Yet another health insurance shopper

[Martha]

I will be shopping multiple states, which is difficult. My current state of residence is Minnesota. Today I tried to set up accounts for spouse and I. Unsuccessfully. They could not verify my identity and some of the identity questions were ambiguous. My spouse's identity was verified the first time through but it failed to allow him to set up an account. The security questions to be able to access your account in case you forget your password were bizzare. Most memorable date in your life? Most memorable person? There is no way I can pick and remember without writing it down answers to nearly every question. After several tries I got a 404 error and we were back at square one. Now it won't verify his identity.

It looks like I have to mail in copies of our driver's licenses and verify the hard way.

However, we could shop before setting up an account. I looked at maybe 20 different policies today. None are what I want. I don't care much about deductibles. What I care about is coverage. Will it cover me out of a network? Every single plan I reviewed from bronze to platinum at best would cover 60% out of network with no maximum out of pocket. Most only covered 50%. So, if I winter in Florida or Texas and have a bike accident I will be liable for at least 40 to 50% of the cost, with no upper limit at all. I still am trying to find out information about the networks but probably they are not nationwide and are all local.

Surprisingly, Minnesota does not have a multi-state plan.

Now to shop in states that do have multi state plans. Unfortunately, most states do not allow you to shop if you don't establish an account. And, you at least have to have a zip code to check options for a particular geographic area.

I think my next step will be to start calling insurance agents. Though, I think I will wait a couple of weeks to let things mellow a bit.

 

[REWahoo]

Martha, I'm sure you are way ahead of me, but if you want to shop TX policies you might want to use the Escapees Mail Service zip code, in Livingston, TX 77399.

 

[Rich_by_the_Bay]

I will be shopping multiple states, which is difficult. My current state of residence is Minnesota. Today I tried to set up accounts for spouse and I. Unsuccessfully. They could not verify my identity and some of the identity questions were ambiguous. My spouse's identity was verified the first time through but it failed to allow him to set up an account. The security questions to be able to access your account in case you forget your password were bizzare. Most memorable date in your life? Most memorable person? There is no way I can pick and remember without writing it down answers to nearly every question. After several tries I got a 404 error and we were back at square one. Now it won't verify his identity.

It looks like I have to mail in copies of our driver's licenses and verify the hard way.

However, we could shop before setting up an account. I looked at maybe 20 different policies today. None are what I want. I don't care much about deductibles. What I care about is coverage. Will it cover me out of a network? Every single plan I reviewed from bronze to platinum at best would cover 60% out of network with no maximum out of pocket. Most only covered 50%. So, if I winter in Florida or Texas and have a bike accident I will be liable for at least 40 to 50% of the cost, with no upper limit at all. I still am trying to find out information about the networks but probably they are not nationwide and are all local.

Surprisingly, Minnesota does not have a multi-state plan.

Now to shop in states that do have multi state plans. Unfortunately, most states do not allow you to shop if you don't establish an account. And, you at least have to have a zip code to check options for a particular geographic area.

I think my next step will be to start calling insurance agents. Though, I think I will wait a couple of weeks to let things mellow a bit.

And just a reminder to check the November Consumer Reports for what I feel is an excellent reference.

Very nice to hear from you.

 

[Martha]

Well, I read insurance summary of benefits all day. No plan in Minnesota gives me any comfort for coverage out of state in southern states where I spend winter. There is no maximum out of pocket. They cover no more than 60% (one plan) but that is of the "approved" amount, which is almost always lower than the actual cost. So, if I had a hospital bill of $100,000 and they approved $50,000, they would pay $25,000 and I would be stuck at $75,000.

So, moving on.

Wahoo, thanks for the Escapee's reminder.

 

[Martha]

Rich, nice to hear from you. It looks like you moved!

 

[rbmrtn]

And just a reminder to check the November Consumer Reports for what I feel is an excellent reference.

Very nice to hear from you.

Here's link to CR november online. Don't if it is everything but the article on HI looks to be there. ( thanks to Rich for tip )

Consumer Reports Magazine

 

[Sarah in SC]

I tried today and it told me that the answers to two or more of my security questions were the same (and they weren't!). Very annoying, but maybe it is just glitchy. I need to shop for me and also for my boss, whose notice of cancellation of his BCBS plan was sent on Tuesday.

I didn't even get as far as you did on the enrolling! And I agree, those are the weirdest questions!

 

[marko]

Well, I read insurance summary of benefits all day. No plan in Minnesota gives me any comfort for coverage out of state in southern states where I spend winter. .

So are you really saying that if you have insurance in MN, if you go south for the winter you're not covered? Do you need to get another policy?

 

[Martha]

So are you really saying that if you have insurance in MN, if you go south for the winter you're not covered? Do you need to get another policy?

I can't get a policy in another state unless I change my residence. It isn't as simple as six months here, six months there. It is a few months in Texas, a month in Iowa, a month in Michigan, a few months in Minnesota. Or whatever.

I need a multi state plan which will cover me wherever I might be in the United States. That will mean I have to move. And states with income taxes, like Minnesota, really do not give you up easily. You have to use care to establish a residence elsewhere, spending at least six months of the year in the new state and doing a wide variety of things to show that it is now your permanent home.

Something like 30 states have mulit-state plans. Odds are that they are pricey. I have not been able to find details on the plans in part because of how bogged down the websites are.

 

[ziggy29]

However, we could shop before setting up an account.

On the exchanges? How did you do that (if so)? And could you see what your premiums (net of subsidy) would be? I can't pull up anything there without getting verified that I can tell....

 

[REWahoo]

On the exchanges? How did you do that (if so)? And could you see what your premiums (net of subsidy) would be? I can't pull up anything there without getting verified that I can tell....

Evidently many of the state exchanges have this capability:

More than a dozen states constructed their own portals for the policies sold to individuals, families and small businesses. Many were reported to be working better than the federal site, partly because they allow shoppers to browse plans without going through the trouble of creating an account, which reduces the burden on the servers.

Software design, not just demand, may be behind health exchange glitches, experts say

 

[ziggy29]

May well be. Because I need to *see* the plans and what my premiums would be before I even know whether I need to sign up at all. Right now I have to jump through a lot of hoops just to be able to see whether I will want to jump in at all.

 

[REWahoo]

May well be. Because I need to *see* the plans and what my premiums would be before I even know whether I need to sign up at all. Right now I have to jump through a lot of hoops just to be able to see whether I will want to jump in at all.

Yep. Since TX goes through the Fed portal, no account, no quote.

 

[Martha]

On the exchanges? How did you do that (if so)? And could you see what your premiums (net of subsidy) would be? I can't pull up anything there without getting verified that I can tell....

Minnesota has its own exchange so it works different from the Federally run exchanges. I can't stand the federal exchange, impossible for me to shop in other states.

 

[W2R]

Martha, it is great to see your posts again!

I thought this article on the topic of PPACA national plans was interesting (though it may or may not be of any help). Apparently BCBS plans are expected to be national.

The law requires at least two national plans in every state within four years, overseen by the federal Office of Personnel Management (OPM), which will negotiate rates and contracts. The law says at least one of the multi-state insurers must be a nonprofit, and at least one must not offer abortion services.

OPM has declined to name the insurers or states under consideration, but the White House says there will be national plans in at least 31 states.

Blue Cross Blue Shield plans are expected to be one of the multi-state plans, raising questions about whether that will really result in greater competition since they are already in every state and dominate some individual markets.

National Health Plans, Designed To Spur Competition, May Be Unavailable In Some States Next Year - Kaiser Health News

 

[Helen]

Well, I read insurance summary of benefits all day. No plan in Minnesota gives me any comfort for coverage out of state in southern states where I spend winter. There is no maximum out of pocket. They cover no more than 60% (one plan) but that is of the "approved" amount, which is almost always lower than the actual cost. So, if I had a hospital bill of $100,000 and they approved $50,000, they would pay $25,000 and I would be stuck at $75,000.

This is absurd.

 

[Katsmeow]

This is absurd.

It may be absurd, but that is how PPO networks work pre-ACA. Right now my daughter sees someone who is out of network. Theoretically, the insurer pays 60%. In reality they say the reasonable charge is about 2/3 of the actual charge and then pay 60% of that.

In reality, it is crazier than that. This is a therapist and so the charge is a regular amount. I've seen months were the entire charge was approved (rare), other months the "reasonable" charge was 50% of the actual, other months it was 70%. I've even turned in multiple charges and had one charge approved at a higher rate than the next visit's charge.

 

[Tandemlovers]

I looked at the "national plan" offered in Wisconsin, Anthem BCBS, last night
as we too will be purchasing on the federal exchange.

Unfortunately, Anthem is not offered in our county, so at this time, we would be
forced to move to an area in Wisconsin where Anthem is offered in order to take advantage
of national coverage. Frustrating.

Our present HMO, however, is offering three types of policies on the exchange.
I have not yet completed the application process, so I don't know whether the policy
coverage would be similar to our present coverage.

 

[MichaelB]

We also need multistate coverage, which is not available in Florida (our residence) but is in Illinois (our part time hang out) The MSP are all Blue Cross Blue Shield, so I spent about an hour yesterday on the phone with Florida BCBS, basically trying to get an answer to just one question:

If I have a Florida BCBS policy and am in another state and need non-emergency health care, and I use a provider in that state's BCBS network, will they charge me 1) the local BCBS in network price, 2) another price, higher than in-network but negotiated and lower than their "retail price", or 3) whatever wild random price they care to charge.

They wouldn't (or couldn't) answer, and kept on insisting that the BCBS insurers and networks are all separate entities. That BCBS combines these same entities to offer one multistate policy in some states didn't make any sense to them.

I have no doubt we all will find a way to deal with this, but will need to wait until the rush subsides. Too many new and inexperienced service reps are on the phones right now dealing with more basic issues. This may mean we have to deal with an agent.

In four years multistate coverage will be available in all states.

 

[pb4uski]

Martha, have you called and talked to a navigator about your snowbird issue? I would imagine that MN has lots of snowbirds so the issue must have come up by now.

 

[bizlady]

Well, I read insurance summary of benefits all day. No plan in Minnesota gives me any comfort for coverage out of state in southern states where I spend winter. There is no maximum out of pocket. They cover no more than 60% (one plan) but that is of the "approved" amount, which is almost always lower than the actual cost. So, if I had a hospital bill of $100,000 and they approved $50,000, they would pay $25,000 and I would be stuck at $75,000.

So, moving on.

Wahoo, thanks for the Escapee's reminder.

I too am in MN and concerned about this if we are traveling. I found out (though have not yet verified) ACA regulations require that emergency services be covered as in-network regardless of where you receive the care.

 

[Rich_by_the_Bay]

Rich, nice to hear from you. It looks like you moved!

... to California near one of our children and grandkids. Fully retired other than a small bit of 1099 work. Living the urban life from a small condo near everything, very happy with our lifestyle decisions so far.

Sounds like your winter/summer thing has worked out for you. I'll shoot you a PM when I get a moment.

 

[NoMoreJob]

I can't get a policy in another state unless I change my residence. It isn't as simple as six months here, six months there. It is a few months in Texas, a month in Iowa, a month in Michigan, a few months in Minnesota. Or whatever.

I need a multi state plan which will cover me wherever I might be in the United States. That will mean I have to move. And states with income taxes, like Minnesota, really do not give you up easily. You have to use care to establish a residence elsewhere, spending at least six months of the year in the new state and doing a wide variety of things to show that it is now your permanent home.

Something like 30 states have mulit-state plans. Odds are that they are pricey. I have not been able to find details on the plans in part because of how bogged down the websites are.

WAIT! The Multi-State Plan designation is confusing and I don't think means what you think it does. It's too complicated for me to try and explain, especially since I don't fully understand all the ramifications and intentions of including them in the exchanges (I think much of it is political).

Most importantly though is that you need a plan with a large provider network across the nation (yes, this sound like multi-state but isn't necessarily). I think that typically any of the 'Blues' (Blue Cross or Blue Shield plans) will offer their full nationwide network on their plans. Do you have a non multi-state Blue plan available to you? If so, call the company offering the plan(s) and ask about their network (on the plan(s) offered) in Florida or Texas or wherever you may be going. I think you may be pleasantly surprised.

We have had a private Blue plan for the last few years and have found in-network providers in both Florida and Arizona to be plentiful. When I called the (different) Blue company offering plans on our state's exchange I was told that the network will be the same.

When I asked about Multi-State plans I was told that the only difference besides the $1 per month price difference is that the MSP doesn't offer elective abortions. That's it as far as our state is concerned.

Just FYI, the customer service rep for our states exchange was totally clueless about what an MSP is. I had to call the company offering the plans on the exchange to get any sort of answer at all. Even then I didn't get a full explanation of the MSP's purpose (a lot of Googling will get you lots of confusing stuff to read) but I did get the answer that is pertinent to today's plan choices.

Oh, and I also understand the ER services are covered under ALL ACA plans no matter where you are - but that isn't good enough as far as I'm concerned if one travel a lot.

 

[ziggy29]

And now the website thinks a 91KB attachment is larger than 10 megabytes. I think I give up.

Not to mention that the (partial) application keeps forgetting stuff I already filled in several times.

 

[Martha]

Martha, have you called and talked to a navigator about your snowbird issue? I would imagine that MN has lots of snowbirds so the issue must have come up by now.

Navigators don't know squat. I am talking to actual agents.