Open Season for Health Insurance

[chance8846]

I’m surprised on the lack of GEHA users on here so far.

I’m on the GEHA self only HDHP. Next year’s premium is going up $5/pp and the deductible is increasing by $50 for the year. It’s still the best value for me compared to all the other FEHB plans.

 

[Phillytroll69]

For those with family has Aetna had similar in network since that's mhpb or whatever...kinda liking the half price premiums

 

[blockdenied]

Yeah but bcbs is unmatched in going to bat for you vs the others

 

[corn4ahead]

I’ve been geha standard the whole time. Best plan available. I’ve had two kids in two different states and didn’t pay anything. The deductible is also relatively low when using out of network providers. Now I’m on the HDHP geha since I don’t see us going to the doctors much. Building up that HSA balance and it’s great. The net difference in deductible is only like $500 and after that, the HDHP actually covers a higher percentage than the standard.

I was debating HDHP this year. Does the HSA grow pretty quick ?

 

[DankVectorz]

I’ve been very happy with BCBS so far. My daughter’s birth only cost us $150 or something like that and last year she was in pediatric ICU for 5 days with RSV and it only cost us $250. No hassles ever so far. Haven’t done much research into anything else though so can’t compare.

 

[Raise when?]

Yeah but bcbs is unmatched in going to bat for you vs the others

Yeah I’ve had hundreds of thousands covered by bcbs, with 2 kids now I can’t switch

 

[mspmn]

I’m surprised on the lack of GEHA users on here so far.

I've been with GEHA HDHP for years. They're great until you actually have to use them for anything other than a routine visit. This year had been horrendous.

I needed a pricey prescription - denied, prior authorization required. Doctor submitted paperwork - denied, data missing. Doctor appealed stating data they wanted was right at the top of the paperwork they submitted - denied, doctor can't appeal, only policyholder can appeal. I wrote a letter stating the exact same thing my doctor said - denied, didn't use official appeal form. I submitted the official form - denied, now they required more info from the doctor. We gave up on that one and found an ok alternative.

I went to an eye specialist. Their website showed the provider and the facility were in network. Claim denied - provider not covered. I called and spoke to a rep who acknowledged the provider was in network and "it's really weird" that they denied they claim. They were completely useless in solving the problem. I submitted an official appeal, two months later I get a letter basically saying "our bad, that provider is covered, we'll pay them."

I needed a minor surgical procedure done. Claim denied - procedure not preauthorized. I have a letter from them showing the procedure was preauthorized three weeks before the claim. This was after the preauthorization was initially denied and I had to appeal that decision and my doctor had to send in more documentation. I called and another useless rep stated they saw the preauthorization and would submit it for processing. One month later, claim still denied. Official appeal is still in process on that one.

I had been a big supporter of GEHA. Once you hit the deductible, the 5% copay is amazing. But with all the headaches of trying to get them to pay for claims this year, I'm going somewhere else.

 

[Kramer]

For families, BCBS can't be beat. My kids spent some time in the NICU and we paid $150??? Emergency appendicitis $200...surgeries $150. Honestly, it seemed so insignificant I can't remember exactly but I was glad to not have a high deductible/co-insurance plan

 

[TimShady]

I've been with GEHA HDHP for years. They're great until you actually have to use them for anything other than a routine visit. This year had been horrendous.

I needed a pricey prescription - denied, prior authorization required. Doctor submitted paperwork - denied, data missing. Doctor appealed stating data they wanted was right at the top of the paperwork they submitted - denied, doctor can't appeal, only policyholder can appeal. I wrote a letter stating the exact same thing my doctor said - denied, didn't use official appeal form. I submitted the official form - denied, now they required more info from the doctor. We gave up on that one and found an ok alternative.

I went to an eye specialist. Their website showed the provider and the facility were in network. Claim denied - provider not covered. I called and spoke to a rep who acknowledged the provider was in network and "it's really weird" that they denied they claim. They were completely useless in solving the problem. I submitted an official appeal, two months later I get a letter basically saying "our bad, that provider is covered, we'll pay them."

I needed a minor surgical procedure done. Claim denied - procedure not preauthorized. I have a letter from them showing the procedure was preauthorized three weeks before the claim. This was after the preauthorization was initially denied and I had to appeal that decision and my doctor had to send in more documentation. I called and another useless rep stated they saw the preauthorization and would submit it for processing. One month later, claim still denied. Official appeal is still in process on that one.

I had been a big supporter of GEHA. Once you hit the deductible, the 5% copay is amazing. But with all the headaches of trying to get them to pay for claims this year, I'm going somewhere else.

Curious if you’ve had GEHA Standard in the past with similar headaches or if they’re specific to the HDHP plan. I’ve had Standard for 12 years and had to jump through hoops here and there but overall have been very satisfied. For example had 4 kids for free and premiums this year are $2,300 less than BCBS Basic for self+family. I was looking at HDHP possibly to maximize tax advantaged savings.

 

[Homsar]

I've been with GEHA HDHP for years. They're great until you actually have to use them for anything other than a routine visit. This year had been horrendous.

I needed a pricey prescription - denied, prior authorization required. Doctor submitted paperwork - denied, data missing. Doctor appealed stating data they wanted was right at the top of the paperwork they submitted - denied, doctor can't appeal, only policyholder can appeal. I wrote a letter stating the exact same thing my doctor said - denied, didn't use official appeal form. I submitted the official form - denied, now they required more info from the doctor. We gave up on that one and found an ok alternative.

I went to an eye specialist. Their website showed the provider and the facility were in network. Claim denied - provider not covered. I called and spoke to a rep who acknowledged the provider was in network and "it's really weird" that they denied they claim. They were completely useless in solving the problem. I submitted an official appeal, two months later I get a letter basically saying "our bad, that provider is covered, we'll pay them."

I needed a minor surgical procedure done. Claim denied - procedure not preauthorized. I have a letter from them showing the procedure was preauthorized three weeks before the claim. This was after the preauthorization was initially denied and I had to appeal that decision and my doctor had to send in more documentation. I called and another useless rep stated they saw the preauthorization and would submit it for processing. One month later, claim still denied. Official appeal is still in process on that one.

I had been a big supporter of GEHA. Once you hit the deductible, the 5% copay is amazing. But with all the headaches of trying to get them to pay for claims this year, I'm going somewhere else.

Very similar to my experience. Tried GEHA HDHP one year, never again.

 

[ClearanceClarence]

A lot of people say they’re considering switching to MHBP, but haven’t read a ton of first hand experiences from people who’ve already used them for a few years. It seems the biggest holdup could be major things like hospitalizations, surgeries, etc. where BCBS is a copay and MHBP is 10% coinsurance. It’d be nice to hear from someone that’s had them and what their bills and customer experiences have looked like.

 

[AS88]

Some things to watch out for when choosing a plan; I prefer to stay away from plans that make you pay a percentage, simply because I don't know what a Dr. will charge and I'll be on the hook for that percentage. Below you can see BCBS which has dollar amounts listed for Primary Care Visit, Specialist Visit, etc. So you know what you'll owe when you go. The GEHA HDHP plan is a lot cheaper per month, but you owe 5% of the Primary Care Visit, etc. So it may end up being less than a Primary Care Visit with BCBS but you have no way of knowing until the bill comes.

I found a plan available in my state that is less than BCBS (by a lot) but also doesn't use percentages. It's worth shopping around for a similar plan with a lower price, especially if you don't go to the Dr. all that often. I know a ton of people who blindly go with BCBS each year (which is fine, it's a good plan) but they could save a lot of money each month if they looked into the other plans.

 

[GroundClutter]

We have had FEB Blue Focus for two years now and will probably keep it.

It is copays for some services and coinsurance for others with a pretty low deductible. Only negative is the limit on office visits but if you exceed the limit you still pay the negotiated rate not what the Dr wants to charge.

Same with the coinsurance, you're paying a percentage of the negotiated rate. It's pretty comical seeing what the Dr or facility wants to charge vs what the insurance says they'll pay on the EOB.

 

[GulfCharlie]

Some things to watch out for when choosing a plan; I prefer to stay away from plans that make you pay a percentage, simply because I don't know what a Dr. will charge and I'll be on the hook for that percentage. Below you can see BCBS which has dollar amounts listed for Primary Care Visit, Specialist Visit, etc. So you know what you'll owe when you go. The GEHA HDHP plan is a lot cheaper per month, but you owe 5% of the Primary Care Visit, etc. So it may end up being less than a Primary Care Visit with BCBS but you have no way of knowing until the bill comes.

I found a plan available in my state that is less than BCBS (by a lot) but also doesn't use percentages. It's worth shopping around for a similar plan with a lower price, especially if you don't go to the Dr. all that often. I know a ton of people who blindly go with BCBS each year (which is fine, it's a good plan) but they could save a lot of money each month if they looked into the other plans.

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Decent research, helping to educate people on things such as this is something we need more and more of. People will not know unless they starting reading or at least see a compendium of information. The last few days and I know 32andBelow has been digging into it a lot as well, have lead me to educate myself more and more on Health Insurance. BCBS is becoming more and more expensive each year.

 

[Horny4.65]

32andBelow I’ve been with GEHA for years. First HDHP now standard family (3). I was thinking about blindly going into BCBS because of some issues with my provider dropping United Healthcare.

Thank you for your info. Can you verify MHBP is under the Aetna network? I was looking a bit online but you may know a lot better.

Thank you!

 

[Pointsixtynine.10]

Yeah I’ve had hundreds of thousands covered by bcbs, with 2 kids now I can’t switch

Haha yup. They got me for the foreseeable future. 2 kids that go to the doctor pretty regularly… pain in the ass switching and new doctors and all that other stuff easier to just pay whatever they’re charging. It’s all been pretty hassle free.

 

[32andBelow]

32andBelow I’ve been with GEHA for years. First HDHP now standard family (3). I was thinking about blindly going into BCBS because of some issues with my provider dropping United Healthcare.

Thank you for your info. Can you verify MHBP is under the Aetna network? I was looking a bit online but you may know a lot better.

Thank you!

Yah it’s Aetna. Everywhere I’ve checked in my world takes it. Another key if anyone calls around to your local doctors. Use the world Aetna or United health or whatever the network is. Don’t try to ask about whatever niche plans. Many people don’t know what GEHA or MHBP is. Everyone knows shay blue cross is

 

[mspmn]

Curious if you’ve had GEHA Standard in the past with similar headaches or if they’re specific to the HDHP plan. I’ve had Standard for 12 years and had to jump through hoops here and there but overall have been very satisfied. For example had 4 kids for free and premiums this year are $2,300 less than BCBS Basic for self+family. I was looking at HDHP possibly to maximize tax advantaged savings.

I have not had the Standard option to compare. This was this first year I had to use the insurance beyond an annual physical, a cheap rx and maybe a Minute Clinic type of visit or two.

 

[ClearanceClarence]

Yah it’s Aetna. Everywhere I’ve checked in my world takes it. Another key if anyone calls around to your local doctors. Use the world Aetna or United health or whatever the network is. Don’t try to ask about whatever niche plans. Many people don’t know what GEHA or MHBP is. Everyone knows shay blue cross is

Gonna have to try this. My wife sees a specialist and on the MHBP find a provider tool it says they’re in network. I tried calling them today to confirm and they were admit they aren’t in network with MHBP, but I didn’t mention Aetna.

 

[TimShady]

MHBP and GEHA don’t use their own networks and many providers never heard of them. You have to use the specific network name when asking or use the provider search tool. Think of it like Mint Mobile uses T-Mobile network.