Any experience with federal BCBS insurance?

[Anonymous]

We just moved to Rockville from out of state and have federal BCBS thru my husband's job.

I'm trying to find a primary care doc for myself and my 13-year-old daughter, but when I search on the "Find a Provider" within a 15 mile radius, the only ones that come up are family doctors in Virginia...could that be right? Gave up sitting on hold to ask a live person.

Is this one of those plans that hardly anyone takes? Is there a better option for NIH employees?

I would really like to find a female adolescent medicine specialist for my daughter who can help with both weight and mental health issues (specifically, willing to prescribe Prozac) since I think finding a new psychiatrist for her will be even more difficult. Because of these issues, we are willing to go out of network if necessary.

Any advice much appreciated!

[Anonymous]

The standard federal BCBS is the most widely accepted insurance in DC, and we have it for that reason even though it is expensive and requires deductibles. Of course a lot of dr.s have stopped taking any insurance (or take it, but only after you pay a concierge fee).

The "basic" BCBS plan is, I think, more restricted, but if you have std you should be able to find someone nearby.

Good luck!

[Anonymous]

P.S. I find checkbook.org to be a good place to start in looking for recommendations for kinds of services. I think it's $25 or $50 to get access to their archives and everything.

[Anonymous]

BCBS is one of he most accepted insurances in this area. We previously had United and it was not a good experience.

[Anonymous]

Most docs in DC, BEthesda, Chevy Chase and Northern VA have dropped BCBS. They will not pay them or will pay them less than medicare rates. They will pay hospital bills because they has an arrangement with them. Because of this the hospitals have been hiring more docs on staff and pushing the private docs out. Hence, the new offices next to Sibley. This doesn't mean these docs are better, in fact, they most likely agree to be on staff payroll because they couldn't survive private practice.

[Anonymous]

PLENTY of docs in the Rockville area still take BCBS. They complain about it, but still take it. I haven't had trouble finding a doc, both GP/internist and specialist.

If you are an NIH employee, you can ask other employees for recs via the many employee listservs.
good luck.

[Anonymous]

Haven't had an issue with Docs taking BCBS.

[Anonymous]

OP - how are you doing your search?

Oddly, I found when I typed in my address I got less hits, but then I typed in just my zip code and more docs. were listed.
That was awhile back, though, so it might have changed.

Also, sometimes it's easier to do a reverse search. If you know of a doctor or see a doc. office that is closeby, I just called (and entered it on the BCBS website to verify) to see if they took BCBS.

[Anonymous]

OP here:

Thanks for the responses! I finally got thru on the phone and learned these two important search tips:

1) select no preference for doctor gender, even if you want a specific gender. The way the system is set up, female doctors are only listed if they specifically chose to point out that they are female, and most of them do not, so you get more hits by not specifying.

2) chose no preference for "accepting new patients?" as well. This one made no sense to me...why would you search someone who is not accepting new patients? Turns out that this changes daily (ie, what plans specific doctors or practices accept) so it's irrelevant. Why they keep it on their search criteria is beyond me.

Now my question is: What about hospital affiliation? I learned the hard way about this in the Boston area...I figured, hey, I'm pretty healthy, I'll just chose the nearby community hosptial. Big mistake. I had two failed surgeries for endometriosis at Mt. Auburn hopsital in Cambridge (for those who know the area) before moving to Brigham and Women's in Boston. World of difference. It's worth it to me to travel when necessary. What are the best choices around here?

Thanks!

[Anonymous]

John's Hopkins is the best if you can plan ahead. If you live near NIH I would recommend Suburban.

[Anonymous]

on the hospital front - think about whether or not you want to end up at a teaching hospital like Georgetown or George Washington. There are lots around here that are not teaching hospitals, but have danced with accreditation problems, now solved, over the years. Suburban, now under the JHU system, is pretty good for a local.

[Anonymous]

A note about why doctors have dropped BCBS (and probably other plans): rents in DC and close-in suburbs are sky-high. Liability insurance is also really high. The reimbursement rates from the insurance companies do not cover the costs of most sole practitioners in DC. So it either needs to be a large practice, and/or a practice that doesn't spend much time on each patient.

My OB/GYN stopped taking insurance a few years back. I recently switched to an out of network GP b/c I was sick of not being able to get an appt with my old GP and not spending enough time with her when I did finally get to see her. We switched pediatric practices b/c the one that did take insurance was so poorly run (and was possibly milking the insurance companies w/ extraneous visits).

We budget for insurance to cover the catastrophic stuff, but almost everything is out of network.

[Anonymous]

i have basic and have no probs finding a doc [ped, ob, and gp]. i'm in nova, but have seen docs in dc too.

[Anonymous]

OP again.

Thanks for the replies...Found 3 pedis that take BCBS, are relatively close, and are affiliated with Suburban:

Christine Saba
Rebecca Gross
Robbie Moyer

Any feedback on them?

Thanks!

[Anonymous]

I live in Rocville and have Standard Option (the better of the two; the names are irritating!) BCBS Federal. The only doctor I had issues with was my neurologist, who dropped BCBS because of exactly what PPs have mentioned: The amount the doctor is reimbursed was incredibly low. I did switch doctors out of annoyance over this, but couldn't find a decent neurologist who accepted BCBS Federal, so went back. (He's Dr. David Katz in Bethesda, BTW. He's excellent for those in need of a neurologist!) The office staff is really great about filling out and submitting forms for reimbursement, so aside from paying a little extra out of pocket, all is good.

GPs in the area are difficult to find in part because the good ones aren't accepting new patients. And they all seem to be incredibly busy, highly recommend or not, so sitting in the waiting room well past your appointment time, then getting less than your scheduled 15 minutes, is pretty common. If anyone has GP recommendations, I'm all ears!

A good ob/gyn practice is Capital Women's Care. There are many area locations, but the one Dr. Judith Gurdian heads (located in one of the buildings next to Shady Grove Adventist Hospital) is excellent. I also can speaking quite highly of Shady Grove Pediatrics (all three doctors there are amazing!). Both places take BCBS Federal, the doctors always take their time and I feel extremely confident in their medical abilities. Both practices are affiliated with Shady Grove Adventist, which had some brushes with losing its accredidation, but that was many years ago and the place has improved quite substantially.

Good luck with your search!