Join Early Retirement Today
Thread Tools Search this Thread Display Modes
Old 08-20-2016, 04:12 PM   #61
Dryer sheet wannabe
Join Date: Feb 2014
Posts: 17
In SoCal, Covered California offers 2 different PPO networks, Anthem and Blue Shield. Originally when Blue Shield started offering CoveredCa plans, they went to their doctor network and said if you want to be included in our CoveredCA network, we are cutting your reimbursement 30% for all of our plans. Many private physicians opted out of the Blue Shield network. This caused a lot of issues with access. Over the last 2 years, Blue Shield has expanded their network, but it is still smaller/narrower than the one offered to their group plans. Nonetheless, the major research hospitals are all included and the network actually is pretty good now.
Anthem had the broader network originally. However, they started narrowing their network in the last couple of years and there are now a number of specialists who previously took Anthem CoveredCa plans who no longer do. Also, Anthem has proposed a major rate hike for 2017.
Thus, it looks like I'll be switching from Anthem to Blue Shield for PPO access next year.
I've tried to get actual data on the breadth of Anthem vs. Blue Shield's network, but have been unable to find it. They both say to check individual doctors using their tools. I've had a dermatologist and neurologist drop out of Anthem since we enrolled, but good alternatives have been available. Also no problem seeing a world class specialist at UCLA.
If you are willing to sacrifice physician choice and want a HMO, Kaiser is clearly the best in SoCal. However, you will need a good advocate to get you the treatment you want/need in a timely manner. Great specialists available at Kaiser Sunset, but you need to navigate the system. There is a tendency to just stabilize and get rid of the patient as opposed to finding the underlying cause and treating it.
All anecdotal experiences.

rrppve is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off

Similar Threads
Thread Thread Starter Forum Replies Last Post
BCBSTX Canceling PPO Plans for 2016 DFW_M5 Health and Early Retirement 63 12-01-2015 06:11 AM
Doctors not accepting Obamacare? jesaco Health and Early Retirement 80 11-18-2014 09:50 AM
Covered vs. Non-Covered Shares PERSonalTime FIRE and Money 3 07-06-2014 08:25 PM
"Charges not covered" Bikerdude Life after FIRE 27 11-26-2007 09:55 AM


All times are GMT -6. The time now is 11:17 PM.
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2016, vBulletin Solutions, Inc.