hungryhorace

Question.

If offered a very competitive 'in network' only plan, would you take it?

Bob

Depends....how competitive, how bigs the network and what's the cost?

For the metrowest area, chances are, you've got Boston Childrens, Mass General, Brigham Womens, Tufts, Beth Israel, Dana, Lahey, Newton Wellesley, etc, etc.

They're all world class and a lot of PCP's are linked to at least a couple of them in some way so if you're not travelling much you should be pretty sorted, certainly for eyeballs, cancer, heart, knackered limb/joints.

sir_eccles

Is your current doctor or provider "in network".

hungryhorace

They are, yes.

It would be for Tufts within New England. They don't appear to extend outside of the North East unfortunately.

hungryhorace

Thanks, Bob. This has re-assured me somewhat. My main concern is that I get ill when out of state and require emergency care, I'll be on the hook for all out of network costs.

notshipman

How much are you saving and do you travel so much out of state and is your general health such that a combination means that the possibility of being ill with this scenario is that probable?

Jerseygirl

I don't think I would like to chance it. I was in Toronto last summer when I had to visit the ER...spent almost a week in hospital...no surgery...the bill was over $30K. We didn't pay a penny towards it.

hungryhorace

$80 for this HMO v $130 for my PPO which covers out of network 80/20 and in network 90/10.

I'll put the figures up properly when I get home.

I am minded to agree with Jerseygirl though. I travel out of state (and this network) with my job, and the thought of being on the cop for thousands in out of pocket expenses fills me with fear.

If it was blue cross like my wife's I wouldn't mind too much as they're nationwide, but it looks like Tufts has hardly any coverage outside of New England.

Sally Redux

I think in an emergency you can go anywhere - at least that's what they said with my HMO.

Is this different though, just a local thing?

hungryhorace

I'm genuinely not sure. I know a trip to ER costs $200, but I was under the impression I would be on the hook for all costs as a result? I need to call my employers insurance line to find out. As if it did cover ER visits with only a $200 co pay that would be fine.

Bob

Need to look at the details, but most would cover some portion of out of network emergency care if you were on the road, but it could be something rubbish like 20-50% but it might be better.

It's really geared towards stopping you from going across the country to get cancer treatment at a better hospital kind of deal, but Tufts is a great institute and dotted around N.E.

Sally Redux

Yes I think you need to call them. It just says $200 copay for emergencies, but I think that should be for anywhere. Otherwise you'd never dare leave the radius of your hospital.

hungryhorace

It says 'in network only' on the plan details. The ER bit when I'm out of state is the only bit that concerns me.

I'm very healthy otherwise, but I banged my head in a flight recently and I would have gone to ER but I was afraid of the out of network costs, even though I would have been covered 80/20.

I shall call them on Monday and find out the exact details though!

Bink

Check with your provider about emergency out of State and what is and isn't considered an emergency. There's normally still some cover for emergencies out of state though the deductible may be considerably higher because it's an 'in network' only plan with emergency cover.

MsElui

my employer offered something like that for dental. It was way way cheaper than the other options but it was as you said - only reimbursable if you use in network - and there were simply not many around i wanted to use. So we wemnt with the more traditional scheme that cost more.