CareFirst Blue Choice dropped Sibley Memorial from network effective today

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Blue Choice is Care First’s HMO. For those that have been around a while, it is the old CapitalCare.

Even this is inaccurate information. All Blue Choice plans aren’t HMOs. I have a Blue Choice plan that is a PPO. General rule of thumb…never get a PPO if you have a choice.

I'm not sure why you would say that. I have only ever had PPOs and both high and low deductible plans. I'm not sure why anyone would pick an HMO over a PPO unless you're in an area with a LARGE Kaiser network.

HMO’s typically cover more of the cost, assuming you stay in network. We had HMO’s for 10 years with no issues. We’d have one now but it’s too expensive and now we have a sucky HDHP. When for my pregnancies/deliveries it was one single $20 copay to the OB at confirmation of pregnancy and I think a $50 copay to the hospital for an entire delivery including epidural. No other bills. DH’s vasectomy was $50. Etc.

I paid $0 for my entire pregnancy. Like no copays for OB visits, scans, birth, anything. I had a PPO.

[Anonymous]

Anonymous wrote:I am trying to check in on the Sibley portal for a surgery next week. I keep getting a connection error. I have BCBS FEP. I don’t know if my portal problems are related to some insurance change?

More likely they're doing Saturday maintenance on their website.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Blue Choice is Care First’s HMO. For those that have been around a while, it is the old CapitalCare.

Even this is inaccurate information. All Blue Choice plans aren’t HMOs. I have a Blue Choice plan that is a PPO. General rule of thumb…never get a PPO if you have a choice.

I'm not sure why you would say that. I have only ever had PPOs and both high and low deductible plans. I'm not sure why anyone would pick an HMO over a PPO unless you're in an area with a LARGE Kaiser network.

HMO’s typically cover more of the cost, assuming you stay in network. We had HMO’s for 10 years with no issues. We’d have one now but it’s too expensive and now we have a sucky HDHP. When for my pregnancies/deliveries it was one single $20 copay to the OB at confirmation of pregnancy and I think a $50 copay to the hospital for an entire delivery including epidural. No other bills. DH’s vasectomy was $50. Etc.

I paid $0 for my entire pregnancy. Like no copays for OB visits, scans, birth, anything. I had a PPO.

I'm a breast cancer patient with CareFirst BlueChoice Advantage, which is a PPO, and have had zero complaints about my insurance coverage. There are specialist co-pays and stuff but from the amounts I'm seeing on the EOBs, what I'm paying is a drop in the bucket. I've had a ton of procedures and medications and see a bunch of different doctors and have run up about $300,000 in bills in the last 10 months. Of that, the out of pocket cost has been maybe $700. Everything my doctors have submitted to insurance has been immediately approved, including when I had an allergic reaction to a drug and needed a different formulation that cost 5x as much. It's making me feel like I can never leave my job because the insurance coverage has saved me from financial ruin. I know it sounds pathetic because the state of health care is such a mess in this country and should be so much better but I can't help but feel grateful to CareFirst anyway.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Blue Choice is Care First’s HMO. For those that have been around a while, it is the old CapitalCare.

Even this is inaccurate information. All Blue Choice plans aren’t HMOs. I have a Blue Choice plan that is a PPO. General rule of thumb…never get a PPO if you have a choice.

I'm not sure why you would say that. I have only ever had PPOs and both high and low deductible plans. I'm not sure why anyone would pick an HMO over a PPO unless you're in an area with a LARGE Kaiser network.

HMO’s typically cover more of the cost, assuming you stay in network. We had HMO’s for 10 years with no issues. We’d have one now but it’s too expensive and now we have a sucky HDHP. When for my pregnancies/deliveries it was one single $20 copay to the OB at confirmation of pregnancy and I think a $50 copay to the hospital for an entire delivery including epidural. No other bills. DH’s vasectomy was $50. Etc.

I paid $0 for my entire pregnancy. Like no copays for OB visits, scans, birth, anything. I had a PPO.

I'm a breast cancer patient with CareFirst BlueChoice Advantage, which is a PPO, and have had zero complaints about my insurance coverage. There are specialist co-pays and stuff but from the amounts I'm seeing on the EOBs, what I'm paying is a drop in the bucket. I've had a ton of procedures and medications and see a bunch of different doctors and have run up about $300,000 in bills in the last 10 months. Of that, the out of pocket cost has been maybe $700. Everything my doctors have submitted to insurance has been immediately approved, including when I had an allergic reaction to a drug and needed a different formulation that cost 5x as much. It's making me feel like I can never leave my job because the insurance coverage has saved me from financial ruin. I know it sounds pathetic because the state of health care is such a mess in this country and should be so much better but I can't help but feel grateful to CareFirst anyway.

It’s not CareFirst you should be grateful to. It’s whoever is paying your (undoubtedly high) insurance premiums.

[Anonymous]

I’ve never seen a PPO plan where I didn’t owe 20% coinsurance and a crazy high premium. Some of you have really generous employers and seem clueless about it.

[Anonymous]

Anonymous wrote:I’ve never seen a PPO plan where I didn’t owe 20% coinsurance and a crazy high premium. Some of you have really generous employers and seem clueless about it.

ACA PPO plans in DC.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’ve never seen a PPO plan where I didn’t owe 20% coinsurance and a crazy high premium. Some of you have really generous employers and seem clueless about it.

ACA PPO plans in DC.

Then you are paying outrageous premiums in order to “pay nothing” for your services. I promise you CareFirst is still making their profit on you. It’s not a charity.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Blue Choice is Care First’s HMO. For those that have been around a while, it is the old CapitalCare.

Even this is inaccurate information. All Blue Choice plans aren’t HMOs. I have a Blue Choice plan that is a PPO. General rule of thumb…never get a PPO if you have a choice.

I'm not sure why you would say that. I have only ever had PPOs and both high and low deductible plans. I'm not sure why anyone would pick an HMO over a PPO unless you're in an area with a LARGE Kaiser network.

+1. Not sure why you would avoid PPO - that’s all I’ve ever had and can go basically anywhere with no issues.

+1,000 we choose PPO over HMO every year. HMOs suck!

[Anonymous]

Just want to make sure people know they can get cds of their imaging from any provider who did them previously along with copies of the reports and take them to your next mammogram. It’s important to do that actually

[Anonymous]

Anonymous wrote:Just want to make sure people know they can get cds of their imaging from any provider who did them previously along with copies of the reports and take them to your next mammogram. It’s important to do that actually

True -for a hefty fee.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:BlueChoice may be different than the regular Carefirst.

There are like 30 versions of CareFirst plans, no joke. When I was looking at their site and searching for my doctors it had a whole list of all the various iterations of CareFirst plans they accepted, with "Your Network" in parentheses next to one of them. Confusing as all get-out.

This. OP is having issues with their very specific plan and this most likely doesn’t affect those who don’t have the same employer.

OP here. Not an employer plan. MD exchange, so anybody covered there. Likely DC HealthLink too as they contract their provider networks together.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Just want to make sure people know they can get cds of their imaging from any provider who did them previously along with copies of the reports and take them to your next mammogram. It’s important to do that actually

True -for a hefty fee.

I am a newly diagnosed breast cancer patient and got all of my images transferred to cds and all radiology reports copied for me, and paid nothing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Just want to make sure people know they can get cds of their imaging from any provider who did them previously along with copies of the reports and take them to your next mammogram. It’s important to do that actually

True -for a hefty fee.

I am a newly diagnosed breast cancer patient and got all of my images transferred to cds and all radiology reports copied for me, and paid nothing.

Adding - I have a PPO

[Anonymous]

That stinks. That’s my insurance. Thanks for the head’s up.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Blue Choice is Care First’s HMO. For those that have been around a while, it is the old CapitalCare.

Even this is inaccurate information. All Blue Choice plans aren’t HMOs. I have a Blue Choice plan that is a PPO. General rule of thumb…never get a PPO if you have a choice.

I'm not sure why you would say that. I have only ever had PPOs and both high and low deductible plans. I'm not sure why anyone would pick an HMO over a PPO unless you're in an area with a LARGE Kaiser network.

HMO’s typically cover more of the cost, assuming you stay in network. We had HMO’s for 10 years with no issues. We’d have one now but it’s too expensive and now we have a sucky HDHP. When for my pregnancies/deliveries it was one single $20 copay to the OB at confirmation of pregnancy and I think a $50 copay to the hospital for an entire delivery including epidural. No other bills. DH’s vasectomy was $50. Etc.

It really comes down to whether the selection of specialists in network is favorable or not. When you have challenging health problems in the family and want the highly-rated doctors in a major metropolitan area, that can be a problem.

I grew up with Kaiser in California. It was a long time ago, but the specialists at that time and place were really hit or miss, and as I moved on in adulthood I realized that two of my diagnoses were wrong and a lot of the treatments I had as a teen through Kaiser were totally barking up the wrong tree. I also waited months for a minor surgery with a specialist once. In fact I got so sick of waiting that I found a kaiser primary care doctor who said he would do it in the office. He was doing me a favor because the wait was really unpleasant, but he did it badly and I needed the specialist to revise it anyway.

Not good HMO experiences.

Kaiser is socialized medicine in the US. It’s built for cost efficiency and minimal patient input/control and draws people who seek convenience over quality. If you want your primary care doc to handle numerous things they only studied for a matter of weeks because there are actual limits on how many they can send to a specialist…this is the plan for you. The people I know who have Kaiser sing it’s praises until they develop a medical issue that needs actual care.