Thursday, March 15, 2012

Health Care Decisions

So the news has officially come out from the state about how our health benefits will change this next year and it's not great.  (Although, I realize that my benefits are still quite good compared to high deductible plans and other types of plans that I know other people have.)  Anyway, one of the biggest changes is that for the POS and PPO choices, that instead of 100% coverage for most things, we'll now only be getting 90%.  Again, I realize this is not so bad....but it's a change for us.  We've had a POS since I've been working for the state and I'm now considering using and EPO instead mostly because it's a little cheaper and we would still get 100% coverage.  However, I'm just a little scared since you always hear horror stories about EPO/HMOs.  I just don't know enough.  One of the things about POS and PPO plans is the fact that you can go out of network if needed.  Well, we NEVER go out of network.  So why are we paying extra money if we never use that.  And the 3 EPOs available have very large networks of doctors.

I need to do some more research before I make my decision.

Oh and in other news, our prescription carrier will be changing over to Express Scripts which is not accepted by Walgreens - wth?  So as of May I have to switch all of our prescriptions over to another store that isn't nearly as convenient.  But again, at least we have coverage, right?

The so called good news of the new plan year is that rabies vaccinations are now covered.  Ha ha.  Oh and allergy serum too - which actually IS good news since before it was only sort of covered by prescription coverage.  BUT if we stay with POS, we'll end up paying a copay and 10% of the costs for each injection so I'm not sure that it's exactly any kind of deal.  Oh and the other good news is that apparently a POS will no longer require referrals for specialists which IS good news because that is one of the biggest pains in the butt, especially with regard to regular allergist visits.

So I guess we take the good with the bad and figure out what to do.  If anyone has any advice regarding a POS vs. EPO plan, I'd love to hear it!

1 comment:

Bracken said...

We have Kaiser and it really isn't bad. Up until 2 years ago we have always had Blue Cross Blue Shield but for cost reasons we switched. You know we deal with plenty of medical issues and prescriptions in our family and I have been satisfied with Kaiser. My frustrations I feel have to do with healthcare in general. Hope that helps but let me know if I can answer any questions for you.