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BCBS Standard vs. BCBS Basic

Messages
30
I've been looking into which insurance option I'm going to take for my family, and standard looks like the way I'm heading. I just had a quick question.

For standard, there aren't regular co-pays for things (emergency care) and they instead have a percentage of the allowance as payment. Do these allowance payments tend to be cheaper than the co-pays on the basic, or do they come out as more? I can only find that allowances vary per institution, but no numbers anywhere as to how much they cost. So if anyone has standard and could let me know around how much those cost, that'd be great.
 
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I had standard for a year. Then basic for a year. I had the same exact visits, as it’s routine what I need. Basic not only costed less, but all the out of pocket/copay added up together was less. From the little I know, standard is better if you tend to visit doctors that are out of network. If you’re going to be in network anyways, I can’t see how standard is better. Again, is this from the absolute bare minimum knowledge I have on insurance.

I had a MRI that cost me $100 with the basic plan. For the standard plan, it would cost 15% with a preferred location. If the MRI cost $675 with standard, then you would pay almost $100. But if it costs more, which it can go up to the thousands, then you’re gonna end up paying more.

CookieMonster

Member
Messages
6
I had standard for a year. Then basic for a year. I had the same exact visits, as it’s routine what I need. Basic not only costed less, but all the out of pocket/copay added up together was less. From the little I know, standard is better if you tend to visit doctors that are out of network. If you’re going to be in network anyways, I can’t see how standard is better. Again, is this from the absolute bare minimum knowledge I have on insurance.

I had a MRI that cost me $100 with the basic plan. For the standard plan, it would cost 15% with a preferred location. If the MRI cost $675 with standard, then you would pay almost $100. But if it costs more, which it can go up to the thousands, then you’re gonna end up paying more.
 
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Chimoty

Member
FAA
Messages
3
Facility
ZOB Cleveland Center
Only a suggestion as I’ve had both, but I prefer what I have now. I have Basic with an FSA of $2000. Annually, that’s still less than I’d pay for standard. I pay less for my health insurance, and I get paid back for all of my health costs for my family. I pay more for normal visits and some %’s end up higher, but the FSA pays me back tax-free throughout the year.
 
Messages
30
Only a suggestion as I’ve had both, but I prefer what I have now. I have Basic with an FSA of $2000. Annually, that’s still less than I’d pay for standard. I pay less for my health insurance, and I get paid back for all of my health costs for my family. I pay more for normal visits and some %’s end up higher, but the FSA pays me back tax-free throughout the year.
I'm not 100% sure on how the FSA works. Do you put a set amount amount of money into it and you can use that money to pay for medical expenses? My previous job had something similar, but any money you didn't use, you lost. Is this the same way?
 

Chimoty

Member
FAA
Messages
3
Facility
ZOB Cleveland Center
I'm not 100% sure on how the FSA works. Do you put a set amount amount of money into it and you can use that money to pay for medical expenses? My previous job had something similar, but any money you didn't use, you lost. Is this the same way?

You establish a certain amount every year that’s taken out biweekly from your paycheck. It’s not taxed. So, let’s say you put $50 aside each paycheck for $1300 a year. From the beginning of the year, you can start using your full balance. If you have to get new glasses in January, you can use up to your full amount even though you haven’t paid it all for the year, yet. There’s an app on your phone that you can take a picture of your receipt or statement and get paid back within days. If you have a balance near the end of the year, you can buy medicines or other products to use it up. I use it on prescriptions, my wife’s products, glasses and our vision and dental care.
 
Messages
30
You establish a certain amount every year that’s taken out biweekly from your paycheck. It’s not taxed. So, let’s say you put $50 aside each paycheck for $1300 a year. From the beginning of the year, you can start using your full balance. If you have to get new glasses in January, you can use up to your full amount even though you haven’t paid it all for the year, yet. There’s an app on your phone that you can take a picture of your receipt or statement and get paid back within days. If you have a balance near the end of the year, you can buy medicines or other products to use it up. I use it on prescriptions, my wife’s products, glasses and our vision and dental care.
Not taxed, that's going to make me do exactly what you are doing. Looking at what the FSA covers gives me hope that I could spend it all every year, it covers almost everything. Thanks for the insight.
 

Motodog

Member
Messages
89
You establish a certain amount every year that’s taken out biweekly from your paycheck. It’s not taxed. So, let’s say you put $50 aside each paycheck for $1300 a year. From the beginning of the year, you can start using your full balance. If you have to get new glasses in January, you can use up to your full amount even though you haven’t paid it all for the year, yet. There’s an app on your phone that you can take a picture of your receipt or statement and get paid back within days. If you have a balance near the end of the year, you can buy medicines or other products to use it up. I use it on prescriptions, my wife’s products, glasses and our vision and dental care.
Not sure, can check, if HSA is available. Health Savings Acc. Best deal going, better than 401k, because it’s a trifecta-tax deductible, grows tax deferred, AND is tax free on withdrawal if used for med
 

AnyTrafficPleaseAdvise

Trusted Contributor
Messages
246
I have standard right now and I'm considering the switch to basic to save $1,200 a year in premiums. I don't go to the doctor's office very often, so I think it makes sense for me to do it. I've read the posts above, does anyone else have insight on making the switch and pros and cons of both? It looks like even with higher copays, I'll end up paying less unless I have an ER visit. That's my one concern; I don't want to be under insured if something goes terribly wrong.
 

tylertrend

Trusted Contributor
Messages
152
I've been under the Basic family plan for years and it is not a plan easily beaten. $8000 outpatient surgery? Ok, that'll be $200 out of pocket. Cheap PT, free annual bloodwork, etc. It's a good plan.
 

Horny4Vectors

Forum Sage
FAA
Messages
442
Facility
N90 New York Tracon
The FSA addition to Basic is perfect. Like others said, less than the cost of Standard and you get out of pocket expenses reimbursed. We have it set up where it automatically pays out whenever the insurance is ran. (Doctor, prescription, etc). The last 2 years we’ve used the full allotment to cover 2 of my kids braces. Definitely the way to go
 

slim

Active Member
Messages
89
Doesn't GEHA use percentages? I was never a fan of that system.
I don't remember the exact breakdowns but I did do a lot of research before choosing one. As a family, we don't go to the doctors much at all but this year we had to go a lot for some problems and I was very glad with what I actually had to pay out of pocket compared to what was billed. I believe there are different percentages for different procedures but once you hit the out of pocket maximum, then it is 100% covered. From everyone I've talked to at work, anyone that has done some research goes with GEHA. It almost seems like many people to with Blue Cross Blue Shield because of name recognition and do not wish to do some research.
 

tylertrend

Trusted Contributor
Messages
152
I don't remember the exact breakdowns but I did do a lot of research before choosing one. As a family, we don't go to the doctors much at all but this year we had to go a lot for some problems and I was very glad with what I actually had to pay out of pocket compared to what was billed. I believe there are different percentages for different procedures but once you hit the out of pocket maximum, then it is 100% covered. From everyone I've talked to at work, anyone that has done some research goes with GEHA. It almost seems like many people to with Blue Cross Blue Shield because of name recognition and do not wish to do some research.
I've looked at GEHA before but it seemed like a wash in the end. Maybe different depending on how many in your family? Plus, I've always had good experiences with BCBS customer service and sorting out errors.
 

Alpha_bravo2

Trusted Contributor
Messages
506
Doesn't GEHA use percentages? I was never a fan of that system.
GEHA recently came out with GEHA elevate plus ( I think it's actually administered by UHC), it's comparable to BCBS basic rates for services but cheaper, and allows you to earn more on your health savings card.

I had the elevate plus plan for 2020 and was pretty happy with them.
 
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