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[quote=Anonymous][quote=Anonymous]We have BCBS Standard.  BCBS Basic and Standard are popular throughout my agency, but pretty much all of my colleagues who have kids with special needs that require out-of-network services have BCBS Standard.[/quote]

I think the relative value of GEHA and BCBS standard depends on how often you see out of network providers. GEHA has a higher copay, but a lower monthly premium.

GEHA Standard pays 65% of the negotiated rate for out-of-network, and if the out of network provider charges more than the negotiated rate, you have to pay the difference between to two rates AND 35% of the negotiated rate. But the GEHA Standard premium for a family (employee share) is only $282.

BCBS Standard will bill you for the difference between the two rates, plus 15% of the negotiated rate (as your copay). But the BCBS Standard premium for a family (employee share) is $589.

Another big cost issue is how much your out of network providers charge relative to the negotiated rate. [/quote]

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