pig's valve & pacemaker-enhanced 29/swm
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[ALCapshaw2]

Yeah, Right !

I'm as concerned as you are about managed care programs.
Hope you get some 'experienced' answers.

One thing you can count on,

ANY change initiated by your company is for THEIR benefit.

 

[LUVMyBirman]

Hi Cort,

In a corporate environment...the less they know about you the better.

Having worked in Human Resources myself. Witnessed....against all rules, sad but true, lower forms of discrimination in the workplace.

I have decided that information will not be divulged about my condition until point in time when insurance paperwork would be submitted. They will get the picture.I would never elaborate or discuss my treatment with anyone within the corporation. Nurse or no nurse. As Al pointed out, it's to their benefit.

Take it easy. See you soon.

 

[Ross]

I had that type of insurance when I was working. I found that it was only good for catastrophic circumstances, other then that it was pay, pay, pay. Your costs will be higher that's for sure.

The nurse thing is a big gimmick. I'd stay away from that one.

 

[Gisele]

Cort, I have 20% co-pay

Cort, I have 20% co-pay

I have BCBS from a city in MA. It is one of the older style plans that does cover a lot if you are sick, but there can be a lot of out of pocket expenses.

I have to pay 20% of BCBS allowed amount for doctors visits including ambulances and Rx (unless I use mail order-then it is $5.00 or $10.00). I just found out yesterday that my Med Flight trip to Boston on 8/1 was over $3,000.00 so my co-pay will be $600.00 plus $$$. Then when I went back to Boston on 8/8 that bill arrived yesterday and my share is $299.00! Over $1,000.00 just for two ambulance rides!

The good thing about my plan is that it won't cost me a dime for inpatient services, and I don't need a second opinion, nor do I ever need a referral. I can go see any doctor anytime.

It has its' pros and cons. When I had my heart surgery 20 years ago it didn't cost me a dime. We will see this time around if it will cost me anything. I'll let you know after my surgery..........Good luck with your plan!

Gisele

 

[nadi]

I also have BCBS HMO and we pay set co=pays for drs visits, rx.s and E.R. visits. We then have a co-insurance with a 1000. max out of pocket. The only problem I have had so far is they lose :a Lot!!" of the referals and pay it out of network.
Other than that no complaint with mine.

 

[Guest]

Al/Gina/Ross...yeah, I know...the more the company knows the better for them and the worse for me. But, heh...they already know a lot about me b/c of the dang surgery earlier this year...LOL...irony rocks . I think I'm a not gonna be callin' 'em .

Ross...yeah, I'm dreading the extra costs... will be worth it for the doctors I have, but geez...I wanna be able to LIVE .

Gisele/Nadi...thanks . I think the best thing to do is just keep shoppin' around. I think it's kinda obvious that not all health plans are the same...and that even between areas/states in the good 'ol USA coverages, etc., can be drastically different...aye.

 

[Zipper]

As health care costs continue to rise, so will companies policies and we, the individual, will continue to pay more. sigh!

Since I went off work on workmans comp over a year ago, I had to take COBRA to keep my Blue Shield PPO at the rate of $564.00 per month. It is worth it since my scrips total approx $420.00 a month...BUT...I'm really wondering what choices will be in open enrollment this year. My hospital (where I worked) seeks new contracts each year to minimize their costs, as I'm sure many business do. I only hope I can keep the coverage I have, but they (the hospital) could (might) drop Blue Shield if they can get a better deal (with less coverage) elsewhere!

It's the pits..this insurance game..I tell ya!!!!

Zipper