Moving with Ex-employer health care insurance

[travelover]

I currently have health care from my former employer (BCBS) and plan to move from Michigan to Washington next year when DW will retire, with similar coverage.

I'm trying to get my arms around the implications for our health care insurance between now and Medicare. Obviously, we need to talk to our current insurers, but before doing that I'd like to figure out what questions need to be asked and answered.

Is it typical for a large carrier like Blue Cross to have some kind of extended or reciprocal "in network" agreements in other states?

As a worst case scenario, if we had to buy new health insurance locally, would having the ex-employer health care insurance ball things up more than help?

 

[MichaelB]

I currently have health care from my former employer (BCBS) and plan to move from Michigan to Washington next year when DW will retire, with similar coverage.

I'm trying to get my arms around the implications for our health care insurance between now and Medicare. Obviously, we need to talk to our current insurers, but before doing that I'd like to figure out what questions need to be asked and answered.

Is it typical for a large carrier like Blue Cross to have some kind of extended or reciprocal "in network" agreements in other states?

As a worst case scenario, if we had to buy new health insurance locally, would having the ex-employer health care insurance ball things up more than help?

Insurance is a state based product. Your current insurer is not likely to help much when looking for insurance in your new location.

The large insurers, such as BCBS and Aetna, tend to offer products in different tiers, that include lower priced policies with small, regional / local service networks, and more expensive policies with large national networks. BCBS calls their large network "Blue Card". They don't offer these policies in every state, though.

If you know where you will be living you can go to health sherpa and look at policies available now. This October open enrollment begins and you will see what policies will be available for 2016.

 

[fosterscik]

I envision a similar arrangement when I finally stop my OMY syndrome. In my plan I have the wording:

BlueCard® Program - BlueCard is a national program offered through the Blue Cross and Blue Shield Association, an association of independent Blue Cross® and Blue Shield® plans, that enables Plan participants to obtain in-network health care service benefits while traveling or living outside of xxxxxxx. With this program, participants have access to a national network of Blue Cross Blue Shield plan contracted healthcare providers, called "Blue Plan" providers. Plan participants have access to the BlueCard Program across the country. This seamless program affords participants the ability to use any “Blue Plan” network doctor or network hospital in any location.
To find a participating provider, participants can access the Network and BlueCard directories through the Plan’s website at http://provider.bcbs.com/ or call the appropriate telephone number listed on the front inside cover of this Plan Document. Provider participation may change from time to time. It is important for participants to verify provider participation prior to receiving services.

I haven't chosen a final retirement location yet so I haven't scoped out the number of providers in that (unknown) area yet. Perhaps you can check for participation by your BCBS plan and look for doctors where you plan to retire.

 

[fosterscik]

I thought I 'd add that I see one major benefit to continuing in my employers plan after retirement and that's the coverage it provides for travel.
My plan, at least, is not subsidized by my soon-to-be exemployer. I do get the benefit of a group rate but it will still cost me ~$500/month/person. I suspect i could get a comparable or perhaps lower rate on an exchange but they tend to be tied to a local group of doctors/hospitals and may not provide any out-of-state coverage. The Blue card program has 50 state in-network coverage (and I believe my plan would also cover international travel as it currently does while I'm an employee - I have to confirm this for retirees however).
My advice - check your benefits carefully before you make the decision. My plan makes this an irrevocable decision (ugh!) - if I do not enroll initially in the plan I can't go back on the plan later.

 

[travelover]

Thanks for the replies, thus far. I did call Human Resources at Mega and they indicated that it should not be an issue with BCBS. I have another choice, which is Michigan based Health Alliance Plan, and HR indicated that that insurer would be an issue if I had chosen it.

The HR rep said if I call BCBS, they will provide me with a list of doctors / health systems that will accept their. Next step is to call BCBS and see if what the HR rep said was true.

 

[MichaelB]

Thanks for the replies, thus far. I did call Human Resources at Mega and they indicated that it should not be an issue with BCBS. I have another choice, which is Michigan based Health Alliance Plan, and HR indicated that that insurer would be an issue if I had chosen it.

The HR rep said if I call BCBS, they will provide me with a list of doctors / health systems that will accept their. Next step is to call BCBS and see if what the HR rep said was true.

So, does that mean you can take your current employer policy with you when you move?

 

[travelover]

So, does that mean you can take your current employer policy with you when you move?

Yes, that is what the HR rep told me. Indeed, I found a coverage website for Michigan BCBS and I put in my policy type (group PPO) and the city where I want insurance and it lists doctors and hospitals that take that insurance.

 

[MichaelB]

Yes, that is what the HR rep told me. Indeed, I found a coverage website for Michigan BCBS and I put in my policy type (group PPO) and the city where I want insurance and it lists doctors and hospitals that take that insurance.

I musunderstood your OP to mean you needed a new policy after moving - not the case. Is your policy Bluecard? Does the card have a little blue briefcase with PPO written in it, or does the word "BlueCard" appear anywhere?

 

[travelover]

I misunderstood your OP to mean you needed a new policy after moving - not the case. Is your policy Bluecard? Does the card have a little blue briefcase with PPO written in it, or does the word "BlueCard" appear anywhere?

Yes it has a little briefcase with PPO written on it. What is the significance of that?

 

[Gotadimple]

Yes it has a little briefcase with PPo written on it. What is the significance of that?

It means that any doctor/hospital that accepts BCBS coverage will accept you as a patient. It is seamless coverage, that is, you don't need to do any paperwork or submit bills for reimbursement. The provider handles it by sending it into the local BCBS and they process the claim on behalf of the Michigan plan. Check your plan documents for a more expansive explanation.

This is an arrangement between all the BCBS plans. The reimbursement rates negotiated by the local plan are used to process claims for other members who belong to different BCBS plans. That saves both the member and the plan $$.

 

[travelover]

It means that any doctor/hospital that accepts BCBS coverage will accept you as a patient. It is seamless coverage, that is, you don't need to do any paperwork or submit bills for reimbursement. The provider handles it by sending it into the local BCBS and they process the claim on behalf of the Michigan plan. Check your plan documents for a more expansive explanation.

This is an arrangement between all the BCBS plans. The reimbursement rates negotiated by the local plan are used to process claims for other members who belong to different BCBS plans. That saves both the member and the plan $$.

Great news. Does this also imply that those accepting the coverage are considered to be "in network"?

 

[Gotadimple]

Great news. Does this also imply that those accepting the coverage are considered to be "in network"?

Not implication - fact. As long as the provider you select in Washington state is in the local BC or BS plan's in network of providers, it is considered in network for the Michigan plan.

Most providers in the populated parts of Washington state maintain a web page and clearly indicate who they have contracts with and if they are considered 'in-network.' Either Premera BlueCross or Regence BlueShield customer service can also help you when you need to find a doctor.

Rita

 

[travelover]

Not implication - fact. As long as the provider you select in Washington state is in the local BC or BS plan's in network of providers, it is considered in network for the Michigan plan.

Most providers in the populated parts of Washington state maintain a web page and clearly indicate who they have contracts with and if they are considered 'in-network.' Either Premera BlueCross or Regence BlueShield customer service can also help you when you need to find a doctor.

Rita

Thanks, Rita. I called Michigan Blue Cross and they said they could help me find a health provider or I could use their website to find one that accepts the Michigan plan. It looks like it should not be a problem. Whew - a load off my mind.

Hopefully DW's retirement coverage is similarly portable.

 

[MichaelB]

That's a nice policy. The BCBS Bluecard is probably the largest private network in the country.