Looking at ACA BCBS PPO Bronze - Do you like your Bronze plan? Thanks!

[cyber888]

I'm planning to retire end of this year, if I don't get OMY syndrome and postpone it to next year.

Since DW and I are pretty healthy, I was thinking of getting the Blue Cross Blue Shield PPO Bronze. Healthcare.gov quote is $145/month for Blue Cross PPO BRONZE for both myself and wife based on my projected withdrawal from IRA or 401K, so I reckon I will probably pay no more than $250-$300/month with an individual deductible limit of $7000 or $14000 combined limit for both DW and I.

The chances of us getting sick at the same time each year are low and would forgo paying $900+/month for the Silver Plan with $5000 deductible.

The Bronze PPO has a Nationwide coverage + 80% for out of network coverage + 3 Free Visits to a Primary care physician. Co-pay after the 3 free visits is $100 for primary care physician. Specialist is $160.

Do you guys think this is a good deal? If you have Bronze, or have BCBS, can you kindly give me any feedback what you think about these plan features, compared to yours. Thanks in advance.

 

[qwerty3656]

I'm really surprised it has nationwide coverage. I went from a company BCBS PPO to an ACA BCBS PPO (silver) and the huge difference is anything outside of Michigan is considered out of network (big deal for us because we are basically a suburb of Toledo OH - but live in Michigan).

 

[Aerides]

I have a bronze BCBC plan similar to the one referenced, Florida. The main thing I look at lately is the doctors in network - there are a few we like to keep. So far so good, and we've both had years where we ended up with far higher needs than anticipated (one wonky blood test and off you go!).

One thing I like about BCBS is their service - approvals, payments, claims, etc., no issues so far.

 

[FLSUnFIRE]

I've been on mine for 7 months and very happy so far. FL Blue Select is the plan I chose. Had my regular checkup/lab, allergist visits, and an urgent care visit for a laceration.



My only gripe is the website with respect to "rewards".. they get credited to my premium but the interface is clunky and slow to update progress.

 

[augam]

I have a BCBS Bronze Plan but it's nearly $1200/month for wife and I and same deductible as the plan you have $7000 individual $14k combined.

How did you get a quote that cheap?

edit:

Me bad - our plan is an HMO

 

[Sojourner]

Do you guys think this is a good deal?

Yes, $250-$300/month for PPO medical insurance for both you and your DW... that's a very good deal.

If you have Bronze, or have BCBS, can you kindly give me any feedback what you think about these plan features, compared to yours. Thanks in advance.

Your plan features sound good to me, especially considering the low monthly premiums.

DW and I have a bronze BCBS (Anthem) HMO plan, and we're paying a bit over $900/month. It covers the basics, and our primary doctors are in-network. It is outrageously priced, IMHO, considering both DW and I are in good health and nonsmokers. Our combined income is too high to be eligible for any ACA subsidies.

 

[PaunchyPirate]

OP, I don’t know if it will change people’s stated opinions, but there are multiple Blue Cross/Blue Shield companies in this country. They each are independent companies with their own business plan, websites, claims processing, payment processes, etc. They are not all created equal. To get the most relevant advice, you might consider indicating which state your from or indicate the name of your BC/BS company. I’m in PA and mine is Highmark BC/BC.

 

[zinger1457]

The Bronze PPO has a Nationwide coverage + 80% for out of network coverage + 3 Free Visits to a Primary care physician. Co-pay after the 3 free visits is $100 for primary care physician. Specialist is $160.

I've had a similar BCBS plan for years and it's worked out OK but rarely use it except for the annual checkup, my biggest issue was with my family doctor using the wrong billing codes and getting billed for things that should have been free, happened multiple times and ended up switching doctors because of it. BCBS is no help when that happens, it's up to you to get your doctor to correct it.
The co-pay's don't mean much until the deductible is paid off, except for the 3 free one's you'll be paying the entire cost for office visits until the deductible is met.

 

[cyber888]

OP, I don’t know if it will change people’s stated opinions, but there are multiple Blue Cross/Blue Shield companies in this country. They each are independent companies with their own business plan, websites, claims processing, payment processes, etc. They are not all created equal. To get the most relevant advice, you might consider indicating which state your from or indicate the name of your BC/BS company. I’m in PA and mine is Highmark BC/BC.

Right, i'm from N.C. I plugged in income as $33,000 on this one, since my yearly expenses in NC is $53,000 including taxes, and $20,000 I get from my after-tax cash pile. This is for me and DW, it comes out to $129/month (see attached). If i up my income to $35,000, then it goes up to $145/month. The is the Blue Cross Advantage program.

 

[PaunchyPirate]

Right, i'm from N.C. I plugged in income as $33,000 on this one, since my yearly expenses in NC is $53,000 including taxes, and $20,000 I get from my after-tax cash pile. This is for me and DW, it comes out to $129/month (see attached). If i up my income to $35,000, then it goes up to $145/month. The is the Blue Cross Advantage program.

It’s a great price as long as you’re comfortable with the coverages.

 

[sengsational]

I've had BCBSNC policies from the marketplace for many years. Not because I want to do business with them, but because they're the only company on HC.gov that offers a policy that (kind of ) fits my needs.

I've always purchased bronze plans because we were low utilizers and the math was obvious; even if visits were subsidized, it wasn't enough to offset the increased premiums. Even if you expect to go to the doctor more, and you are in the 233% FPL sweet spot, the way the math works is that there is a narrow spend amount (maybe between $6000 and $7000) where the the silver is slightly cheaper. But the chances that your spending will end in that range is pretty small. Spending less than $6000? Bronze is cheaper. Spending more than $7000? Bronze is cheaper. The bottom line for me has always been that I'm buying the max out of pocket, and the MOOP is the same between bronze and silver.

Make sure you know, though, that the latest trick is limiting the network. My two choices for HDHP/HSA capable policies were to pick one of two megamedical complexes to be in-network. If you pick company A, company B and everything unaffiliated is out of network. And the max out of pocket is infinite for out of network (you might as well not have insurance).

One thing I like about BCBS is their service - approvals, payments, claims, etc., no issues so far.

That suggests that there's a big difference between Florida and NC.

I'd advise the OP that he should expect the customer service to be abysmal.

Like many big companies, if you have something "easy" that you can do on the web site, you can probably get it done by calling (the overseas call center). But if you can't do it online, then neither can the call center employee. And they never just tell you they can't do it; they put you on "silent hold", which means they mute their phone (so it's not recorded as a hold and doesn't impact their statistics) and they try to "out wait you". If you persist, they might finally tell you to call some other phone number, or give you a case number and to call back, or something. That's after wasting an hour.

If, somehow, you get past the over seas call center and talk to someone in North Carolina, then it's better, but it seems at every turn they're running into some procedural or system roadblock. So you can understand them, they're nice, they're trying, but it's still difficult to get anything done.

The web site is also lacking. It has a very confusing way to present claims. You can go to "documents" and they have one line for each claim, which seems reasonable, but when you click on one, it opens an EOB PDF document that has multiple claims. So each one you click on, you might get a repeat EOB or another EOB, no way to tell. And there's nowhere that lists only your EOB's. EOB's don't have an ID number, and there can be more than one EOB on a single date.

The main web page has a total that shows the amount reached towards your deductible, but there's no report showing how they arrived at that total. The CSV report available doesn't have totals and my considerable attempts to reconcile never matched. The customer service failures continued when I asked for help via the web site messaging. I asked if there was a report that showed how they're arriving at these totals, but never got a response.

So I've gone on too long, but for the OP, just realize that as much as they might try, and want to succeed, they've not been anywhere close to a reasonable level of customer service in my opinion.

 

[swakyaby]

I have the ACA Blue Shield high deductible ppo bronze plan with HSA for the past 3 years, in California. My experience has been mostly positive. When you stay in network as I have, the actual out-of-pocket costs are reasonable. Although it’s a high deductible plan, it seems DH and I pay out somewhere between $500 and $2000 a year, so nowhere near the deductible limit. The ability to go to a specialist without a referral, ppo plan, is also nice. I have called the Blue Shield customer service on 3 separate occasions the past 3 years and found them to be very pleasant, helpful, and empathetic. Hold times were minimal. If I had the premiums the OP quotes, I wouldn’t hesitate to enroll. Anyways, that’s my experience.