Anonymous wrote:

Anonymous wrote: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.

DP. I’m switching to MHBP Standard. If you’ve had any experience with their OON claims process, could you please share feedback?

1. some claims went through fine
2. some claims got held up based on location (somehow the system insisted they were in instead of OON) takes a LOT LOT of work to override the system. They tell you the provider is in network and needs to file (clearly not the case). The phone reps agree with you, send it back and the system throws it out repeatedly. Then they finally try to fix it and pay 100% (supposed to pay % of allowed - like a massive error on their part) but they pay the OON doctor not me....more phone calls. It is like a full time job. I had to appeal to OPM to get it cleared up. The cost of your time is high. Plus your OON dr considers increasing your cash price after seeing the huge check Aetna sent. Albeit the dr did have to give it back.
3. Normal claims? this week they paid the dr instead of me. Geesh. More phone calls. And tried to tell me my OON claim is in network and provider needs to file it. Here we go again......

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?

Because is some cities the best providers ie PTs or ADHD providers don't take insurance at all. So we need out of network reimbursement.

Secondly you get dental.

When I lived in DC and was younger, I loved Kaiser, too! Moved out of the area and signed up for MHBP standard which has been great. I’d love to do a high deductible plan and build an HSA, but when I did the math of what insurance paid over the last few years (excluding what they paid for preventive care), it was a significant amount each year due to an ER visit and then speech therapy for one kid. I am considering switching to MHBP Value, but it’s looking like it will be a wash compared to Standard, so I’ll probably stick with Standard. I do NOT want any plan that uses United Healthcare. They were horrible to deal with and never wanted to pay claims.

Anonymous wrote:No one has mentioned Kaiser, but we love it! I paid exactly $0 for my 3 pregnancies and births. ($30 copay to get pregnancy confirmed and then absolutely everything else was free, even the hospital stay). We especially love their urgent care system. And we've liked all our doctors and pediatricians.

But yes, switching to Kaiser would mean all new doctors if you're new to Kaiser. You can only see Kaiser doctors. And they aren't into therapy.

Kaiser is the worst. Only worth it if you never have to see specialists. In other words, if your health care requires nothing outside of typical, go for it.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I love Kaiser! Very reasonable. All labs handled in house. I was very impressed with my prenatal care and birth experience. We now have a truly wonderful pediatrician. So easy to schedule and reschedule appointments in their app. Plus, I get a $500 gym credit and $275 in health funds.

Just double checked and it is $375! And your spouse can also do it.

Ohhh how do you get the gym credit?

+1 I'd also like to know - and is it $500 total or for each you and spouse?

Anonymous wrote:

Anonymous wrote:I love Kaiser! Very reasonable. All labs handled in house. I was very impressed with my prenatal care and birth experience. We now have a truly wonderful pediatrician. So easy to schedule and reschedule appointments in their app. Plus, I get a $500 gym credit and $275 in health funds.

Just double checked and it is $375! And your spouse can also do it.

Ohhh how do you get the gym credit?

Anonymous wrote:Has anyone figured out what makes BCBS standard better than basic? Xxx amount of reimbursement, a certain condition, etc?

out of network reimbursement- many of our doctors don’t take insurance.

Has anyone figured out what makes BCBS standard better than basic? Xxx amount of reimbursement, a certain condition, etc?

Anonymous wrote:we fled GEHA last year. they are horrendous. i work at an agency that allows enrollment under the Foreign Service Benefit Plan and it is FABULOUS.

Same. It took a little getting used to not having the mostly copay model and rather the mostly coinsurance model. I wanted to be in it for at least a year since apparently you can then have it for life, even if you go to a non-national security agency. It's also made me more aware of how much healthcare actually costs. I switched last year after another significant rate hike for BCBS Standard.

Big fan of Kaiser but I understand a lot of people don’t like HMOs. No complaints from me, though.

I like Kaiser too, it is simple to get care and the out of pocket expenses are low. I think I paid $100 copay for my MRI and the wait time was within 10 days. My SIL and my son had hard times getting MRI appointments and the copays were $500 - $1000 with their respective plans.

Anonymous wrote:I love Kaiser! Very reasonable. All labs handled in house. I was very impressed with my prenatal care and birth experience. We now have a truly wonderful pediatrician. So easy to schedule and reschedule appointments in their app. Plus, I get a $500 gym credit and $275 in health funds.

Just double checked and it is $375! And your spouse can also do it.

I love Kaiser! Very reasonable. All labs handled in house. I was very impressed with my prenatal care and birth experience. We now have a truly wonderful pediatrician. So easy to schedule and reschedule appointments in their app. Plus, I get a $500 gym credit and $275 in health funds.

Anonymous wrote:

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

DP. I’m switching to MHBP Standard. If you’ve had any experience with their OON claims process, could you please share feedback?

We hade MHBP and they wouldn’t fill my prescription for retin a for after cystic acne because it was also used cosmetically. I think the only way forward was we had to jump to accutane.