Change doctors for lower premiums?

[easysurfer]

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.

 

[45th Birthday]

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.

 

[MichaelB]

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.