Now that I am starting a new job, I have all these options for health insurance. My previous job was a start-up so we had no choices. Now I am have so many choices I don't know which to choose! The company gave me a booklet explaining the options but it is just confusing me more. I can choose from PPO, HMO or Indemnity. I almost never go to the Dr. Just 2 times a year to the gyno and 1-2 times to the Gastro (IBS) doctor, and maybe 1 time to the PCP. Would PPO be the best option for someone like me? That is what I am assuming from reading this booklet. If there is anyone who is knowledgeable in healthcare please help!
OSCARtheGROOM
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What insurance companies did they offer?
julz33
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I was wondering the same thing... it doesn't say which companies in here. I guess I will ask the HR guy tomorrow!
OSCARtheGROOM
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I would.
1017Bride
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To help clarify your options let me tell you a little bit more about what HMO and PPO mean.
I forget exactly what each one stands for but here is what they basically are:
HMO-basically they will only cover either anywhere from 80-100% only for doctors in your network. If you go out of network, you suffer because you have to pay it all out of pocket.
PPO-they will cover most of the payment for doctors in your network and if you go out of network they will pay a good percentage (maybe 40 or so percent).
I dont' know what indemity is. Hope this helps.
Yes definitely find out what insurance company they offer. We have Cigna and it is fine.
JodiBabe
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An HMO you have to use the plan Dr's
A PPO I think you can use almost any dr.
Be sure to check Deductibles & copays
I am not to sure of Indemnity but I think they don't always cover everything.
OSCARtheGROOM
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I have new york goverment. empire bluecross/blueshield. I pay for my co payment. Thats it.
MCDO15
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whatever you do, just don't go by cost alone. We had Athna... while it was ok, we started to see the issues with it when we had some real medical concerns. Waiting for referreals and authizations is not fun. Now we have United Health Care which requires no authizations..just go in.
princess99
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I have my masters in Heatlh care administartion, do not go with an HMO! You have to have a gatekeeper ( PCP) give you permission to go to the PCP. You are better off with a PPO. This is just my opinion.
peabody
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Posted by OSCARtheGROOM
I have new york goverment. empire bluecross/blueshield. I pay for my co payment. Thats it.
That's what I have too!!
Julie, do you have State benefits like Beth and I?
February05
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yes... PPO would be the best option to go with (and this is what many companies are gearing towards these days)... there aren't many Indemnity plans left... that means that you pay out of pocket, and then you get reimbursed (not something that can easily be done for a hospital visit, or even a routine Dr.'s appt)... HMO limits you to having to always go to your PCP (primary care physician) first... like princess said... the gatekeeper. PPO's allow you the most freedom to choose your Dr.'s, and not have to get a referral first. Also, they are becoming even more flexible
Sunny
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PPO is better and you don't need referrals, but the copays are usually much higher.
At my jon my choice was fully covered by my employer hmo, or a PPO where I had to pay some towards it.
Gonnacatchapeacock
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Go with the PPO...freedom to choose a doctor is always best.
You don't want to be dealing with the 'run around' when you REALLY need it.
I chose DMO for dental and I regretted it. I changed it and picked out of network services.
It's worth the extra $$$ IMHO.
julz33
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Posted by peabody
Posted by OSCARtheGROOM
I have new york goverment. empire bluecross/blueshield. I pay for my co payment. Thats it.
That's what I have too!!
Julie, do you have State benefits like Beth and I?
No, I don't have state benefits!
Thanks Everybody! I will ask the HR guy today about what companies we use.
nov04LIbride
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I have PPO (with Empire)--it is sooo much better because you don't need referrals. I have a $12 copay. I had HMO at my last job, and it was so hard finding a dr. in the HMO, I was traveling further, and then if I ever needed a specialist I had to pay for ANOTHER trip to the general dr. to get a referral! Good luck, I would definitely go with the PPO.
bridget&jimmy
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I have Empire Direct HMO and I do not need referals and can go to any doctor in the book which is massive and only have to pay my copay. They also included Sloan Kettering and other speciality hospitals. So it depends on the type of HMO.
Kosta's Kitty
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I have MDNY HMO- I don't need a referal to go to other doctors. I do have a co-pay and can only go to in-network doctors.
NPbride
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Posted by Kosta's Kitty
I have MDNY HMO- I don't need a referal to go to other doctors. I do have a co-pay and can only go to in-network doctors.
That's what Fi had and it wasn't great insurance but he never had any problems with the medical portion of benefits. So, not all HMO's require a referral.
Valentinegirl
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Posted by nov04LIbride
I have PPO (with Empire)--it is sooo much better because you don't need referrals. I have a $12 copay. I had HMO at my last job, and it was so hard finding a dr. in the HMO, I was traveling further, and then if I ever needed a specialist I had to pay for ANOTHER trip to the general dr. to get a referral! Good luck, I would definitely go with the PPO.
I have Empire PPO also. I have had Empire for 8 years.
