Ask MetaFilter questions tagged with insurance and healthinsurance

Should I get these tests done now, and will insurance cover treatment in the future?

Anonymous — Wed, 02 Dec 2009 11:01:50 -0800

A complicated question about a specific medical condition, insurance, and pre-existing conditions. Hello,
I'll try to explain this clearly- apologies if it's a bit long, the background is necessary!
I live in New York. Three months ago I switched jobs, and the new job told me I had to wait three months for my insurance to kick in. I did not elect to take COBRA or any interim insurance because I recently had surgery and that knocked my premiums up past what I could afford.

About three weeks after starting the new job I got the results back from a pap smear and they said they'd found HPV of the "dangerous, may possibly cause cancer" variety, and that I had to go in for a colposcopy. I explained that I was waiting for my insurance to kick in and they said it should be ok to wait the two months till this happened.
So last week I got laid off. Now there isn't going to be any insurance till I don't know when.

Planned Parenthood will do the colposcopy on a sliding scale that I can just about afford, but my concern is: if I get this test while I have no insurance, and god forbid it turns out I have cervical cancer or pre-cancer that needs to be treated... when I get a job and get insurance, will this then count as a pre-existing condition and not be covered?

I'm really worried about this. The strange thing is that I already have a condition- ulcerative colitis- but whenever I've started a new job, the employer's insurance has covered it with no problem. So that's a pre-existing condition, right? But everyone is saying that this will be different and that I absolutely should wait to get the colposcopy till I already have insurance.

So, two questions. Is there, for some reason, a difference between things like ulcerative colitis and (knock wood) cervical cancer, that would mean that the former is covered while the latter is not? Is it true that if I test positive my new insurance wouldn't cover treatment?

Second question- I know you are not my doctor, but would it be all right to wait until I do get insurance to get tested? It's already been almost three months now and I'm getting really nervous, thinking that something awful and dangerous might be growing inside me and I just have to wait. I know that the earlier you catch these things, the better, but I also know that if it IS pre-cancer, this kind tends to move slowly- is it all right to wait a bit longer?

Thanks...I'm sorry if this is a bit disjointed but the whole subject makes me incredibly stressed out and nervous and I feel a bit helpless in this situation. I want to do what's best for my health without putting myself into years of debt.

Thanks in advance to all of you....

Help a Canadian travel with peace of mind!

exquisite_deluxe — Sun, 01 Nov 2009 23:29:19 -0800

I'm a Canadian abroad with expired health insurance. What options do I have for a new policy? I need private health insurance for a 6 week trip to India, departing from New Zealand. I've been out of Quebec, Canada since October 2008, and I'm returning in December 2009. My private health insurance (bought through Travel Cuts) has expired, and they will not sell me a new plan without being in Canada.

I was then going to book through World Nomads, which does allow policy purchases after leaving Canada. However, they require Canadians to confirm that they are still covered under provincial health insurance. Since I have been out of Quebec for more than 183 days this year, and did not obtain a letter of extension before departure from Canada, apparantly I am no longer covered. So I can't get the World Nomads insurance.

All the policies I have looked at require booking before the trip, or being out of Canada for less than six months. I have seen this question asking about good travel insurance in Quebec, but it doesn't seem to address what to do without having a valid extension from Quebec health.

Help!! Do I have any options?? My main concern is having coverage for major medical emergencies.

Thanks in advance!

Should I care that my UCSF doctor is joining Hill Physicans?

otherwordlyglow — Thu, 01 Oct 2009 13:09:34 -0800

All of UC-San Francisco's physicians will shortly end their affiliation with Brown & Toland and become members of Hill Physicians Group. What will this mean for patients? I have been bombarded with news that my primary care doctor, along with all of UCSF's doctors, will, as of 1/1/10, be switching affiliations to become a member of the Hill Physicians Group. Apart from having to switch my health insurance from Healthnet/B&T to Healthnet/HPG during Open Enrollment if I want to continue to see UCSF doctors is there some reason I should care? I guess Hill is part of the Catholic Healthcare West network. Is that significant? Does this switch have any benefits to the consumer or is it just some procedural paperwork that should be somewhat transparent from a user standpoint?

Health insurance only for execs' kids?

ethorson — Fri, 14 Aug 2009 06:56:16 -0800

Can a company provide health insurance for an executive's dependents (spouse, kids, etc) but not for other employees' dependents? Is it legal for a company to provide health insurance for some of its employees' dependents but not for others? For instance, can the plan specify that it covers the CEO's spouse and kids but not a web developer's or project manager's kids? (given that all three employees are eligible for insurance, etc). There was a bit of discussion of this issue in this thread, but I'd like to hear (a) whether anyone has actually experienced a policy like this and (b) what, if any, regulations (HIPAA, ERISA, etc) might prohibit it.

I'm asking for a friend who is located in Virginia and works at a company with fewer than 10 employees. This is *not* the insurance plan currently implemented at their company, but a proposed change to the existing plan.

Travel insurance reccomendations for an unusual trip!

mateuslee — Thu, 23 Jul 2009 05:01:18 -0800

Any travel insurance recommendation for an unusual trip to Peru? I am an dual-citizen American/European living in the Netherlands and so I have Dutch health insurance, however, if I am abroad for more than 3 months my insurance plan is void.

In a couple of weeks I will fly to rural Peru to conduct fieldwork in some rather unpleasant conditions: high in the Andes, and also in the jungle.

I know a few people have asked about travel insurance before, but I'm looking for something more heavy-duty (mainly wrt health) should I need serious treatment.

Does anyone have any recommendation?

Thanks a lot!

What are my options for insurance?

suncoursing — Wed, 15 Jul 2009 15:39:18 -0800

What are my options for insurance? I'm starting grad school this fall in Texas, after a few years at a startup. If I were an RA or a TA, I'd automatically be enrolled in the staff insurance plan, but I'm not eligible for that because I'm on a fellowship. I can keep my current insurance through COBRA but, at $600/month, it's a bit expensive. The plan is really nice (no co-pay for a lot of things, $200 annual deductible and maximum out of pocket, no maximum benefit for health or perscriptions, etc.), but it's way beyond anything I need.

The student insurance plan is ~ $160/month, but it has a maximum benefit of $100k. I could handle a plan with a $100k deductible, but $100k maximum benefit means it would only cover relatively minor problems that I could afford without insurance, leaving me with most of the bill for anything catastrophic. Maybe there's something I don't understand about insurance, but this plan seems completely pointless. There's an option to increase the maximum benefit to $500k for an extra fee, but that's still an order of magnitude lower than the maximum benefit for the BCBS plans I've looked at.

BlueCross BlueShield of Texas has various plans ranging from $40/month to $200/month. The $160/month plans look much better than the student insurance plan, and if I'm willing to take a $10k deductible, I can get away with only paying $40/month. If I don't have a pre-existing condition, is there any reason I should prefer group coverage to individual insurance? Are there other insurance providers I should be looking at? I found this list (http://www.tdi.state.tx.us/health/lhiah_lst_incl.html) through a previous post, but since I know absolutely nothing about any of these companies, I might as well go with BCBS if I'm just going to randomly pick a company off that list.

So my options are (roughly in order of preference):
1. BCBS insurance. Only $40/month!
2. Defer my fellowship for a semester, get an RA or a TA, and then pay $300/month to get the staff insurance through COBRA.
3. COBRA. $600/month.
4. ???. Is there something I could do that I don't know about?
5. No insurance
6. Student insurance.

Other than the large deductable, is there any reason I wouldn't want option 1?

Also, do I actually need dental insurance? It seems like insurance only ever covers half the cost anyway, and I doubt anything really horrific will happen if I skip getting a cleaning for a year.

Help me pay 12 months of premiums for 3 months of coverage

Nothing — Tue, 24 Mar 2009 08:11:27 -0800

I live overseas for 10 months a year. I am finding it very difficult to get health insurance. No preexisting conditions, no smoking, not obese, but I am only barely a resident of California, and this seems to be a tripping point. All I want is a basic, high deductible plan for emergencies. I am currently covered in Virginia (from a while back, never told them I moved), but since my residency is California now, they probably won't cover me. What are my options? I just spent 4 hours on applications and was turned down every time. Everything else I see on google looks dodgy.

Paying for cancer

Anonymous — Mon, 16 Mar 2009 12:25:47 -0800

I may have breast cancer. I do not have health insurance. What now? I am in my late thirties and the sole support of two teenagers. We live in California, and our closest family is in Florida. I am a long-term contractor at my current job, but no longer think they are going to hire me on, and so I have started looking for permanent work elsewhere. I don't have health insurance, and open enrollment has passed on my agency's health plan.

A hereditary breast/ovarian cancer risk factor, a BRCA1 deletion mutation, runs in my family. According to the literature, women with this particular mutation have an 80% chance of developing breast or ovarian cancer. My sister, my mother, my mother's sister, my grandmother's sister, and my grandmother's sister's daughter have have had breast or ovarian cancer. My mother, my mother's sister, and my grandmother's sister died from it. My sister was diagnosed stage 1/2 borderline, and had chemo and a bilateral mastectomy less than a year ago.

Well, yesterday I felt a lump in my breast. It was about the size of my fingertip to the first knuckle.

It could be nothing, but it could be cancer. If it were cancer, the treatment would probably be very aggressive -- meaning I may not be able to work.

If I got a diagnosis before securing insurance -- would that be a 'pre-existing condition' the company would not like to pay for?
And how do I get health insurance? Is 'Emergency Medi-Cal' or medicare an option?
If I had to go out on disability, I could not pay my rent. What if I moved to Florida to live with my dad -- how would that affect my state insurance and/or disability benefits? Would I apply here, then go there? Go there, then apply?

I don't mean to be hysterical. I know that it could very well be nothing at all. But it does seem like the timing of the diagnosis wrt insurance could be important, so I need to be smart about this. Hope for the best and plan for the worst, as they say.

Thanks for any advice you can give me.

Short-Term Health Insurance

thewestinggame — Fri, 20 Feb 2009 19:17:17 -0800

Looking for health insurance. I'm off my parents' plan in a few months and confused/overwhelmed. I'm 21 years old, female, and about to be a recent college graduate whose state of residence is NY. I have no major health problems/pre-existing conditions, don't smoke, and am in reasonably good physical condition. I get insurance now through my dad's job (coverage through BCBS, if that matters) but that expires after graduation and there is no grace period afterward. I also can't get coverage post-graduation through my college.

I'm anticipating needing insurance for 3 or 4 months and I've read up on short-term coverage through the old mefi posts and google results but either the coverage suggested to others isn't available to NY residents or ER visits are limited to 1 per year (or is that typical?). I'm trying to find COBRA alternatives, too.

A couple last things- I need insurance with excellent out-of-network coverage as I will be crossing the USA at least three times in the 3-4 months. I'm new to looking for health insurance, but I think low ER copays are a primary consideration.

Where can I go to compare coverage? Do I have to pick insurance companies' websites and do my own comparison legwork or is there some kind of aggregation/clearinghouse service? Does anyone have suggestions or advice?

Thanks!

I just got $449 unexplainable dollars from my old health insurance company. Is it mine for keeps?

juliplease — Thu, 13 Nov 2008 18:32:40 -0800

I just got $449 unexplainable dollars from my old health insurance company. Is it mine for keeps? I recently became eligible for health insurance through my workplace, so I canceled the personal health insurance plan I'd been using. I didn't tell them that was why, though. I told them it was because I was frustrated with the inconsistent customer service I got when I needed a three part procedure. I had called ahead and was told they would cover all three parts, and then they only covered two, leaving me with a $200 bill.

When I called to get more info, I got three different reasons for why. I wrote a strongly worded letter and canceled the plan when my new insurance kicked in.

Tonight I received a check from the old company for $449. There's no letter, there's no mention of the check in my online profile, but the check has my name on it. Do I call them and deal with it, or just feel really proud of my strongly worded letter and start holiday shopping a little earlier?

Secondary Health Insurance better, what to do?

ewiley28 — Tue, 11 Nov 2008 12:23:11 -0800

How do primary and secondary health insurance policies work together? Will I get the advantages of the secondary even though I have the primary? I have a PPO plan from Blue Cross Blue Shield (BCBS) of Texas through my employer. My husband's employer has not provided health insurance in the past, but is offering a plan through BCBS of Massachusetts starting with the new year. The coverage under his plan is better with no deductible, $5 cheaper copays and substantially better hospital coverage. The cost to him to add just our son is the same as to add me and our son, so we are planning on enrolling both of us.

My question is, will I get the advantages of his plan over mine, or since the Texas plan is my primary, will I just get those terms? I'm thinking what should happen is I should get any feature of the secondary plan that is better than my primary.

Will this happen automatically? Or will I need to submit paperwork? Like to get the $5 back on office copays?

I don't think I can get out of my primary because it is paid for 100% by my employer and so I don't think I can waive it.

How do I even start to fill out these short-term health care applications?

Skwirl — Fri, 29 Aug 2008 19:37:42 -0800

How do I fill out an application for short-term health care if I barely even remember which doctors/clinics I've been seen at, let alone why? So, now that I'm all unemployed and without healthcare, it seems like a good idea to sign up for a short term or catastrophic plan. Michael Moore's Sicko has me all freaked out that if I don't disclose every last hangnail, the insurance won't even matter in a pinch because they'll go all Private Investigator on me and drop me for some minor misrememberence.

So, I probably need to collect all of these disparate records into one place. Google Health seems to be ready to serve this function, but it seems like a Bad (!) Idea (!) to put that kind of stuff up on the web behind a wimpy password when it has no good reason to be there. Is there another service where they'll go from a list of clinics you've been at, then have you sign some release forms and send you the stuff without doing your own legwork? Is this what health care brokers do? Are health care brokers a good idea or a rip off?

Usefulness of short-term health insurance

samthemander — Tue, 12 Aug 2008 01:17:54 -0800

[New Grad Filter] Is it worth it to pay for one month of interim health insurance? I'm a 22-year-old healthy female in California transitioning from student health insurance to the plan provided by my First Real Job.

As such, I will be without medical insurance for 15 days. Neither the school's insurance plan nor the job's is flexible as to start/end dates.

I've looked around and read many previous askmefi posts about short-term health insurance and seen Assurant in particular cited as a less-than-useful investment. (The company avoids paying claims, etc.) Are all short-term policies this shady?

Do you have any direct experience with purchasing a short-term health insurance policy?

And, because I'm super-clueless, do you even think it's worth it? (Minimal coverage runs around $90/month.) I'm young and healthy, so maybe it's a waste of money to pay for 15 days of coverage. However, I will be moving during the 15 days, which does increase the likelihood of incurring some kind of an injury.

Thanks!

Individual vs. Group Health Insurance: Moral & Financial Dilemma

mygothlaundry — Thu, 17 Jul 2008 08:43:48 -0800

Moral, Economic & Logistical Health Insurance Question: Can/Should I switch myself and my son to a private health insurance plan from my (bad, expensive) group one even though that will result in my whole company losing their coverage? It's time for health insurance renewals at my small (REALLY small: 4 employees) nonprofit in North Carolina. For the last two years I've been covered under their plan, which costs me about $200 a month and does not cover my 16 year old perfectly healthy son at all. They quoted me an additional $345 per month to cover him and I couldn't afford it; so for the last two years he's just gone without insurance. Obviously, this has to change and, since my insurance will now cost $250 a month and I absolutely do not have an extra $50 per month, this is the time to change it.

I've been researching individual plans and have found a couple that are really close to $200 and will cover us both. Granted, they are high deductible but frankly, we're both pretty healthy and I'd rather have us both covered than only one. So it would seem like a no-brainer to switch off the health insurance EXCEPT, and here is the clincher:

My work's insurance company has told us that since we are so small, if any one employee opts for no coverage, they will drop the entire group. "IF that employee has other group coverage (spouse, government such as Medicaid or Medicare) they can opt out. Otherwise on a group your size it must be 100% participation of all eligible employees." is the exact quote from my email last week when I inquired about this.

That would mean that two of my coworkers, who have major health issues, would be completely screwed. That's what has kept me from doing this for the last two years. I don't want to consign them to death and I kind of feel like I would be doing just that. But I'm tired of feeling like I'm depriving my child in favor of my coworkers. I thought of getting an individual plan for my son in addition, but that's going to cost at least $100 per month, which means I would have to come up with an additional $150 more per month than I am right now. I work for a non-profit; I make a non-profit salary and honestly I really can't afford even what I'm already paying. There is no way I could come up with $150 extra. To maintain the status quo and add an extra $50 per month is going to be nearly impossible and it makes me sick to think of paying more when I can't even add my own child. This is making me bang my head against the wall. Help. What should I do?

Dad needs help paying the bills

Koko — Thu, 01 May 2008 06:22:21 -0800

Health insurance options for 65-year-old diabetic in Massachusetts? My father's health has been failing for some time; he's 65, a type 1 diabetic and is constantly in and out of hospitals and care homes. He is, of course, permanently disabled; unfortunately, so is his wife, so neither of them have insurance through work.

His wife, J, is working on various ways to get him insured; he recently lost his state disability ("Mass Health", I think my brother called it), and Medicaid says that they make too much money from Social Security to qualify. J has applied for AARP Supplemental, but says that unfortunately, none of the insurance companies pay beyond the 120 days that Medicare will allow (I'm not sure what that means). She's working with a social worker at his current nursing home to reapply for state health programs, as a long-term nursing home stay seems likely in his future.

Are there any other options, state, federal or private, that she should be looking into? I realize, considering his pre-existing condition and the fact that he lives in the US, the answer's probably a resounding NO, but I figured it couldn't hurt to ask. Any Mass. residents with similar situations found solutions? Thanks in advance!

Mental health services paid out-of-pocket: to tell or not to tell?

Anonymous — Tue, 26 Feb 2008 17:31:52 -0800

If I have paid for mental health services out-of-pocket, should I leave those things off of any history forms I fill out when applying for individual/private health insurance? Will the insurance companies find out? I've read the old threads on this...many people say to pay for mental health services out of pocket because otherwise you may be denied health insurance coverage later on. But does that mean I should lie on any forms I fill out when applying for coverage later on, pretending that any meds/shrink appointments that I paid for on my own just didn't happen? If so, how is it that insurance companies don't find out about those--can't they look at my medical records? Ehealthinsurance.com says "During the underwriting process, it may be necessary for the insurance company to review your medical records. " And if I get caught in my lie-by-omission, what happens? Wouldn't that be even worse? I feel like I must be missing something here.

This is in the US, naturally.

extra bonus question: if I should omit the mental health care...last year I began filling out an online application for insurance, filled in some of the mental health stuff, saved it, but never went back to finish the application. What's the chance that information has been saved or shared with other insurance companies?

Will my health insurance cost go up if I test positive for an STD?

Anonymous — Thu, 07 Feb 2008 21:04:25 -0800

Can your health insurance company raise your rates when you have a positive STD test? Does this typically happen? Long story short, I recently had the occasion to need an STD screening really fast, like by-the-end-of-the-day-please fast (basically I had another date with the um... relevant person and I wanted to be able to say something concrete about the situation instead of just general ickyness).

I anticipated that I'd end up at a planned parenthood or something, but it turned out that the only thing I could find near my work was an express testing service that sends you straight to a lab for all the screenings, no doctor consult or anything. When I asked the guy on the phone about whether they would take insurance, he went off unprovoked about how messed up health care is in this country, and I COULD tell my insurance, but they'd probably double my premiums if I tested positive because they would consider me high risk, and "it's not fair, but that's how it is."

Is this true? I have health insurance through work, and I never had an entrance physical or anything like that, I just got the standard rate for a person of my general demographic characteristics.

The whole ordeal just kind of smelled funny. The price for the lab work was pretty expensive, but not beyond my means, so I just paid for it. I'm OK with the idea that I got ripped off this time; I did need the service, it didn't break the bank, whatever. But I'm curious if they guy had a point or was just completely full of it.

Web searching reveals nothing helpful, at least using the search strings I could think of.

How is the health insurance stipend built into my hourly rate affecting my income tax?

Anonymous — Thu, 31 Jan 2008 14:09:05 -0800

My new company doesn't provide health insurance but a $2500 stipend is "built into" my hourly rate to cover the cost. I've got a plan that costs $175/month but how much does it suck for me that the stipend money is being taxed? I like the job and am happy to be insured. I just want to understand what it really costs me to handle my health care this way compared to the full benefits I got from previous employers, especially in regards to income tax. Can you help me think it through and do the math?

I'm a healthy, single, mid-twenties female living in DC and working in Virginia. I work full-time and am making $28/hour. (I'm anonymous because it's work-related. Throwaway e-mail account: insurancestipend@gmail.com)

Can a person taking a break from college get health insurance?

Braeog — Sat, 19 Jan 2008 15:41:47 -0800

Health insurance for someone taking a break from college? My girlfriend is taking a few months off from college and so won't be eligible for her parents' health insurance. She doesn't have a job that provides benefits, either. She's in her early 20s and is pretty healthy, but has really awful luck when it comes to random health issues popping up and so it would be a good idea for her to have insurance in the next few months. She's off her parents' policy in the next week or two. What can she do? Would COBRA apply in this case? What other temporary insurance providers are there?

COBRA vs. out-of-pocket group insurance?

ahimsa — Mon, 14 Jan 2008 16:40:36 -0800

I left my prior job in December and was hired by a temp agency. The agency offers an out-of-pocket health insurance plan. Does this mean I can't opt to continue my old coverage with COBRA instead? Does the fact that my temp agency offers a basic health insurance group plan, though they don't put any money toward it, mean that I am not eligible for COBRA?

The CORBA information my old company sent me says:
"Continued coverage will end for an electing individual on the occurance of any of the following:...
* The date on which the electing individual becomes covered under any other group health plan (as long as the new plan contains no restrictions on coverage for pre-existing conditions which affect the electing individual) after COBRA is elected;"

and
"Under COBRA, your right to continuation of coverage terminates if you become covered by another employer's group plan that does not limit or exclude coverage for your pre-existing conditions."

and on the form:
"Please answer the following questions:
Are you covered under another health plan? YES NO"

I'd prefer to opt for COBRA rather than the health insurance through my temp agency, because (1) I think the plan is better and (2) I think I'd have a gap in coverage because there was a week between the two jobs.

But does the availability of this out-of-pocket group insurance mean I'm no longer eligible for COBRA? Or do I need to buy a month's worth of COBRA coverage to close the gap and also get the new employer's oop insurance plan from then on?

Thanks in advance!!

Individual policy cheaper than group?

MrToad — Tue, 04 Dec 2007 05:59:31 -0800

Why is my wife's individual health insurance policy cheaper than being on my group policy? I work for a company of just under 100 people which puts us in the small business category with regards to health insurance. Per our insurance company, our organization is categorized as having a "normal" amount of claims. Last year, I looked at putting my wife on our plan and it would have cost me approximately $250 more per month to add her. We shopped around and were able to get her an individual policy with the same insurance provider with BETTER COVERAGE for $195/month.

While my wife is young (35) and healthy, it still does not make sense to me that she should be able to get a better and cheaper policy with the same provider (Anthem in VA) than she could get with my, albeit small, group.

We're looking at a 14% increase in rates for my company this coming year, so now I'm looking at getting my kids on her policy rather than carry them on mine.

I'm sure I'm just missing something, but could someone please enlighten me as to why she gets cheaper coverage than my group?

As always, thanks for any info you can provide.

Should I keep COBRA or try another health insurance provider if I'm moving to a new state and staying freelance?

waxpancake — Sat, 01 Dec 2007 16:28:55 -0800

I recently left my job at Yahoo! in Northern California and am relocating to Portland, Oregon to try my hand at self-employment. Extending my existing medical coverage with COBRA will cost me, my wife, and our three-year-old son $1200/month, which seems absolutely insane. Please help me understand the risks or consequences of waiving COBRA and getting new a new insurance plan. Continuing my Aetna PPO option through COBRA will cost me more than double every other quote listed on eHealthInsurance in Oregon for our family, even for those plans that appear to be comparable. (My existing plan has a $750 annual deductible, $2,750 maximum out-of-pocket, and $15 co-pay for office visits and preventive care with no deductible.)

What's so great about COBRA that it costs more than double everything else? Am I going to screwed with some sort of pre-existing condition nonsense by not continuing coverage from my previous employer? What are the risks by giving up COBRA? Plus, will I even be able to use COBRA if I'm moving from California to Oregon? (Aetna doesn't appear to offer individual coverage in Oregon, so is every doctor out-of-network?)

And finally, is there anything I should look out for when buying through eHealthInsurance? If anyone has specific recommendations for Oregon providers, that would be wonderful.

Insurance - for the kids, you know?

Wavelet — Thu, 15 Nov 2007 21:58:22 -0800

New baby, er, dependent child! How to insure? We just had our first baby. My husband and I have separate health insurance policies through our respective employers. How does insuring the child work? Do you pick one insurance policy, or should the child be listed on both policies? We both have PPO flavor health insurance, if that is relevant.

I have a choice, do I want an HMO?

Mozzie — Tue, 09 Oct 2007 14:20:15 -0800

I have a choice of going on my employer's insurance plan or staying on the insurance plan my husband's employer offers. My plan would be an HMO with low co-pays and great coverage (100%), but it's an HMO. Everything has to be approved in advance, etc. My husband's plan is an EPO, with slightly higher co-pays, and all that. The difference in monthly premiums is slight ($50). What to pick? I'm in good overall health with no chronic conditions, or prescriptions of any kind. My doctor and his group/hospital are in both networks. The only benefit I've ever used on a health plan, other than a few office visits, is mental health and that was many years ago. But for mental health, my husband's plan allows more visits. My gut feeling is that either one is good for now, but if I get a serious health issue I'll wish I didn't have the HMO and it's approvals.

Is my impression of HMO's correct? Does being in an EPO suck in a different way? On the HMO, everything is covered 100% so long as you get the referral, etc. That is pretty tempting...

Doctor, doctor...how do I choose?

BitterOldPunk — Fri, 27 Jul 2007 22:26:38 -0800

How do I choose a primary care physician? For the first time in a decade, I have good health insurance (I'm in the US), and at age 41 it's time to take advantage of it and have all that unpleasant probing done that I've been putting off for far too long. I've googled extensively, I've contacted my insurance carrier for a list of approved providers, and I live in a city with a world-class medical center. So I should be set, right? But just picking a name at random from the list doesn't seem like the best way to go about it. I know there are sites that purport to give doctor ratings, for a fee. Has anyone used them, and are they worth it? I want a doc for more than a check-up: I want to find a genuine health-care provider who'll be my doctor for the next thirty years. Is that even possible these days? How'd you pick your doctor, what questions did you ask them, and what were your criteria? (If it matters, I'm a lifelong heavy smoker who'd like to quit, a moderate drinker, and I've never been seriously ill or even hospitalized, except for breaking my jaw in a bicycle wreck as a teenager.)