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-   -   HDHP or PPO (https://britishexpats.com/forum/usa-57/hdhp-ppo-728842/)

laety Aug 17th 2011 7:07 pm

Re: HDHP or PPO
 

Originally Posted by Sugarmooma (Post 9565283)
I have a $700 deduct, then it is 80/20%. $25 co-pay for GP, $50 co-pay for specialists and $1500 OOP expenses.

In October it is changing to the evil Aetna:eek: Deductible is going to be $1500, co-pays $75 and OOP expenses $2000....also most of the doctors in the immediate area are not on the plan either:(

so why the change? is it forced by your work?

scrubbedexpat097 Aug 17th 2011 7:23 pm

Re: HDHP or PPO
 

Originally Posted by laety (Post 9565304)
so why the change? is it forced by your work?

Every year during the budget (I work for a county government) they look to see if they can save money and sometimes they shop around and find an insurance that is cheaper for them. That usually means it will cost more to the employee, but they pay for it so I guess we don't complain:rolleyes:

Bob Aug 17th 2011 8:23 pm

Re: HDHP or PPO
 

Originally Posted by Sugarmooma (Post 9565283)
In October it is changing to the evil Aetna:eek:

I feel your pain. Aetna are shit.

Bob Aug 17th 2011 8:27 pm

Re: HDHP or PPO
 

Originally Posted by Sugarmooma (Post 9565333)
Every year during the budget (I work for a county government) they look to see if they can save money and sometimes they shop around and find an insurance that is cheaper for them. That usually means it will cost more to the employee, but they pay for it so I guess we don't complain:rolleyes:

The missus who is a teacher goes through something similar. This year was the first time in about 10 years she has seen an actual $ increase in pay, previously it had all gone in covering the raise of insurance premium cost.

Duncan Roberts Aug 18th 2011 1:37 am

Re: HDHP or PPO
 

Originally Posted by laety (Post 9565304)
so why the change? is it forced by your work?

We switched from a $0 deductible plan to a $3000 deductible plan. The company kicks in a monthly amount that adds up t half of that and the difference in price for us is about $2300 a year less so I worked out we will save a large amount this year. We just hit our deductible so I'm going to do all the stuff that I've been holding off on since now it will be 100% covered. You have to sit down and work things out each year if you have a choice of plan, you may find that the one that looks worse is actually going to save you a significant amount of money.

penguinbar Aug 18th 2011 3:45 am

Re: HDHP or PPO
 
You also need to compare the plans regarding monthly premiums VS deductibles. I took a plan that was 30 more a month but the deuctable was $300 vs. $1000. I remember the days when I wouldn't have to worry about the cost of health insuranced because it was reasonable!

scrubbedexpat097 Aug 18th 2011 12:44 pm

Re: HDHP or PPO
 

Originally Posted by penguinbar (Post 9566094)
You also need to compare the plans regarding monthly premiums VS deductibles. I took a plan that was 30 more a month but the deuctable was $300 vs. $1000. I remember the days when I wouldn't have to worry about the cost of health insuranced because it was reasonable!

Like the HMO we had years ago, just $5 for any drs visit, hospital visit and no extra charge for tests. Only problem was no choice of doctor or hospital. Also if an emergency happened and you had to use a non participating facility it ended up costing a fortune!:blink:

laety Aug 18th 2011 12:57 pm

Re: HDHP or PPO
 
is it generally easy to find a GP?
and if you need a "specialist" Ie dermatologist etc.. do you have to be referred, like in the UK? (Im asking because in France - where Im originally from) you can just go to any doctor you like without having to have a referral letter first

scrubbedexpat097 Aug 18th 2011 1:07 pm

Re: HDHP or PPO
 

Originally Posted by laety (Post 9566880)
is it generally easy to find a GP?
and if you need a "specialist" Ie dermatologist etc.. do you have to be referred, like in the UK? (Im asking because in France - where Im originally from) you can just go to any doctor you like without having to have a referral letter first


I don't think it is hard to find a GP. A suggestion is to ask around maybe with
co-workers which may give you an idea who is good. Then make a "new patient/meet the dr" appointment, this way when you are sick it will be easier to get an appointment as you will already be an established patient.


As for specialist, a lot depends on the insurance as to whether you would need a referral. Lots of times you don't.

Bob Aug 18th 2011 6:26 pm

Re: HDHP or PPO
 

Originally Posted by laety (Post 9566880)
is it generally easy to find a GP?
and if you need a "specialist" Ie dermatologist etc.. do you have to be referred, like in the UK? (Im asking because in France - where Im originally from) you can just go to any doctor you like without having to have a referral letter first

Depends on the plan you have. Generally, finding a PCP=GP isn't hard, but if in a busy area, finding one who takes on new patients for the family could be.

Some don't take on certain insurance as well, but your insurance would have a doctor locator, stick in the zip code and it'll bring up doctors who'll take you.

Seeing a specialist easily or not, depends on insurance. HMO, you would need a PCP referal, if a PPO plan, then you wouldn't, if the specialist was in network it'll cost less than if out of network and you may or may not have to pay up front.


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