FYI, about 7 weeks ago I had a trip to urgent care which led to a diagnostic ultrasound. (Blue Cross Anthem paid most, but I later got billed for about $300 for the complete visit.) Urgent care physician sent me to the emergency room with ultrasound results in hand thinking I need to be admitted … at the ER they asked why I was sent there, a doctor talked with me for 5 minutes and wrote me a perscription, a nurse came out and gave me a single injection. I was in and out in 30 minutes. Total ER hospital bill was $4600, Blue Cross Anthem paid all but $1800. Pissed me off big time but realized it probably saved my life. Blue Cross was not interested in looking into it further, that's how the system rolls. They paid $2800 for 5 minutes of the doctor's time and a single injection (which I continued with for a week and cost $16 each at the pharmacy.) This is why the system is broken. I got the experience first hand.
Current policy had gradually declined in benefits and I had previously accepted a higher deductible to keep premiums about the same. That decision has now come back to kick my @ss.
After that incident I became a patient of a great doctor, highly recommended and I know why. So now that I need him I find myself current in the political debate … because I want to keep him. So this is a very strong consideration in finding a new policy.
Step One : comparing plans on the exchange.
Spent a total of 20 minutes on CoveredCA website looking through 22 competing plans that my family of 3 qualified for. Range was from a Blue Cross Anthem Bronze at $258/mo to a Kaiser platinum at $1014. Yes, for $258/mo I can insure my family with a maximum out of pocket of $6350. I believe this means if I'm hospitalized for a week that's the most it's going to cost that includes the deductible. Wow.
After the first run through, we chose a Blue Sheild policy at $455/mo with no deductible. It compared exactly with Blue Cross Anthem plan at $567/mo. These rates reflect a premium assistance of $696! Thank you Federal Government. Will dig further into the details of the competing plans and confirm our local doctor, labs & hospital all accept the insurance policy.
From first appearances this could save us about $250/mo. in premiums with the higher plan. No deductible, unlimited lab work and doctors visits at $45 copay. X-ray and imaging at $65 co pay. Perscriptions at $19 copay. This is going to save us a lot.
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