<p>S recently started his job with the federal government in the DC/VA area and has to choose a medical insurer. Anyone with any experience? I have always been insured by our local BCBS, which only has offices in Hawaii so don’t really know where to start. Hubby was with Kaiser HMO but switched to BCBS when we got married.</p>
<p>Thanks for feedback on this subject. He does have several MDs he likes in HI that all participate & are preferred with BCBS, so am leaning toward trying to find a BCBS insurer on his plan that is a PPO, giving him more choice & flexibility. This will be his primary insurance & his coverage under H’s plan 2ndary until it goes away when he turns 26.</p>
<p>Does he travel a lot?
If so, BCBS may be the way to go. The coverage is broadest and there is less opportunity for accidentally receiving care you didn’t realize wouldn’t be covered.</p>
<p>If he will be primarily in the DC area, we found almost every provider who took BCBS also took GEHA. Very similar coverage but premium was about half.</p>
<p>However, got burned when a dependent traveling out of the area had multiple visits to a non-preferred hospital…</p>
<p>Yes, he has been traveling for work. Was just rear-ended while on business travel across the coast! Not sure how much travel he will continue to do, but seeing how much travel he’s doing as a new hire, I suspect quite a bit.</p>
<p>BCBS is probably the best option locally but they’ll need to be careful about which coverage level it is with BCBS as the networks do vary a lot between the HMO/Open Access (POS) plans <- these share a network, and the PPO plan. We’ve found some doctors and specialists are only on the PPO plan so that can make a difference too. Otherwise locally Aetna and United are big players as is Kasier but my personal experience with Kaiser makes me loathe to recommend them.</p>
<p>Thoughts about pros & cons of standard vs. high options? I’m leaning toward GEHA at the moment. </p>
<p>Kaiser can be good for folks who area always in one of their coverage areas but not so good if you travel & are not near such places–one of my friends had D transported by ambulance due to dance injury & it was NOT Kaiser facility & huge 5 digit bill that was NOT covered! On the other hand, brother is a Kaiser doc & S could finally see him & be covered!</p>
<p>High option is for people with chronic medical problems, lots of expensive medications, etc.</p>
<p>We asked about this when switching to GEHA and that is really what they advised. That’s where you see the difference in benefits. We did pay more out of pocket for prescriptions but because the premium was lower, we wound up saving money anyway.</p>
<p>There isn’t dental coverage or optical coverage to speak of in either BCBS or GEHA, so that’s something to consider. They do sell separate add-on dental and vision coverage through various providers but it has never seemed like a great value to me.</p>
<p>We had some issues with reimbursement when GEHA changed some of their procedures and we were getting a different answer every time about where to send bills, but that was right before we switched back to BCBS, so I can’t say if they’ve resolved that issue.</p>
<p>There is a magazine called Checkbook that rates the plans every year. As a fed, your son should have access to the ratings through the OPM website. Have him ask the HR people about it if he can’t find it.</p>
<p>I dropped the BCBS Federal Employee Plan a couple of years ago and switched to SAMBA. The coverage on their standard option is very similar to the BCBS standard plan but the premium is $62/month cheaper for self only. They use the CIGNA network of physicians. It’s worth a look.</p>
<p>Thanks–I recall SAMBA being mentioned before. Have you been happy with coverage under SAMBA? I don’t know anyone using it, since it’s not licensed in our state to do business & most use BCBS or Kaiser.</p>
<p>I’ve had SAMBA for 2+ years now and have absolutely no complaints. Claims are handled quickly, customer service is excellent, and the price is certainly much better than BCBS. I only have one doctor not on the CIGNA network so I pay out-of-network rates for him but it’s not that much more. Lab work is all free if processed by a Quest lab.</p>
<p>The reason I first switched from BCBS is because SAMBA had a Dependent Children Healthcare Plan that covered dependent children up to age 26. It was the only Fed plan that had such a thing and the premium was reasonable (~$200/month or so for the same coverage that the rest of the family had). I figured I would go back to BCBS once my son aged out of the SAMBA DCHP but I’ve been happy with them so I’m going to stay. Of course, I’m also saving about $1750 a year in premiums over BCBS, too :).</p>
<p>S just turned 26 today and really HAS to buy an insurance plan that starts in the next 30 days. Any further input? He lives in Arlington, VA, flies regularly to FL and CA and HI. We’ve had a HI BCBS PPO high family plan all our lives and it has served us pretty well.</p>
<p>My family switched from BCBS to NALC/Cigna (high option PPO) a couple of years ago, based on advice from an expert friend who writes the Checkbook issue about Federal Health plans, and have been very pleased. We have several conditions, but the coverage has been comparable and the premiums are better…and they are going up less than $2 a month next year. If he can find a copy of the most recent Checkbook–Human Resources should know it and can locate one for him…it’s very helpful.
PS One needs to join the Letter Carriers union to join this plan, but the cost is nominal.</p>
<p>I recommended SAMBA 2 years ago in this thread and I’m recommending them again. They’ve been excellent. And they didn’t raise their self + family premium for 2014, which was a pleasant surprise.</p>
<p>Here’s a great tool to help compare federal plans. You can plug in your expected expenses and it will calculate which plan is the best fit based on your priorities as well as which will be cheapest for your individual needs. </p>
<p>Thanks. Have sent him the link to this thread and told him to talk with coworkers ASAP. We’ve had a HI based policy all my life, but they don’t issue policies to folks living in CA/DC.</p>
<p>When we lived and worked in the DC area we had Kaiser, which I liked very much. In order to keep my Federal medical I have bought a low cost GEHA plan to go along with the plan I have through the University. When, and if we move to California, I want to get back into Kaiser.</p>