BC/BS and Health Care Bill

[oliverdickens]

After getting fine print from BC/BS retirement policy, my company, in a response to proposed health care bill details, not only raised premiums for the fourth straight year 10%, but also dropped ALL coverage for preventative, routine care. Dollars spent will not even be applied against the deductable. Said they were getting prepared early for changes coming down the pike.

With that said, they will not cover needed Colonoscopy and rep said, "Well good luck in negotiating cost as it is considered preventative, and if submitted we will deny and not even help with discounting"

So the question is, any advice out there on how to approach doctors in area to see how to get this done at the lowest price possible as a cash payment. Most may not even want to talk to you, so appreciate how others get this done. Will have to do this for any bloodwork to get prescrips renewed and will not be doing annual pyhsicals this year.

Am thinking about just going self insured and taking my chances, as if they go and do this kind of stuff, really have little confidence BC/BS would cover anything anyway. Over five years, could save over $50,000 grand with this approach.

Thanks for the advice on negotiations for best cost on services.

 

[DangerMouse]

I had a friend in the same position, that is would have to cover the cost of the colonscopy out of pocket. She called around a number of centres and asked what they charged for a cash patient and what was included in that charge. She did mention there was a significant difference in price between various locations.

 

[Gotadimple]

Ok, so if I understand correctly, your company went with a different plan from BC/BS, one that does not cover preventative services. Fundamentally, they are not interested in funding the cost of health care for retirees, and you've ended up with a catastrophic plan. The health plan legislation details (of which there is not nothing yet defined) has nothing to do with it, as there is no legislation in effect.

Going bare is not an answer. Perhaps dropping your retiree coverage and moving to an individual plan with BC/BS or other carrier is a better answer. You have to balance the cost of coverage with the cost of non-discounted care.

Certainly there are physicians and physician groups willing to provide services for a cash discount, but it may not be as great what BC/BS can negotiate with the provider. Talk to your doctor about this to find out what his/her practice can offer you in terms of cash discounts.

BOTTOMLINE: BC/BS did not eliminate the coverage, your company did. BC/BS or any other carrier is happy to provide coverage to an employer for their retirees if the employer is willing to pay the cost.

Being left with a less than desirable health plan can happen to anyone, employed or retired. You still have some options.

-- Rita

 

[oliverdickens]

I understand what you are saying relative to bill and passage and who knows what will happen now.

However, BC/BS says, because the health care bill could mandate preventative care, it would be better for company to drop it now, and than if it is forced in by law, than premiums can go up to cover. Thus better not to have in plan as preminums would have to stay the same as law would mandate that. Typical meca corp/insurance company scheme.

Thanks for the advice on self pay. Guess I better hone my negotiation skills.

 

[Gotadimple]

However, BC/BS says, because the health care bill could mandate preventative care, it would be better for company to drop it now, and than if it is forced in by law, than premiums can go up to cover. Thus better not to have in plan as preminums would have to stay the same as law would mandate that. Typical meca corp/insurance company scheme.

You say it more nicely than I would. It's hogwash. The company doesn't want to pay for your preventative care.

Going bare is not the answer, but as you now have a catastrophic plan, honing your negotiation skills seems the best short-term course.

Rita

 

[dgoldenz]

You say it more nicely than I would. It's hogwash. The company doesn't want to pay for your preventative care.

Going bare is not the answer, but as you now have a catastrophic plan, honing your negotiation skills seems the best short-term course.

Rita

x2

Are you not healthy enough to get your own coverage? Retiree plans are usually very expensive if they are not subsidizing your cost.