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-   -   Have anybody used Healthcare.gov to get health care coverage? (http://forums.pelicanparts.com/off-topic-discussions/894207-have-anybody-used-healthcare-gov-get-health-care-coverage.html)

Dave Kost 12-08-2015 10:35 AM

Have anybody used Healthcare.gov to get health care coverage?
 
I checked around, on the heathcare.gov site, and found I can save a conciderable amount on my monthly premium, without any increase in copay/ coinsurance. It sounds too good to be true.

What pi__d me off, is my Current provider didn't offer this plan to me in the past few years!

Im 63 and have had a Heart Bypass.

I'm ready to make a switch.

Any thoughts? Advise?

Thanks,

Rich76_911s 12-08-2015 10:43 AM

I have had to go through the healthcare.gov site.

The provider has to provide you the same options as the healthcare.gov website at the same price. Regardless of where you get your insurance is has to cost the same to the consumer.

My experience with healthcare.gov is that it sucked donkey nuts. This year I tried www.stridehealth.com. Same plans, same price, but hopefully I have a middleman that can help me deal with the government and insurance companies. Because all the government does is blame the insurance company, and the insurance company blames the government while you the consumer sit and spin.

I'm SOO thankful that I get to deal with the government, IRS, and insurance companies all for one service. And it sure is convenient that none of the 3 communicate with eachother.

Tobra 12-08-2015 10:49 AM

By current provider, do you mean the people selling you the insurance or your physician?

There is an extremely good chance your doctor does not accept the .gov insurance, because it pays 70% of what a regular plan does. The list of doctors on the .gov insurance website is almost certainly wrong. You will need to call the doctors to see if they accept it.

Your copay may not change, but your deductible probably does.

Dave Kost 12-08-2015 10:51 AM

I have Blue Cross Blue Shield of PA. They won't sell me the lowest price plan at the same price that is shown on the gov web site?

Check out Highmark Connect Blue EPO 5500.

Dave Kost 12-08-2015 10:57 AM

Tobra-

Thanks for the response.

Both my doctors are approved under the plan- Connect Blue EPO 5500. When I checked the costs, you can fill in a question air that asks what doctor and medication you will be using. Both doctors are approved as well as the medications.


The cost is $389 month verses $740.00. Both BCBS plans.

Thoughts? Am I confused? Sound to good to be true?

Help

sammyg2 12-08-2015 11:02 AM

Quote:

Originally Posted by Dave Kost (Post 8909476)
I checked around, on the heathcare.gov site, and found I can save a conciderable amount on my monthly premium, without any increase in copay/ coinsurance. It sounds too good to be true.

What pi__d me off, is my Current provider didn't offer this plan to me in the past few years!

Im 63 and have had a Heart Bypass.

I'm ready to make a switch.

Any thoughts? Advise?

Thanks,

Other people are being forced to pay part of your premiums for you.

you're welcome.

Dave Kost 12-08-2015 12:05 PM

any other expert?

charlesbahn 12-08-2015 12:15 PM

A lot of the "too good to be true" is hidden in the (much) higher deductibles.

BCBS patients used to come in and their eye exams were paid for. Now, almost none are since their .gov insurance plan deductibles are so much higher. We spend a lot of time explaining this since most don't understand why they didn't have to pay with the old Blue Cross but do with the new BC for the same exam.

Charles

Dave Kost 12-08-2015 01:15 PM

Thanks Charles.

I just got of the phone with a Gov Healthcare consultant.

THERE ARE PLANS AVAILABLE ON THE GOV SITE THAT YOUR HEALTH INSURANCE COMPANY CANT OR WONT OFFER YOU, IF YOU CALL THEM DIRECTLY. AND OF COURE, THE PLANS COST'S ARE HIGHER THAT WHAT IS AVAILABLE ON THE GOVERNMENT HEALTHCARE SITE.

I am going to save ~$ 300.00 month plus have a lower deductible. I ended up choosing a Silver plan not a Bronze Plan. The caveat is I was on the phone for 1 1/2 hours along with a BCBS representative and a gov consultant. I could of done it on line but didn't want my application to get misplaced. I still pay BCBS monthly for my premiums.

Bottom line is, get a quote from healthcare.gov….. you have until Dec. 15th.

red-beard 12-08-2015 01:17 PM

I checked the plans on BCBSTX. The Bronze plans which can use a HSA went up 26% (PPO) and 33% (HMO).

targa911S 12-08-2015 01:26 PM

Quote:

Originally Posted by Dave Kost (Post 8909504)
I have Blue Cross Blue Shield of PA. They won't sell me the lowest price plan at the same price that is shown on the gov web site?

Check out Highmark Connect Blue EPO 5500.

I was subscribed to UPMC health care. I had no problems with them. This year I get medicare so I only had to use them for 1 year. The difference between going direct with UPMC and healthcare.gov was $400 a year and they wanted a lot of paperwork. I was paying $485 a month going direct.

sammyg2 12-08-2015 01:29 PM

http://forums.pelicanparts.com/uploa...1449613726.jpg

Rodsrsr 12-08-2015 01:30 PM

Quote:

Originally Posted by sammyg2 (Post 8909515)
Other people are being forced to pay part of your premiums for you.

you're welcome.


THIS ^^^^^^


Many people wont qualify due to income.

Dave Kost 12-08-2015 01:43 PM

Targa 911s- UPMC wasn't an option for me because I will spend about 5-6 months in Florida. UPMC does not offer coverage in Florida, so I needed to stay with a national carrier.

targa911S 12-08-2015 01:52 PM

gotcha...

Tobra 12-08-2015 01:53 PM

Quote:

Originally Posted by Dave Kost (Post 8909511)
Both my doctors are approved under the plan- Connect Blue EPO 5500. When I checked the costs, you can fill in a question air that asks what doctor and medication you will be using. Both doctors are approved as well as the medications.

Did you ask the doctors directly or trust what the website/guy selling it was telling you?

It is quite likely that there is a Connect Blue EPO 5500 and a Silver Connect Blue EPO 5500. I don't know about PA, but in CA they listed all the BC/BS providers as contracted with the exchange plans, when about 80% of them were not. I don't want to say that the PA exchange is perpetrating that sort of fraud on the people of that great state, but that is exactly what the CA exchange did. The majority of the doctors opted out due to the 30% discount on reimbursement they were forced to accept. The doctors that did not opt out, did not find out about it until too late.

Bottom line is, if it sounds too good to be true, it probably is.

Dave Kost 12-08-2015 02:30 PM

Tobra-

The health care market in Western Pa. is confusing at best. BCBS and UPMC-University of Pittsburgh Medical Center have been at war for a few years now. Suing each other (BCBS now owns hospitals and UPMC in now an insurance carrier) Because of this, our State Supreme Court had a decent decree, that if you have an existing condition, your current healthcare doctors HAVE to keep you a a patience.

I did check on the gov site and my doctors will accept the BCBS coverage I selected. I end up choosing Connect Blue EPO 750.

Thanks for the tip for checking with the doctors.

What pi__ed me off was when I went to BCBS for their recommendation last year, they never mentioned the gov plans. My bad for not checking.

onewhippedpuppy 12-08-2015 03:28 PM

Quote:

Originally Posted by sammyg2 (Post 8909515)
Other people are being forced to pay part of your premiums for you.

you're welcome.

Yup. I was self employed last year and had healthcare through the website as decreed by our supreme leader. Prices were more than double what they were prior to Obamacare when I had considered self employment and quoted insurance. At renewal time, they were slated to go up by another 30%. Fortunately I ended up working for someone else to avoid having to be personally raped. What an effing racket.

motion 12-08-2015 03:32 PM

Quote:

Originally Posted by onewhippedpuppy (Post 8909887)
Yup. I was self employed last year and had healthcare through the website as decreed by our supreme leader. Prices were more than double what they were prior to Obamacare when I had considered self employment and quoted insurance. At renewal time, they were slated to go up by another 30%. Fortunately I ended up working for someone else to avoid having to be personally raped. What an effing racket.

This was pretty much my experience. I had health insurance a few years ago, but it was dropped because evidently, it wasn't sufficient. Every time I log onto that government site and get a rate, the premiums are ridiculous. I did some digging around and found that 30% annual rate hikes are the norm. No way in hell I'm going to contribute to that mess, and fund other people's free insurance. I'll just pay the penalty each year ($1,500) and self-insure.

Tobra 12-08-2015 07:48 PM

Self insured is okay if you are pretty healthy, but that is not the case for Mr Kost
Quote:

Originally Posted by Dave Kost (Post 8909792)
Because of this, our State Supreme Court had a decent decree, that if you have an existing condition, your current healthcare doctors HAVE to keep you a a patience.

I don't think the Supreme Court can dictate something like that. Setting that aside, assuming that they could, they can't dictate that anyone provide a service for free. If your doctor does not accept your insurance, you pay out of pocket. If need surgery, and they are not on staff at a hospital that accepts your insurance, it could put you in a tight spot.

Don't be too down on BC/BS. The .gov policies are only available on the website. I am fairly certain the actual premiums are contingent upon what your income is.


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