Florida BCBS through ACA: experiences/reviews

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ZumZabo
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Florida BCBS through ACA: experiences/reviews

Post by ZumZabo » Thu Nov 08, 2018 9:11 am

I have health insurance through my employer with Anthem Blue Cross and it is the best health insurance I’ve ever had. I’m 58 and dw is 56. I totally enjoy the job but am there primarily for the insurance. I need 30 hours per week to qualify so I am there 5 days (approx 38 hours) to have a margin of comfort for when I take unpaid time off to vacation etc.. I would actually prefer to work two or three days a week since I love the job but there goes the insurance. I don’t really need the income and would like to have more control of my days. I’ve been looking on the ACA sight and some of the policies on the site appear to be adequate and affordable with the subsidies I would likely qualify for. The only reviews I can find speak to lack of choices for providers, denial of claims and total chaos concerning billing. I see a lot of comments stating that a provider promised during the application process is not available when service is needed. One site I found was a consumers affairs sight, almost exclusively horror stories, but nobody contacts them with good news. I am in the Orlando area and would like to know if anybody using Florida Blue through the ACA exchange has any personal experience or a source for some objective reviews.

Thank you all in advance for your help.
What made me think I could start clean slated? The hardest to learn was the least complicated: Emily Saliers / And if I claim to be a wise man, it surely means that I don't know: Kerry Livgren

ZumZabo
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Re: Florida BCBS through ACA: experiences/reviews

Post by ZumZabo » Mon Nov 12, 2018 7:30 am

In light of no response at all with my original post, perhaps I should broaden my search. Is there anyone at all in the state of Florida who has early retired and has private health insurance and is happy with it? If so, where do you access it? I have seven years until Medicare and spouse has nine years. I really enjoy my employment and would like to continue working there part time. Just don’t want to be full time just for health insurance. Any help would be appreciated.
What made me think I could start clean slated? The hardest to learn was the least complicated: Emily Saliers / And if I claim to be a wise man, it surely means that I don't know: Kerry Livgren

magazinewriter
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Re: Florida BCBS through ACA: experiences/reviews

Post by magazinewriter » Mon Nov 12, 2018 9:29 am

I’m in Florida and have Florida Blue through healthcare.gov. I’ve been happy with it and have not had any problems. I have not had any major illness or hospitalization so my experience is limited.

There are various types of Florida Blue plans and I have what I consider the best one, BlueOptions which is a PPO and has a nationwide network. The FloridaBlue HMO and one called Blue Choice (I think) are much more limited in their networks.

It is hard to say what will happen over seven years, however. I’ll be going on Medicare in late 2019.

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sperry8
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Re: Florida BCBS through ACA: experiences/reviews

Post by sperry8 » Mon Nov 12, 2018 9:30 am

I have BCBS (Florida Blue Select) out of Miami. Bought via the healthcare.gov website even though I don't qualify for subsidies. No issues with billing or usage - but their provider directory is not current. Either that or the doctors simply don't honor what is listed in the directory. So it's best to call your preferred provider(s) directly to understand if they take BCBS. I spoke with doctors who were listed in the directory and listed as accepting new clients. They weren't. I also spoke with doctors who were in the directory who said they accept BCBS. They didn't (said they used to, but no longer do).

Now with all that said, for the doctors I met who were in the network and did take the insurance everything ran smoothly. No issues it all. As an fyi, I met specialists and PCPs for tests.

BCBS CS is average, a win in my book (nothing special, but not horrible).

Note there are three levels of care - Select, and two others whose names slip my mind at the moment (Options & Choice?). The key is as you move up the levels more doctors participate but of course the more you pay in premiums. I'm in the lowest level (Select). You can Google to read up on their three levels in more detail.
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ZumZabo
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Re: Florida BCBS through ACA: experiences/reviews

Post by ZumZabo » Tue Nov 13, 2018 8:15 am

magazinewriter and sperry8,

Thank you both very much for your responses. Doesn’t sound like either of you have had terrible experiences but not so compelling that I am ready to give up my current coverage for an ACA policy.
I will continue to dig.

Happy Thanksgiving

If anyone has a referral for an agent in the Orlando area who deals with health insurance I would appreciate it. Perhaps they would have seen some real life experiences other than the smiling faces we see on the advertisements. Any help or leads appreciated.
Last edited by ZumZabo on Tue Nov 13, 2018 8:22 am, edited 1 time in total.
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JoeRetire
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Re: Florida BCBS through ACA: experiences/reviews

Post by JoeRetire » Tue Nov 13, 2018 8:20 am

ZumZabo wrote:
Thu Nov 08, 2018 9:11 am
I would actually prefer to work two or three days a week since I love the job but there goes the insurance. I don’t really need the income and would like to have more control of my days.
You say you don't really need the income, but are concerned about insurance.

I don't think I understand. Are you that tight against it financially such that you cannot afford to pay for good insurance?

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Re: Florida BCBS through ACA: experiences/reviews

Post by ZumZabo » Tue Nov 13, 2018 9:04 am

JoeRetire wrote:
Tue Nov 13, 2018 8:20 am
[quote=ZumZabo post_id=4203667 time=<a href="tel:1541686271">1541686271</a> user_id=58356]I would actually prefer to work two or three days a week since I love the job but there goes the insurance. I don’t really need the income and would like to have more control of my days.
You say you don't really need the income, but are concerned about insurance.

I don't think I understand. Are you that tight against it financially such that you cannot afford to pay for good insurance?
[/quote]



What I mean is I don’t spend the income I make to cover living expenses. We would be fine perpetually without working. This doesn’t mean I want to take on the risk of unlimited upside health expenses by self insuring or that I would spend $XX,XXX per year on premiums without investigating the options. People do exhaustive research shopping for a car or a vacation don’t they? Health insurance is kind of a big deal and recurs annually rather than once every five or 10 years like a car. What is “good insurance“? That’s what I am investigating. I am reading about some people having problems getting the providers and care they feel they are paying for. So for now, I am seeing that expensive may not necessarily equal “good” I could work three days per week (which I would do under any circumstance, I really enjoy the environment and the people) and spend it all on insurance or work five days, get the insurance and keep the money. That’s what I am currently doing but obviously looking at other options.
Last edited by ZumZabo on Wed Nov 14, 2018 5:06 am, edited 1 time in total.
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Watty
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Re: Florida BCBS through ACA: experiences/reviews

Post by Watty » Tue Nov 13, 2018 9:08 am

I retired a few years ago and I was in a different state. I also had BCBS which was a PPO plan, when I looked at BCBS ACA policies none of my doctors were in the ACA plans and it looked like a very limited network of doctors compared to my work BCBS plan. I would not have minded changing doctors but when I looked into it very few of the primary care doctors in the BCBS ACA network were actually accepting new patients which made it even worse. I was also concerned with how long it would take to get an appointment with an in network specialist if I needed one.

I ended up going with a Kaiser HMO plan which has a decent reputation here.

The next year BCBS withdrew from the ACA in my area. They are returning to the ACA in 2019 in my area.

With all the changes there is no telling what the ACA will look like in 2020 and beyond so I would be cautious about making any long term plans involving ACA.

Unless you work for a very small company then you may be eligible for COBRA so I would take a hard look at that especially if you will not qualify for an ACA subsidy. Even if it costs more it may be a lot better since you may have a lot lower deductible and a much better network of doctors.

When I first retired I retired in July so that my 18 months of COBRA coverage would take me through the rest of that year and the entire next year. If you don't mind working more hours through next summer then you could retire in July of 2019 and have COBRA coverage through the end of 2020 and not have to worry about ACA changes until then.

When COBRA runs out then one option is to go back to work full time again for just long enough to get health insurance then you can use COBRA for another 18 months. I know someone that was retired but they have health issues and were worried about the future of ACA so they when back to work for a few months then quit when they turned 63.5 so that 18 months of COBRA would cover them until they turned 65 and could get on Medicare.

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Blueskies123
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Re: Florida BCBS through ACA: experiences/reviews

Post by Blueskies123 » Tue Nov 13, 2018 9:30 am

I have had BCBS in the last 3 years. None of my doctors were on the Select HMO but all of them were in the Options PPO. I have had two knee surgeries and two shoulder surgeries and had zero problems with BCBS, however, the Options version is incredibly expensive without subsidies. The Select is much more affordable.

ZumZabo
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Re: Florida BCBS through ACA: experiences/reviews

Post by ZumZabo » Tue Nov 13, 2018 10:51 am

Watty wrote:
Tue Nov 13, 2018 9:08 am
I retired a few years ago and I was in a different state. I also had BCBS which was a PPO plan, when I looked at BCBS ACA policies none of my doctors were in the ACA plans and it looked like a very limited network of doctors compared to my work BCBS plan. I would not have minded changing doctors but when I looked into it very few of the primary care doctors in the BCBS ACA network were actually accepting new patients which made it even worse. I was also concerned with how long it would take to get an appointment with an in network specialist if I needed one.

I ended up going with a Kaiser HMO plan which has a decent reputation here.

The next year BCBS withdrew from the ACA in my area. They are returning to the ACA in 2019 in my area.

With all the changes there is no telling what the ACA will look like in 2020 and beyond so I would be cautious about making any long term plans involving ACA.

Unless you work for a very small company then you may be eligible for COBRA so I would take a hard look at that especially if you will not qualify for an ACA subsidy. Even if it costs more it may be a lot better since you may have a lot lower deductible and a much better network of doctors.

When I first retired I retired in July so that my 18 months of COBRA coverage would take me through the rest of that year and the entire next year. If you don't mind working more hours through next summer then you could retire in July of 2019 and have COBRA coverage through the end of 2020 and not have to worry about ACA changes until then.

When COBRA runs out then one option is to go back to work full time again for just long enough to get health insurance then you can use COBRA for another 18 months. I know someone that was retired but they have health issues and were worried about the future of ACA so they when back to work for a few months then quit when they turned 63.5 so that 18 months of COBRA would cover them until they turned 65 and could get on Medicare.

Thank you Watty,
I have definitely thought about the COBRA option for my last eighteen months there when it happens. I work for a very large company that has that as an option. Problem is my wife is a little less than 2 years younger than me so if I use COBRA to bridge the gap until Medicare for me, she is uninsured or using private insurance until 65 years and no one can know what that looks like then.
Hadn’t thought about returning to work again to reactivate COBRA availability. Also considered cutting back to two or three days and testing ACA. If If we hate it, I could return to full time and reactivate insurance. I would never be more than six months away from an enrollment period if I knew I was planning to reactivate. I need an average of thirty hours in the previous six months to qualify. When I am ready to not work at all, quitting and starting again to restart the clock for COBRA has some appeal excepting the obvious risks. Company changed insurance avalibility, they are not hiring, I’m not employable due to illness etc...

No clear answer yet.
What made me think I could start clean slated? The hardest to learn was the least complicated: Emily Saliers / And if I claim to be a wise man, it surely means that I don't know: Kerry Livgren

ZumZabo
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Re: Florida BCBS through ACA: experiences/reviews

Post by ZumZabo » Tue Nov 13, 2018 11:02 am

Blueskies123 wrote:
Tue Nov 13, 2018 9:30 am
I have had BCBS in the last 3 years. None of my doctors were on the Select HMO but all of them were in the Options PPO. I have had two knee surgeries and two shoulder surgeries and had zero problems with BCBS, however, the Options version is incredibly expensive without subsidies. The Select is much more affordable.
Thank you Blueskies123,
Seemingly the varying tiers of coverage really matter. Wasn’t aware of that until you and previous posters mentioned it. Obviously cost matters but I am willing to pay for quality if I actually receive it. No major health issues currently but we never know. Insurance of any type is always expensive until you need it. I will investigate the differences between the policies. May offer some clarity that I haven’t had up to now.
What made me think I could start clean slated? The hardest to learn was the least complicated: Emily Saliers / And if I claim to be a wise man, it surely means that I don't know: Kerry Livgren

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