Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Help me understand the appeal of BCBS standard. It seems worse to me than basic? Pay way more in premiums to get a deductible too and also relatively high (and therefore unpredictable) coinsurance. Why?

We switched to basic for one year and it was a huge headache. I can’t remember what the issue was, but I have IBD so take a biologic and see a doctor often, at least once or twice a month. It was a while ago, may have even been before ACA, so perhaps it’s better now.
Kaiser is awful my parents have it an they withhold modern medicine as long as possible to save costs.

I THINK when I looked at this last year, Standard did better with OON coverage. Haven’t looked this year. I have basic for me, but the rest of my family (eg kids with therapy bills) are on a different BCBS through my husband.

Yes, the main advantage is that standard will cover out of network at least partially while basic does not cover anything out of network. However the cost difference only makes sense if you need a lot of OON providers.

Anonymous wrote:

Anonymous wrote:I have BCBS standard but the monthly premiums for 2026 are nearly $1000 for the family plan.

That’s insane. I’m sorry, but you should really run the numbers.

I did over the shutdown and I am moving to MHBP standard. There are a few differences and a little more Out of pocket for OON doctors but we should save a few thousand dollars next year.

Any thoughts on which plan is best for a teen on semiglutides for pre-diabetes?

Anonymous wrote:

Anonymous wrote:Help me understand the appeal of BCBS standard. It seems worse to me than basic? Pay way more in premiums to get a deductible too and also relatively high (and therefore unpredictable) coinsurance. Why?

We switched to basic for one year and it was a huge headache. I can’t remember what the issue was, but I have IBD so take a biologic and see a doctor often, at least once or twice a month. It was a while ago, may have even been before ACA, so perhaps it’s better now.
Kaiser is awful my parents have it an they withhold modern medicine as long as possible to save costs.

I THINK when I looked at this last year, Standard did better with OON coverage. Haven’t looked this year. I have basic for me, but the rest of my family (eg kids with therapy bills) are on a different BCBS through my husband.

I was BCBS Standard for nearly my entire federal career. Switched to MHBP Standard that started January this year. Retired recently but sticking with MHBP for the foreseeable future.

Anonymous wrote:Anyone used Compass Rose? We’ve been with GEHA standard for 15 years but they seem to have increased company’s and percentages for this year along with increasing premiums. We need to stay under the United Umbrella as our pediatrician only takes United.

Yes - family of 4, have had it for several years now. It works well for us - I think they've only flat out denied one thing ever. When I used the maternity benefits it was a $200 co-pay for me and $200 for the baby. It was a high risk pregnancy with longer than normal hospitalization and a NICU stay for baby. Still only paid $400 total.

Every doctor associated with Inova/the Inova system is in-network. Labs are zero cost if you go to Labcorp. Certain things like imaging, PT, and medical devices (orthopedic boot) are reimbursed on more of a percentage basis.

Out of network reimbursement is pretty easy.

My spouse and one child have chronic conditions and coverage has been good there.

I feel like customer service at UMR (their claims processor) isn't as good as it used to be, but it's not terrible. Some of those folks have really gone the extra mile to work through issues with me.

I compared plans this year with premiums going up, but we are not switching. We're pretty satisfied.

Anonymous wrote:Help me understand the appeal of BCBS standard. It seems worse to me than basic? Pay way more in premiums to get a deductible too and also relatively high (and therefore unpredictable) coinsurance. Why?

We switched to basic for one year and it was a huge headache. I can’t remember what the issue was, but I have IBD so take a biologic and see a doctor often, at least once or twice a month. It was a while ago, may have even been before ACA, so perhaps it’s better now.
Kaiser is awful my parents have it an they withhold modern medicine as long as possible to save costs.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:BCBS Basic. All of our doctors take it, and it seems to offer the best coverage in the event of a hospitalization or something else unexpected like that. Co-pays are high, but that's a known cost.

Is BCBS focus a good option?

If you don’t use the doctor often, it has pretty low co-pays, but limits the number of visits per year. If you end up going to hospital or getting surgery it’s 30% co-insurance, but of course capped with the out of pocket maximum.

We’ve had focus for years and really liked it. Low premiums and as long as you stay in network almost everything is covered.

Anyone used Compass Rose? We’ve been with GEHA standard for 15 years but they seem to have increased company’s and percentages for this year along with increasing premiums. We need to stay under the United Umbrella as our pediatrician only takes United.

Anonymous wrote:Help me understand the appeal of BCBS standard. It seems worse to me than basic? Pay way more in premiums to get a deductible too and also relatively high (and therefore unpredictable) coinsurance. Why?

Apparently some folks on here just like to throw away money.

Help me understand the appeal of BCBS standard. It seems worse to me than basic? Pay way more in premiums to get a deductible too and also relatively high (and therefore unpredictable) coinsurance. Why?

Anonymous wrote:

Anonymous wrote:BCBS Basic. All of our doctors take it, and it seems to offer the best coverage in the event of a hospitalization or something else unexpected like that. Co-pays are high, but that's a known cost.

Is BCBS focus a good option?

If you don’t use the doctor often, it has pretty low co-pays, but limits the number of visits per year. If you end up going to hospital or getting surgery it’s 30% co-insurance, but of course capped with the out of pocket maximum.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Checkbook does a helpful book each year. Generally, high-deductible plans are more cost-effective if you consider the much higher premiums for regular plans.

I don't quite understand the GEHA and MHBP HDHPs. The biweekly premiums are the virtually the same as the standard plans. Yes, you get $$ in your HSA from the gov, but the deductible on the standard plans is much cheaper ($350-500). We don't have a lot left over to invest in the HSA, and due to the premiums being about equal, we can't even invest the delta between them.

I tried doing the math for us, and due to a high monthly prescription for me, therapy for a couple of us, and psychiatry appointments, if we did bump up against the family deductible, it would be towards the end of the year. So we would pretty much always be paying out of pocket but not saving any of the money provided in the HSA.

I don't know what plans you are comparing but the GEHA HDP is almost $300 cheaper per month than BCBS basic, and almost $500 cheaper per month than BCBS standard (family option). MHBP has similar premiums. That is a whopping $6000 a year you are saving vs BCBS standard that could go into your HSA. The net deducible for the HDPs is only $1600, so your premium savings more than covers that deductible. Whether you are a low healthcare spender or high spender, GEHA comes out on top compared to BCBS. Now, their issues with JHU is problematic and I will probably be switching to MHBP for the Aetna network.

I am not talking about the BCBS standard/basic plans. I means the GEHA/MHBP standard plans vs the GEHA/MHBP HDHP plans.

The GEHA standard plan is $30 more per month vs HDP. It has a $600 per year lower net deductible, but the OOP max is much higher. It also has a high copay and surgery coinsurance. Basically in 95% of scenarios, you are better off with the high deductible version.

Anonymous wrote:I was looking into BCBS but there was “20% con-insurance” listed for a lot of items. That sounds so high. Anyone have experience with that?

It depends on the plan. Basic doesn’t have many percentage co-insurance except now for labs and maybe incidental tests/supplies. It’s also 20% of the “negotiated amount” so for a standard lab test it will be just a few dollars, not what the doctor’s official price is.

BCBS Standard and Focus use the percentage for more items.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have BCBS standard but the monthly premiums for 2026 are nearly $1000 for the family plan.

That’s insane. I’m sorry, but you should really run the numbers.

The thing is it’s not perfect but it’s about the best health insurance you can have. I know I may be “overpaying” but I’m risk averse in this area.

All plans have out-of-pocket maxes that protect you in worst-case scenarios. If you compare premiums plus OOP maxes, you’ll see that even in a worst case, you are massively overpaying.

For me, the lack of red tape and network of drs with bcbs standard has been good. Obviously ymmv but I’ve been willing to pay for it because of that good experience.