Seattle Health Insurance for the newbie
October 14, 2007 8:05 PM Subscribe
I just started working with a company that gives me an option to pick different plans (value or choice) from three different providers. My options are United Health Care / Definity Health (which was preselected by our HR's computer system), Blue Cross Blue Shields, or CIGNA Health. Are their any Seattle Mefites who have had experience with one, two or all of them?
It appears that all of the providers offer the same level of money coverage, but I am trying to find who would be the best fit for me. I am a 25 year old male, non smoker, and I live on Capitol Hill in Seattle, WA. I have never been without coverage or insurance before, but my last job just had one provider, which was based out of Portland, so I had to use their partner network up here, which meant UW Medicine or US Health Works for any insured coverage.
I realize this may sound be like a dupe, but from prior searching I've found questions by self insured or uninsured searchs for doctors. I am trying to find a plan that will actually let me be able to visit doctors in the areas I work / live, and possibly even have parking!
It appears that all of the providers offer the same level of money coverage, but I am trying to find who would be the best fit for me. I am a 25 year old male, non smoker, and I live on Capitol Hill in Seattle, WA. I have never been without coverage or insurance before, but my last job just had one provider, which was based out of Portland, so I had to use their partner network up here, which meant UW Medicine or US Health Works for any insured coverage.
I realize this may sound be like a dupe, but from prior searching I've found questions by self insured or uninsured searchs for doctors. I am trying to find a plan that will actually let me be able to visit doctors in the areas I work / live, and possibly even have parking!
FWIW, I've had to sue the Maryland-based branch of Blue Cross Blue Shield in order to get it to pay a claim.
You might try the websites of the various insurers to find participating doctors in the areas you're interested.
posted by exogenous at 8:18 PM on October 14, 2007
You might try the websites of the various insurers to find participating doctors in the areas you're interested.
posted by exogenous at 8:18 PM on October 14, 2007
You really need to talk with someone who works for your company. Different companies purchase different plans from the vendors, so, for example, CIGNA may be a great choice for you but a terrible choice for someone from another company, even if you're both in the same area.
posted by LizardOfDoom at 8:20 PM on October 14, 2007
posted by LizardOfDoom at 8:20 PM on October 14, 2007
i don't live in seattle but i have had experience with united health care. run in the opposite direction, as fast as you can.
posted by brandz at 8:22 PM on October 14, 2007
posted by brandz at 8:22 PM on October 14, 2007
I have to stay with United Health Care, but luckily for me, my HR department takes care of working out their mistakes for me. It seems like they screw up every time we seek medical treatment.
posted by B(oYo)BIES at 8:26 PM on October 14, 2007
posted by B(oYo)BIES at 8:26 PM on October 14, 2007
United Heath doesn't exactly have a sound rep.
But. Wtf? Seattle company and no Group Health Cooperative?
posted by mmdei at 1:10 AM on October 15, 2007
But. Wtf? Seattle company and no Group Health Cooperative?
posted by mmdei at 1:10 AM on October 15, 2007
I used to work for Definity. My friend used to work for them and had their insurance. Her deductible was huge. RUN AWAY.
As for BCBS: I've had BCBS of Western NY for over 10 years now through my mom, and they've never given us any real problems. The only problem I had with them was when I started attending an out-of-state school and they decided to just tell me they were canceling my coverage rather than ask "hey, btw, are you still in school full-time?" They'd never done this before when I was attending an in-state school, so I wasn't happy. A quick fax fixed it within a few days.
posted by Verdandi at 2:24 AM on October 15, 2007
As for BCBS: I've had BCBS of Western NY for over 10 years now through my mom, and they've never given us any real problems. The only problem I had with them was when I started attending an out-of-state school and they decided to just tell me they were canceling my coverage rather than ask "hey, btw, are you still in school full-time?" They'd never done this before when I was attending an in-state school, so I wasn't happy. A quick fax fixed it within a few days.
posted by Verdandi at 2:24 AM on October 15, 2007
They are all going to suck, really.
I've only had experience with Cigna, and they bascially have denied every claim that has been submitted. I've had to call and call just to get things though.
posted by corpse at 4:17 AM on October 15, 2007
I've only had experience with Cigna, and they bascially have denied every claim that has been submitted. I've had to call and call just to get things though.
posted by corpse at 4:17 AM on October 15, 2007
Second corpse--they all suck, and there's not a lot you can do about it. I have BC/BS (in Maine, but it's the same band of thieves at the top) and they are tighter than a motherfucker when it comes to paying. I think it's almost a standing order to automatically deny all claims over a certain dollar amount. YMMV.
posted by Civil_Disobedient at 5:39 AM on October 15, 2007
posted by Civil_Disobedient at 5:39 AM on October 15, 2007
Stay away from United - I'm in Seattle and stuck with United until next year, and they don't cover all doctors. And one of my doctors told me that United makes it difficult for small practicitoners to join theire network. Swedish Hospital, the largest hospital in Seattle, terminated their relationship with United this summer in the middle of negotiations and sent out letters to all patients informing them that they wouldn't accept United after the end of September. They're back in negotiation, and the termination date has been extended to sometime in November.
posted by slowstarter at 8:03 AM on October 15, 2007
posted by slowstarter at 8:03 AM on October 15, 2007
Best answer: Just a note--Blue Cross / Blue Shield is not a single company. It's a federation of independent health plans across the country that franchise the name and symbol. So someone's terrible experience with BCBS in any other state is usually completely irrelevant, because they're totally different companies. In fact, there are two BCBS companies operating in Washington--are you looking at Premera or at Regence/Asuris?
Also, you might want to check out the aggregate complaints for each company at the Washington Department of Insurance webpage. While personal anecdotes can be helpful, I'd really make sure to weigh that against more systemic data. Almost any insurance company (or airline, or car company, etc.) is sure to have had at least one situation where they royally screwed someone. Your goal should be finding a quality company--one that covers the procedures you're most likely to need* with the doctors you prefer to see--that also has the lowest number of those "royally screwed someone over" cases.
Note that in the linked table, companies with no complaints don't show up. Since it doesn't look like United or Cigna is there, while Regence Blue Cross / Blue Shield is and has about three times the average number of complaints of every other health insurance company in the state, you might want to cross them off. (Of course, assuming that the "Blue Cross Blue Shield" you're considering is Regence BCBS.)
*I know you said they have a similar level of money coverage, but I'm not sure whether you simply mean they have similar copays and cost sharing--have you looked at what actual procedures are covered or not covered for each? For example, if you're a woman in your thirties, does your insurance cover childbirth, abortions, and offer low copays on hormonal birth control? If you're a man in his fifties, how much of the cost of a routine colonoscopy does the company cover, and how often can you get one? If you have a family history of melanoma, does your insurance cover yearly check-ups with a dermatologist?
If they all have similar procedures that are covered, check if they all have the same lifetime limit. God forbid you should get a chronic or serious illness, or get hit by a car, but a million dollars ain't what it used to be. Any company that offers "unlimited" lifetime coverage or a very, very high lifetime limit is the one that's a better plan, all other things being equal.
posted by iminurmefi at 8:48 AM on October 15, 2007
Also, you might want to check out the aggregate complaints for each company at the Washington Department of Insurance webpage. While personal anecdotes can be helpful, I'd really make sure to weigh that against more systemic data. Almost any insurance company (or airline, or car company, etc.) is sure to have had at least one situation where they royally screwed someone. Your goal should be finding a quality company--one that covers the procedures you're most likely to need* with the doctors you prefer to see--that also has the lowest number of those "royally screwed someone over" cases.
Note that in the linked table, companies with no complaints don't show up. Since it doesn't look like United or Cigna is there, while Regence Blue Cross / Blue Shield is and has about three times the average number of complaints of every other health insurance company in the state, you might want to cross them off. (Of course, assuming that the "Blue Cross Blue Shield" you're considering is Regence BCBS.)
*I know you said they have a similar level of money coverage, but I'm not sure whether you simply mean they have similar copays and cost sharing--have you looked at what actual procedures are covered or not covered for each? For example, if you're a woman in your thirties, does your insurance cover childbirth, abortions, and offer low copays on hormonal birth control? If you're a man in his fifties, how much of the cost of a routine colonoscopy does the company cover, and how often can you get one? If you have a family history of melanoma, does your insurance cover yearly check-ups with a dermatologist?
If they all have similar procedures that are covered, check if they all have the same lifetime limit. God forbid you should get a chronic or serious illness, or get hit by a car, but a million dollars ain't what it used to be. Any company that offers "unlimited" lifetime coverage or a very, very high lifetime limit is the one that's a better plan, all other things being equal.
posted by iminurmefi at 8:48 AM on October 15, 2007
I am not in Seattle, but as a health care provider, my advice, like those of other responders here is, avoid United Health Care at all costs. Providers do not like United (because they are very slow to pay or find a way not to pay, and take up hours of our time to track our claims). Therefore your better providers, especially sole providers, private practioners) often drop out of the United Panel or never get on it in the first place.
posted by Lylo at 9:10 AM on October 15, 2007
posted by Lylo at 9:10 AM on October 15, 2007
Best answer: Just chiming with one more thought. On thinking about this for a couple of minutes, I'm a bit surprised that all three plans your company offers are the same level of coverage. Typically, companies that offer group health insurance to their employees offer different "levels" of plan--for example, an HMO (cheaper premiums + lower copays + less choice of providers) and a PPO (more expensive premiums + higher copays + possible deductible + more choice of providers). Googling Definity Health plan, it looks like that is an Consumer-Directed Health Plan--which typically have *really* high deductibles (the whole idea being that by shifting financial risk from the insurance company to the insured person, the person will become more conscious of their spending and keep costs down). The Washington Post ran an article about CDHPs here that you might find enlightening.
So, I'd really really recommend going first to your HR department and asking for a meeting with the benefits coordinator. Ask that person to sit down and explain the difference between each of the plans to you. (I can't imagine why they would offer three plans if they all provided identical coverage, so I'm sure there is some difference.) If the three plans do offer different types of coverage, you should probably be more concerned with selecting the type of coverage that is appropriate for you, rather than the company itself. In general, plans that are cheaper up-front (in terms of monthly premiums) either shift more risk to you--that is, you'll end up paying out the nose if you fall ill--or they restrict your provider choice in some way. Plans that are more expensive up front shift less risk to you, which means that you might end up paying more overall if you don't get sick, but you face less uncertainty about how much you will pay overall.
If I were a betting man, I'd guess that the reason that Definity was "preselected" in your employer's system is that it likely has the lowest premiums. (It also probably provides the least coverage in the event that you fall ill or become injured.) That doesn't mean it's the best plan for you; it means that the company wants you to make the decision about whether it's worth paying more money in monthly premiums to upgrade the amount and type of coverage you're getting. Once again, your HR person that deals with the health plans can probably help walk you through the advantages and disadvantages of each plan.
posted by iminurmefi at 9:50 AM on October 15, 2007
So, I'd really really recommend going first to your HR department and asking for a meeting with the benefits coordinator. Ask that person to sit down and explain the difference between each of the plans to you. (I can't imagine why they would offer three plans if they all provided identical coverage, so I'm sure there is some difference.) If the three plans do offer different types of coverage, you should probably be more concerned with selecting the type of coverage that is appropriate for you, rather than the company itself. In general, plans that are cheaper up-front (in terms of monthly premiums) either shift more risk to you--that is, you'll end up paying out the nose if you fall ill--or they restrict your provider choice in some way. Plans that are more expensive up front shift less risk to you, which means that you might end up paying more overall if you don't get sick, but you face less uncertainty about how much you will pay overall.
If I were a betting man, I'd guess that the reason that Definity was "preselected" in your employer's system is that it likely has the lowest premiums. (It also probably provides the least coverage in the event that you fall ill or become injured.) That doesn't mean it's the best plan for you; it means that the company wants you to make the decision about whether it's worth paying more money in monthly premiums to upgrade the amount and type of coverage you're getting. Once again, your HR person that deals with the health plans can probably help walk you through the advantages and disadvantages of each plan.
posted by iminurmefi at 9:50 AM on October 15, 2007
...Blue Cross / Blue Shield is not a single company. It's a federation of independent health plans across the country that franchise the name and symbol.
Interesting, I didn't know that. One less vote against, then.
posted by Civil_Disobedient at 4:20 PM on October 15, 2007
Interesting, I didn't know that. One less vote against, then.
posted by Civil_Disobedient at 4:20 PM on October 15, 2007
Response by poster: Wow, thanks for all the input. I now have a starting point to go ahead with. I just got the packet in the mail yesterday, so I was overwhelmed by all the options.
From what I can gather, each company is offering the same coverage for the dollar, they just give you a choice to pick who to get it from (or to pay extra for more coverage). I am working for a small division of a very large (50K+ employees) company, so I assume they are doing this because they are all over the place and can't find one company that covers all regions.
posted by mrzarquon at 8:23 PM on October 15, 2007
From what I can gather, each company is offering the same coverage for the dollar, they just give you a choice to pick who to get it from (or to pay extra for more coverage). I am working for a small division of a very large (50K+ employees) company, so I assume they are doing this because they are all over the place and can't find one company that covers all regions.
posted by mrzarquon at 8:23 PM on October 15, 2007
Response by poster: (also the company headquarters is in chicago)
posted by mrzarquon at 8:24 PM on October 15, 2007
posted by mrzarquon at 8:24 PM on October 15, 2007
This thread is closed to new comments.
posted by pupdog at 8:17 PM on October 14, 2007