Health Insurance

[dlphg9]

100% do not get Coventry. When I was working at a local hospital we switched from BCBSKC to Coventry and the place I worked at wouldn't even take them for a lot of things.

[penguinz]

Originally Posted by dlphg9

100% do not get Coventry. When I was working at a local hospital we switched from BCBSKC to Coventry and the place I worked at wouldn't even take them for a lot of things.

I had Coventry when I had knee surgery about 20 years ago. Cost me $50 out of pocket for the surgery and PT.

First follow up with the ortho I mentioned I couldn't believe it was so cheap.

His response was the Coventy was great for patients because it was very inexpensive.

It sucked for doctors because Coventry was very bad about paying out if the did at all.

He said usually when a patient has Coventry he would be lucky to break even on his costs.

[loochy]

Originally Posted by penguinz

I had Coventry when I had knee surgery about 20 years ago. Cost me $50 out of pocket for the surgery and PT.

First follow up with the ortho I mentioned I couldn't believe it was so cheap.

His response was the Coventy was great for patients because it was very inexpensive.

It sucked for doctors because Coventry was very bad about paying out if the did at all.

He said usually when a patient has Coventry he would be lucky to break even on his costs.

Then why would he choose to be in the Coventry network?

[penguinz]

Originally Posted by loochy

Then why would he choose to be in the Coventry network?

I thought the same as well. All I can think is that it was because he was younger his name wasn't on the building so he had less say into what networks the practice was in.

[blake5676]

Originally Posted by penguinz

I had Coventry when I had knee surgery about 20 years ago. Cost me $50 out of pocket for the surgery and PT.

First follow up with the ortho I mentioned I couldn't believe it was so cheap.

His response was the Coventy was great for patients because it was very inexpensive.

It sucked for doctors because Coventry was very bad about paying out if the did at all.

He said usually when a patient has Coventry he would be lucky to break even on his costs.

That's not exactly how it works but honestly most doctors don't know a thing about health insurance. There's probably a few that are solo offices or independent from a hospital, but you ask you're average family physician or and ortho how much X company pays and they won't have a clue. But they probably do hear from management or billing that one company is better than the other for their specialty.

Coventry doesn't exist anymore, they were acquired by Aetna about a decade ago and slowly completely phased out into Aetna plans, but they were not unlike any other "big" insurance company. They each have their own fee schedule for the services provided. For example, Blue Cross may pay me $48 for doing one procedure yet United Health only pays me $31 for the exact same thing. I certainly have insurance companies I like better than others, but it mostly boils down to what they pay for services rather than ease of dealing with. Sure, some can be cumbersome at times but they all have to approve or deny claims w/in 30 days of submission and you basically know what you're getting paid before you send it.

So on that note, when people say one insurance company they had was SO MUCH BETTER than a different one they had another time, it usually actually means they had a better plan/contract and not that the insurance company was better. In your example, you didn't only pay $50 because Coventry kicked ass. You paid that amount bc you were either close to hitting your out of pocket max or you had a really good plan with killer copays or cost sharing.

Where people run into trouble with actual insurance companies is when they or their employer use one of the smaller guys that have narrower networks and more stringent pre-authorization requirements. If you have one of Aetna, UHC, Blue Cross, Medicare, Humana, etc, then your insurance company is basically as good as the plan you're signed up for. Not a ton of difference between them other than that, with some mild caveats.

[BWillie]

Originally Posted by TLO

My company is changing up providers for the health insurance they offer this upcoming year, and the options are pretty lackluster.

I know diddly dick about trying to find private health insurance, but surely someone on here has some knowledge to share.

Where do I look? What would constitute "good coverage" in your opinion?

Any suggestions welcome.

I'm going to be going on my girlfriend's insurance this year. I didn't even know I could do that. She can claim me as domestic partner lol. Instead of $31 a month at a $3,000 deductible it's $51 a month at a $3,000 deductible instead of Obamacare.

[EPodolak]

Eat right and exercise and don't smoke and go with the employer option.

[BigCatDaddy]

Originally Posted by EPodolak

Eat right and exercise and don't smoke and go with the employer option.

And get that 4th booster, TLO,.

[BWillie]

Looks like I'm going to have to go back to The Marketplace to get Health Insurance. My girlfriend got laid off a while back and she can't even get an interview so can't get healthcare through her right now once Cobra runs out. Can't wait to get ripped off and pay $1200 a month.

Looked into part time jobs that offer benefits but you have to work like 23+ or 28+ hrs plus. I would do 10 lol but that is about it.

Maybe becoming a Canadian citizen so I can get healthcare is an option

[Jewish Rabbi]

Originally Posted by BWillie

Looks like I'm going to have to go back to The Marketplace to get Health Insurance. My girlfriend got laid off a while back and she can't even get an interview so can't get healthcare through her right now once Cobra runs out. Can't wait to get ripped off and pay $1200 a month.

Looked into part time jobs that offer benefits but you have to work like 23+ or 28+ hrs plus. I would do 10 lol but that is about it.

Maybe becoming a Canadian citizen so I can get healthcare is an option

Damn, didn’t know you had a girlfriend. Sorry for her.

[KCJake]

It's over $600 a month for just me through my work. I've been to the doctor twice in the last 15-20 years. I just can't justify it

[blake5676]

Originally Posted by KCJake

It's over $600 a month for just me through my work. I've been to the doctor twice in the last 15-20 years. I just can't justify it

Not sure on your age? but that's relatively high for a work sponsored plan assuming you don't have some "cadillac" super plan with almost no deductible and super low out of pocket max.

If it's just an average plan with a medium to high deductible (4-8k) then I'm guessing that you're either paying the vast majority of the premium and your employer isn't paying much OR you have a small group with a poor health rating pool of employees.

You could likely find a similar premium plan on the individual marketplace, but those plans are usually only a good deal for someone earning a low enough income to get a subsidy to cover the majority or all of the premium. If you are above that threshold, you're probably paying that same premium for a shit plan with an $6k deductible in a relatively narrow network or with a "new" insurance company you've probably never heard of that may or may not be around for another few years.

The insurance game really is a shitty proposition these days. You can't just self insure at a reasonable rate anymore.

[kepp]

Originally Posted by KCJake

It's over $600 a month for just me through my work. I've been to the doctor twice in the last 15-20 years. I just can't justify it

Do they offer a high-deductible health savings account option?

[BigOlChiefsfan]

Go talk to your doctor/his secretary. They know who pays the bills. I've lived long enough to get most of the basics free these days, but I paid out the wazoo when I spazzed out a time or two before the geezer-rates kicked in. FWIW, eat less beef, walk more (push a cart around Walmart then get what you came for) and let your girlfriend do most of the work. Buy a pair of 10 lb dumb bells or kettle bells - and use 'em 3 days a week. Read up on 'indian clubs' and buy or make yourself a pair. They're designed to make you a better swordsman. Turns out - you don't need to stab people to benefit.