British Expats

British Expats (https://britishexpats.com/forum/)
-   USA (https://britishexpats.com/forum/usa-57/)
-   -   HMO's and the like.. (https://britishexpats.com/forum/usa-57/hmos-like-424422/)

BigDavyG Feb 6th 2007 5:03 am

Re: HMO's and the like..
 

Originally Posted by ScottMc (Post 4371043)
Ok, so would the decision perhaps be something like..

I'm hardly ever ill,relatively young and don't have loads of capital - HMO for now.

Bit older, potentially have more illnesses but built up more capital - PPO.

I know that's a generalisation but I'm trying to get it straight in my head.

Nope - the options I was given at work they were both the same price - I would say seeing as you mentioned cigna as the hmo to steer clear and go for ppo.

Elvira Feb 6th 2007 5:04 am

Re: HMO's and the like..
 

Originally Posted by ScottMc (Post 4371043)
Ok, so would the decision perhaps be something like..

I'm hardly ever ill,relatively young and don't have loads of capital - HMO for now.

Bit older, potentially have more illnesses but built up more capital - PPO.

I know that's a generalisation but I'm trying to get it straight in my head.

It really isn't as simply as that. You have to compare not only the details of the actual plans, but also the location and reputation of the specialists and hospitals included.

For instance, one absolute requirement as far as I am concerned is easy access to an ER, and to have a top-notch cancer hospital in the plan. Emergencies can happen to anyone, and cancer can strike at any age.

What you do not want is a requirement to go to an overburdened community ER for emergency care, or cancer patients having to make do with a non-specialist center.

Bob Feb 6th 2007 5:18 am

Re: HMO's and the like..
 

Originally Posted by dan_alford (Post 4370891)
I would be interested to know what kind of health insurance that health insurance workers get :D

Manc worked for state farm I think, for a while, didn't have any insurance :lol:

Bob Feb 6th 2007 5:23 am

Re: HMO's and the like..
 

Originally Posted by ScottMc (Post 4371043)
Ok, so would the decision perhaps be something like..

I'm hardly ever ill,relatively young and don't have loads of capital - HMO for now.

Bit older, potentially have more illnesses but built up more capital - PPO.

I know that's a generalisation but I'm trying to get it straight in my head.

It's more a case of taking what your employer offers most of the time....but if you get the choice, look at the small print, what the deductibles are, especially for eye balls and teeth, what the co-pays are and % of coverage before they fully cover the cost, it could be 100%, or it could be 80/20 split, 20% on a million dollars of cancer treatment or a heart opp...could you afford that?

Also check what your covered for if/when you have kids such as pre/post natal care...if ambulance fee is included and if there is an overnight stay requirement before they pay...check to see how long they'll pay for you to stay in a hotel...see what happens if your in an accident out of state or out of network.

Look for what preventative care you have, such as physicals, other exams, etc, etc.

Dan725 Feb 6th 2007 6:09 am

Re: HMO's and the like..
 
As everyone has said, it isn't that simple, and sometimes you don't have a choice. That said, if you work for a biggish company, you might well get a choice in plan.

This is one of those areas that to do it justice, you cannot simplify it; and must wade through the small print to make sure you know whats what. I have found this to be the case with everything to do with all insurance in the US; all legal paperwork; all title deeds; all car purchases, all contracts of any kind. It truly seems everyone is out to screw you, and the only way to fight it is to be vigilant and educate yourself by knowing exactly whats what. The nice and simple UK way of doing things does not apply here - you don't particularly have good consumer rights here (if you indeed have any at all), and the system is stacked to prey on the unwary. In fact, a lot of the time, it counts on it - its really great when you turn the tables right on them by quoting small print.

If that sounds like a lot of crap you shouldn't have to deal with - it is, however, having spent the time to really educate myself on everything to do with finance, investment plans, insurance, home ownership etc, I'm certainly glad I did. The more you know the better prepared you are to make good decisions here; and the less money you will end up spending on unneccesary middlemen, bad plans, etc - not just health insurance but pretty much everything.

NC Penguin Feb 6th 2007 12:16 pm

Re: HMO's and the like..
 

Originally Posted by Bob (Post 4371123)
Manc worked for state farm I think, for a while, didn't have any insurance :lol:

He didn't work in or sell health insurance did he?


NC Penguin


All times are GMT -12. The time now is 8:04 am.

Powered by vBulletin: ©2000 - 2026, Jelsoft Enterprises Ltd.
Copyright © 2026 MH Sub I, LLC dba Internet Brands. All rights reserved. Use of this site indicates your consent to the Terms of Use.