Affordable Care Act Scene 2 - Insurance Premiums

<p>I just pulled up a list of providers within 5 miles of D2’s college town (OOS) and got a list of 200. My BCBS rep said: if they are OOS but accept BCBS [or ‘on the list’ or whatever term you wish to use,] they are covered. I’d say, to be confirmed, but at this point, I don’t care. It’s not my determining factor. </p>

<p>Have fun with this one: remember, I’m on the east coast. It shows I can use UCLA. </p>

<p>So. Remember my question- why is the cheaper HSA plan offering lower deductibles and caps (and, in some respects, a better co-insurance and Rx scheme?)</p>

<p>Because for the HSA, if you enroll as a family, there is no “individual” ded or OOP. It’s just the family number. Too complicated to explain. Yet. Plusses and minuses to this; I will be re-running numbers to see the impact on us, best and worst-case scenarios.</p>

<p>Why didn’t I know this difference, calmom? Because it’s not stated anywhere. I’m down to a throw-a-dart case, anyway.</p>

<p>That’s rich, you’re on the east coast and can use UCLA and I live less than 90 miles from the hospital and I may not have access to it.</p>

<p>GP, That is awesome. </p>

<p>If the UCs are out of network, are the $15,000 to $30,000 out of pocket caps real, or are we subject to other costs?</p>

<p>What is emergency care? If a person breaks a leg in another state and is hospatilized for a week, is that person covered? And how?</p>

<p>Why did Anthem end Blue Card as we know it? How much Blue Card cost?</p>

<p>What can be done so the information Anthem gives out is not contradictory? </p>

<p>Why cant they update their provider list? It is 6 months old.</p>

<p>I know I am not really adding anything new here. :)</p>

<p>Okay, their on the list. I am going to get everything in writing. I am not leaving anything to chance. Are their other hospitals besides Stanford or UCSF you would like to know if you have in network access to. Which region do you reside? I will find out exactly what coverage your kid has in New York.</p>

<p>Wow… Thanks. Find out why LF gets to use UCLA. :)</p>

<p>I would like to know if I could use UCLA? :)</p>

<p>That is more than enough for me.</p>

<p>Thanks.</p>

<p>I am in Region 2. Marin, etc.</p>

<p>Okay…</p>

<p>Thanks…</p>

<p>Sounds like there is a solution. GP can buy insurance in New York or wherever LF is? :)</p>

<p>I apologize if this was asked before. H and kids are on grandfathered individual plan. I was kicked off my individual plan but today got the email that my plan will continue another year. I signed onto the exchanges (many hours to make little progress) last weekend then gave up. If H and kids and I keep our old plans for now, can we still change up until the end of open enrollment in March or whenever? Our current old policies are bcbs and the cheapest exchange plans for us are also bcbs.</p>

<p>“Sounds like there is a solution. GP can buy insurance in New York or wherever LF is?”</p>

<p>:)</p>

<p>Texas, </p>

<p>Only if the law changes. I would clarify which one, but I am not allowed :).</p>

<p>Maybe I’ll ask Anthem to exclude all Ca. providers from LF’s network. :)</p>

<p>Texas makes a good point. If I lived in NY I would probably have a better network in Ca than the one for which I qualify.</p>

<p>Under the Blue Card program, if I enrolled in a Blue Shield plan I would definitely have a far more extensive network out of state than what I would have in Ca. This sounds like a quintessential example of unintended consequences.</p>

<p>Busddiver, </p>

<p>I did not cotribute to the Cyber Monday problem. </p>

<p>Might have to save up to pay a deductible, you know. ;)</p>

<p>Psychomomma, what mine told me is that enrolling in Dec yeilds a 1/1 start date, that enrolling in Jan, the policy wouldn’t take effect til 2/1.
Something along those lines. Since Dec is the 15th, maybe the next bars are always the 15th. Don’t know.</p>

<p>Guys and gals, I didn’t put on my super ranger power helmet on and focus its laser beam on the UCLA question. It shows as a provider, but there could be some unknown twist. (Just as the individual deductible doesn’t apply to individuals in my HSA family offering.) Or maybe it means ER. Wouldn’t that be a letdown, since emergencies are often covered.</p>

<p>psychmom, first off, I am envious of you. Second, I see no reason why you can’t cancel your grandfathered plan and enroll in any other plan prior to March 31.</p>

<p>In reality, it is probably March 15 in order to have coverage on April 1</p>

<p>Power Rangers. :0</p>

<p>Man, oh man, we have had some interesting discussions over the years, in this thread and others, but never have I seen a Power Rangers reference. Or maybe you meant ranger power, either way, it was a nice laugh, lookingforward. </p>

<p>Blast from the past.</p>

<p>Here’s a slightly different question that I still think should fall under the parameters of the thread, as the answer would logically affect the practical decision of what plan to purchase:</p>

<p>Can anyone point me to any data that compares outcomes at different hospitals, preferably breaking it down somewhat by type of procedure? For instance, is there a meaningful difference between outcomes for someone who gets an appendectomy at a leading hospital vs. a similarly situated person at an average local hospital? Does the answer change in the case of a patient undergoing chemo? How about brain surgery, or a quadruple bypass?</p>

<p>It seems to me that customers really can’t evaluate the options properly unless we know both this data and some concrete information on how easy it would be to demonstrate “need” for an out of network doctor or hospital in cases where it did seem to make a difference.</p>

<p>Lots of 'em, but you also want to look for risk-adjustment.<br>
This one you can play with [url=&lt;a href=“http://www.hospitalsafetyscore.org/]Home[/url”&gt;http://www.hospitalsafetyscore.org/]Home[/url</a>] hospitalsafetyscore.org </p>

<p>Cedars and Reagan UCLA get a B.</p>

<p>Oh, sorry I posted this- my two local favorites get less than A, too. Ugh, and UWMC. Will be interesting to see what other sites folks find.</p>