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Old 11-21-2014, 08:22 PM   #21
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So $1800 for the year to keep your doctor. Must be really good.

Most Bronze plans do cover annual physical.

Don't know about flu shots, which I've never taken.
I've had some shaky doctors in the past

The kinda reminds me of looking for features vs costs in a car. What's most important to one person may not be for another. No one perfect answer.

Actually, the way I figure, the amount is more like $1400 a year instead of $1800. ($150 x 12) - $400, as the math.
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Old 11-22-2014, 09:49 AM   #22
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I've had some shaky doctors in the past

The kinda reminds me of looking for features vs costs in a car. What's most important to one person may not be for another. No one perfect answer.

Actually, the way I figure, the amount is more like $1400 a year instead of $1800. ($150 x 12) - $400, as the math.
Your doctor might leave the plan, the practice, or the profession, but you still get to pay the higher premiums. Tough decision.
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Old 11-22-2014, 10:47 AM   #23
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If it is only to continue seeing a primary care physician, you could keep the cheaper plan and pay the doctor cash out of pocket.
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Old 11-22-2014, 10:57 AM   #24
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Your doctor might leave the plan, the practice, or the profession, but you still get to pay the higher premiums. Tough decision.
Yes, a tough decision.

The way I figure, if the doctor leaves (the practice, profession, or moves to far away) then all bets are off and I'd probably go back to square one and start from the cheapest plan first.

But I do like having a doctor that I'm comfortable with when he puts on the rubber gloves

An analogy I guess is like those who invest if actively managed funds. (Yes, I guess there are those who don't index ). If the fund manager decides to jump ship what do you do? That happens all the time. Do you follow the manager? Or do you stick it out with your current fund company? or go to indexing?
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Old 11-22-2014, 10:59 AM   #25
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This is a tough one, and this is what I plan to do:

1. PPO all the way - no HMO
2. Look for a plan where my specialist doctors are in network for the new plan- don't care so much about the PCP since all he does is a quicky annual physical, 2x a year blood workup, and shots
3. Consider the cost alternatives of paying my one specialist as out of network vs working with him directly to come up with a fee schedule vs going with a higher cost ACA plan where he is in network. But there is no way I'd give up this specialist. I've been with him for 12 years and I know my care could not have been any better.
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Old 11-22-2014, 11:02 AM   #26
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If it is only to continue seeing a primary care physician, you could keep the cheaper plan and pay the doctor cash out of pocket.
I thought about that too. Just paying the doctor out of pocket. Of course, that's assuming the number of visits per year are stable. Otherwise, the more visits, the more the cost difference becomes a wash.

To be more specific that choice is between a Blue Choice PPO or Blue PPO where the Choice means the insurance policy is picky and only has small selection of in-network doctors and facilities.
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Old 11-22-2014, 11:25 AM   #27
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In my area, the BCBS plan choices for PPOs include a (much) cheaper option and a more expensive option (same network, similar coverage, more than 2X the cost of my previous non-ACA plan). None of our doctors participate in the cheaper plan. We could probably change doctors and not be worse off.


However, the difference that keeps us in the more expensive network is the hospitals. None of the "good" hospitals are in network on the cheaper plan. Only bad ones. The good ones are all in network on the more expensive plan.


You don't want to go out of network because the financial penalties of doing so are painful.
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Old 11-22-2014, 11:58 AM   #28
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This is the same BCBS approach in Florida. The top tier, broad national network (BlueCard) policy (BlueOptions) and a restricted, PPO network policy group (BlueSelect). At first glance they appear to have more than 20 policies between them, in reality it is two policies with 20 or so different combinations of deductible, copay and total out of pocket.

It is easy to browse their network for providers in the BlueCard network, much more difficult to do so for the restricted network. This is obviously intentional. Both the smaller network and the provider payment scheme are obscure - not an encouraging sign. It seems to be the norm for the industry. Selfishly, I can't wait for Medicare.
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