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2016 health plans

Posted on 11/11/15 at 10:18 am
Posted by rlanders23
Member since Oct 2011
121 posts
Posted on 11/11/15 at 10:18 am
Alright, ladies and gents of the MT, I need help. I'm self-employed and live in the Houston burbs with a wife and two kids. Unfortunately, the bcbstx ppo plan we have in 2015 will no longer be offered, so I'm shopping for alternatives. Again, unfortunately, there seem to be no ppo plans offered for individuals in Houston, so the ideal plan is already eliminated. My question is twofold:
1) am I missing an obvious solution (like, there actually are ppo's that I don't see) or am I stuck with an hmo?
2) any other mt'ers find themselves in a similar situation and find a reasonable solution?

Thanks in advance. And no, I didn't vote for Obama, so spare me the political rant -- I'm already mad enough ;-)
Posted by hungryone
river parishes
Member since Sep 2010
11987 posts
Posted on 11/11/15 at 10:42 am to
Have you looked at a high deductible health plan and health savings account? Definitely investigate this option.
Posted by rlanders23
Member since Oct 2011
121 posts
Posted on 11/11/15 at 10:55 am to
Yea, that's what we had this year (the bcbs bronze ppo, which was hsa compatible. The hmos offered exhibit these same features but with a much more limited network. In other words, if you like your doctor...plan on him/her not accepting this sh!tty hmo plan
Posted by Rouge
Floston Paradise
Member since Oct 2004
136773 posts
Posted on 11/11/15 at 10:56 am to
many people are in this boat, including Momma Rouge. Several doctors are already telling her that she is SOL and that their practices are not, and will not, accept HMO.
Posted by Day Wisher
New Orleans
Member since Sep 2010
399 posts
Posted on 11/11/15 at 10:58 am to
Going through the same thing with BCBSTX. We're moving to Baylor Scott White Health Jan, 1st. They have the only individual PPO plan that I could find. So far they're much better to deal with than BCBSTX.

edit: All of our current doctors in Dallas accept this plan minus the pediatrician who is no great loss.

This post was edited on 11/11/15 at 11:00 am
Posted by ItNeverRains
37069
Member since Oct 2007
25363 posts
Posted on 11/11/15 at 12:08 pm to
You think this year is bad, wait until 2017
Posted by Wasp
Off Highland rd.
Member since Sep 2012
1482 posts
Posted on 11/11/15 at 2:40 pm to
Why do you suggest it is shitty? The HMO is cheaper right? The service is different but part of it is to offer a cheaper plan to people that aren't concerned with where they go and just want more affordable insurance.
Posted by GetCocky11
Calgary, AB
Member since Oct 2012
51215 posts
Posted on 11/11/15 at 3:50 pm to
Don't even have an HMO option where I live anymore. The Bronze EPO plan through the marketplace costs as much if not a little more than the PPO plan offered through my employer.
Posted by Rouge
Floston Paradise
Member since Oct 2004
136773 posts
Posted on 11/11/15 at 4:54 pm to
quote:

The HMO is cheaper right?
cheaper is not better when your doctors will not accept HMO patients
Posted by Wasp
Off Highland rd.
Member since Sep 2012
1482 posts
Posted on 11/11/15 at 6:43 pm to
may not be better for you but for others who hardly ever go to the doctor and don't care who their doctor is, it is better.
Posted by Rouge
Floston Paradise
Member since Oct 2004
136773 posts
Posted on 11/11/15 at 7:26 pm to
And why am I supposed to care about others?
Posted by Wasp
Off Highland rd.
Member since Sep 2012
1482 posts
Posted on 11/11/15 at 7:45 pm to
Great point

Posted by matthew25
Member since Jun 2012
9425 posts
Posted on 11/11/15 at 8:00 pm to
Houston, the 4th largest city, with 6,000,000 in the SMSA, can't put together an affordable health plan.

Mississippi has 2.9 million population and several plans. We are so poor that 95% can get the tax subsidies.
Posted by rlanders23
Member since Oct 2011
121 posts
Posted on 11/11/15 at 8:27 pm to
@wasp, basically, just want to be able to purchase insurance like I have in the past, which is be given a menu of options for which I pick the appropriate plan based on my family's needs and budget constraints.

Whether or not the next door neighbor likes or can afford that plan is really none of my business or concern, but let's not make this a political chat.

To answer your first question, I assume it's sh!tty because of the networks listed on the various providers sites. The hmo is roughly the same price (3% cheaper) but will require us to find all new doctors (ob for the wife, pediatrician for the kids, etc.). Is this a huge deal? Probably not, and I'm sure we'll figure out a proper alternative because there's no sense dwelling on it. But again, I'm basically being told to cough up more money for less service (fewer docs to choose from and worse customer reviews on the docs).

My goal here was simply to see if anyone had beat me to a better solution than the hmo's I'm finding. I've gotten some good pointers here and appreciate the help. Sounds like many of us are in a similar situation.
Posted by Wasp
Off Highland rd.
Member since Sep 2012
1482 posts
Posted on 11/11/15 at 9:10 pm to
The health insurance business is changing rapidly. Plans have had to drop product that are unsustainable. Across the country, health plans are having some of the worst years in recent history. Insurers aren't necessarily to blame, unless they are given the blame for being screwed by the Affordable Care act and strong armed by providers. The large hospitals in Louisiana increase their charges by 5-10% every year while operating between 10-20% cost/charge.

All this is to say, insurers(particularly not-for-profits) really do want to provide you with the best health insurance they can.
Posted by Bestbank Tiger
Premium Member
Member since Jan 2005
70663 posts
Posted on 11/11/15 at 10:44 pm to
Have you looked into any sharing ministries?
Posted by rlanders23
Member since Oct 2011
121 posts
Posted on 11/12/15 at 6:37 am to
@wasp, understand the insurance companies aren't purposely trying to provide a worse product. Like you said, it's a changing environment, and they're trying to do their best to make money, which means attracting and retaining customers.

@bestbank, I haven't looked into the sharing ministries simply because they make me nervous. As much as I believe in the private sector it sort of scares me to jump into an unregulated arena. Much of that hesitation could be borne out of ignorance, so please, if you've used them, share your experience. Have you had positive experience dealing with those folks?
Posted by Bestbank Tiger
Premium Member
Member since Jan 2005
70663 posts
Posted on 11/12/15 at 8:15 am to
quote:


@bestbank, I haven't looked into the sharing ministries simply because they make me nervous. As much as I believe in the private sector it sort of scares me to jump into an unregulated arena. Much of that hesitation could be borne out of ignorance, so please, if you've used them, share your experience. Have you had positive experience dealing with those folks?


I joined one a year ago because it was more affordable than traditional insurance.

I haven't needed to use it for any medical bills so I would have to go on testimonials, but the sharing ministries are all well established. They're not allowed to exist if they weren't operating before 1999.

Theoretically the whole thing could be a scam, but the odds are very low that someone's been getting away with something that widespread for that long.
This post was edited on 1/16/21 at 9:08 pm
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