Need private Blue Cross/Blue Shield health plan. Help me pick.

January 29, 2013 10:21 AM

Need private health insurance for my partner, my workplace will be reimbursing all his private health insurance instead of adding him as family/dependent. So cost is minor issue, more concerned with good, specific coverage. We would like to go Blue Cross/Blue Shield due to previous positive experiences. Confused as to what plan will work. He works in a high-stress, very physical outdoorsy job. Without fail, he makes a few urgent care/ER visits a year and would appreciate some therapist coverage to deal with anxiety related to job. Being able to see specialists, get bloodwork and labs done without breaking the bank would be appreciated as well. Any advice? Florida here, if it matters. Looking for low deductible, fixed doctor and hospital visit costs.
posted by caveatz to Health & Fitness (6 answers total)

Every BC/BS plan in each of the 50 states in different. This question is unanswerable here as we don't even know where you are. And even if we did, you best option is to sit down with a local insurance agent who sells BC/BS health policies and go through the options there. That is your quickest route to the best answer.
posted by COD at 11:57 AM on January 29, 2013

FWIW the OP says he is in Florida. I agree this is a very difficult question to answer, though, and OP's best bet is to talk to a local insurance agent.
posted by Justinian at 12:17 PM on January 29, 2013

The poster says this is for Florida, so we do know where they are.

No agent will help will help you because insurers don't pay commissions for individual health insurance. You can go direct to BCBS of Florida here:
http://consumerdirect.bcbsfl.com

If money is no object, take the most expensive plan with the lowest deductible/out of pocket max. Generally, this plan will be a PPO which covers 100% (possibly after a small deductible) in network and 80% out of network (after a larger deductible).

Note that a downside to individual insurance (vs. group coverage) is that pre-existing condition exclusions are more likely to apply. You'll want to read the fine print and make sure you understand what is covered and when. If it were me, I would probably push to have the partner covered under the group plan if at all possible.
posted by MarkAnd at 12:18 PM on January 29, 2013

Sorry - missed the mention of FL in the question. However, when I had health insurance issues in the past (VA) I didn't have any issue with a local agent. He sat down with me, went through the options, etc. And this article at the WSJ indicates that agents are paid on individual policies. Why else would they sell them if they are not getting a check? However all agents are not equally competent so I would try to find a referral from somebody you trust.
posted by COD at 12:42 PM on January 29, 2013

I wouldn't announce the employer's plan to reimburse the cost of the private plan too loudly. Many insurers prohibit this for private plans. If they discover the employer is providing funds, your partner could lose the insurance.
posted by Thorzdad at 1:41 PM on January 29, 2013

Talk to a broker? Not in FL, but in IL when you put in the BCBS application it gives you the option of selecting a broker. I ended up going with my company's insurance but my broker (who worked with BCBS and a few other companies) was pretty knowledgeable, got me more accurate quotes than the BCBS website, and it was free.
posted by sm1tten at 4:56 PM on January 29, 2013