Florida Blue making a profit in the marketplace

Well there is certainly pressure on doctors whose group is bought by a hospital or hospital group which the original group avoided by involving BC. I hated it when it happened in my group and it likely sped my ER.

I wonder how much less pressure there is though with this arrangement? The closest thing in my experience was a Medicare Advsntage plan who had an np whose job was to take care of members in rehab facilities ( with their MD caring for them too). I know there was pressure on her to discharge these people as soon as possible and she had to justify outliers. I don't think the members got bad care and she was a very good clinician who advocated when needed. I can see similar pressures arising here and maybe not every provider fights so hard for thr patients especially if there is a bonus structure involved
 
Glad to read this. Florida is where we're considering relocating to and Blue Cross Blue Shield is likely the provider we'd have on exchange.
 
As I have said many times. Our premiums when down from $345 in 2015 to $150 (for 2 people 63/58) in 2017 (After Subsidies). We have a GREAT silver plan with Florida Blue ($0 Deductible $4k OOP) The fact they are making a profit makes me smile (for a change when talking about healthcare). 2018 may be a different story.
 
ShokWaveRider said:
As I have said many times. Our premiums when down from $345 in 2015 to $150 (for 2 people 63/58) in 2017 (After Subsidies). We have a GREAT silver plan with Florida Blue ($0 Deductible $4k OOP) The fact they are making a profit makes me smile (for a change when talking about healthcare). 2018 may be a different story.
Click to expand...

Is that with a premium subsidy and/or cost-sharing? Our rates for ages 49 and 53, if we bought now (we live in FL) would be $861/mo (for two people) with a $12,700 max OOP (HSA plan). This is without any subsidies/cost-sharing.

Maybe our county is especially expensive compared to yours? I don't get it.
 
simple girl said:
Is that with a premium subsidy and/or cost-sharing? Our rates for ages 49 and 53, if we bought now (we live in FL) would be $861/mo (for two people) with a $12,700 max OOP (HSA plan). This is without any subsidies/cost-sharing.

Maybe our county is especially expensive compared to yours? I don't get it.
Click to expand...

That is what we pay after all subsidies (Whatever they may be). We hire a company to do it for us every year. The Bailey Group, they deal direct with Florida Blue and the ACA Exchange. we never had to talk to anyone other than them. It is definitely the way to go.
 
ShokWaveRider said:
That is what we pay after all subsidies (Whatever they may be). We hire a company to do it for us every year. The Bailey Group, they deal direct with Florida Blue and the ACA Exchange. we never had to talk to anyone other than them. It is definitely the way to go.
Click to expand...

Thanks so much!!! Hopefully we will still be able to use them when we eventually retire. Only time will tell.
 
Lisa99 said:
Glad to read this. Florida is where we're considering relocating to and Blue Cross Blue Shield is likely the provider we'd have on exchange.
Click to expand...

So this is good news. Are we all planning to move to Florida now? :dance:
 
Obviously the CEO of Blue Cross Florida knows what he is doing. We need to send him around the country to educate and revitalize the other health plans. :)
 
I ran some numbers with the Florida ACA plans and it looks like the premiums will be around 1500 monthly with 7,000 deductible per person. Not much difference than what I am currently paying (1700/month 2 people 62 years and 57 years). However, I believe next year premiums HERE will be close to 2000/month. All these premiums are WITHOUT subsidies.

In reviewing the Florida plans it looks like only HMO's and EPO's are available. I have not had an HMO plan in over 35 years. The were not poplular in the 80's and I am surprised they are back. Looks like an EPO is a hybrid between an HMO and PPO plan.

Anyone in Florida care to provide feedback if you are currently covered under the ACA in Florida. Are the HMO plans as restrictive as the ones in the 80's? Are there many dr's in the ACA network or is it a carved down plan? Are you satisfied with the care you receive?
 
Florida BCBS has three plans available. An HMO, a limited network plan (Blue Select) and a broad network plan (Blue Options). The broad network is their BlueCard, which is the same used across the country for other group plans.

Each of these is offered with many different combinations of cost sharing, so it appears as 60 or so offerings, but it is really 3 plans.

The EPO is really a PPO that has an EPO pediatric dental component. For adult medical care it is all PPO. The liomited network plan seems to use an approach BCBS is using elsewhere. They have a restricted local network in the regioin where the plan is offered, but still access a broader national network away from home.

Florida Blue has a tool you can use to gauge the provider network, here https://providersearch.floridablue.com/providersearch/pub/index.htm .
 
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MichaelB said:
The EPO is really a PPO that has an EPO pediatric dental component. For adult medical care it is all PPO. The liomited network plan seems to use an approach BCBS is using elsewhere. They have a restricted local network in the regioin where the plan is offered, but still access a broader national network away from home.
Click to expand...

You just got my attention with national coverage since we travel a lot.

To make sure I'm understanding, the FL BCBS EPO includes coverage in their national network? If so, hallelujah!

Our current plan only covers us in NV so when my back went out we had to drive 5 hours from Arizona to NV. It was agonizing. I don't want to stop traveling but it's scary to not have coverage of any kind away from home.
 
Interesting
 
National coverage is important to us also. Looks like the premium for us is 1630/month with Blue Option plan that is HSA compliant.
 
Lisa99 said:
You just got my attention with national coverage since we travel a lot.

To make sure I'm understanding, the FL BCBS EPO includes coverage in their national network? If so, hallelujah!
Click to expand...
Yes, the Blue Options plan. It's the one we've used. :) It is, of course, also the priciest, but it includes the BlueCard Network, which is the same network large groups get and has very good coverage across the US. You can go to the Florida Blue website to see the coverage, or just Google "BCBS BlueCard" and I'm sure you will get lots of useful info on the network reach.
 
littleb said:
....Anyone in Florida care to provide feedback if you are currently covered under the ACA in Florida. Are the HMO plans as restrictive as the ones in the 80's? Are there many dr's in the ACA network or is it a carved down plan? Are you satisfied with the care you receive?
Click to expand...

I'm a full pay customer with an HSA plan in the western FL Panhandle (NW FL for the locals...). Florida Blue was able to secure good contracts with the largest non-profit hospital group in my area, and that operation has bought out a lot of the local docs. The ones that have not signed Florida Blue contracts have given me pricing comparable to what I would be paying if they were still in the network.

While I'm spending more on health care than I did when I was on an employer plan, I'm happy with the quality of care available.

I think $1200/mo. is steep for ACA mandated "benefits" plus what is essentially catastrophic coverage, but I also know how costly a catastrophe can be :(, so I shut up and pay :)
 
Our Plan is Blue Select. But we trip over doctors here when we walk down the road in St. Augustine, Fla.. It is the BEST plan we have had for years. But perhaps it is short lived as I have a pre-existing condition.
 
ShokWaveRider said:
Our Plan is Blue Select. But we trip over doctors here when we walk down the road in St. Augustine, Fla.. It is the BEST plan we have had for years. But perhaps it is short lived as I have a pre-existing condition.
Click to expand...

Why would it be short-lived? It's my understanding that if you never have a payment lapse you can't lose coverage.
 
Lisa99 said:
Glad to read this. Florida is where we're considering relocating to and Blue Cross Blue Shield is likely the provider we'd have on exchange.
Click to expand...

Same here, could accelerate our goal to move to FLA if the marketplace stabilizes. I certainly don't see that happening in my home state.
 
REWahoo said:
Uh oh. "Here be dragons..."
Click to expand...

Sorry if I touched a nerve. No idea how it is controversial. I intentionally don't keep up with the goings on with the current health insurance goings on.
 
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