Heath Insurance Advice PLEASE!

Updated on March 23, 2008
A.E. asks from Mesquite, TX
14 answers

My husband's employer has been covering us for almost 4 years, but this is getting ridiculous! Paying close to $600/month for insurance that has no office co-pay and no well child coverage after age 2. Adults get one free physical (up to $250 a year) but kids get nothing..... um did I mention this is a local school district he works for! And the $600 does not include any dental or anything other than health insurance w/ a RX plan! We have a super low deductible, $350 each, but since my kids NEVER get sick, I have to pay that $350 before they even pay for shots or a well child visit. I want a plan that I can take them to the doctor for a check-up for a low co-pay and the same if they are sick. Me paying $50-$70 a year for a couple of visits is better than $350 before insurance pays anything! This is the only policy that my husband's employer offers.

We are planning to get an individual policy and we're trying to decide between Unicare and Blue Cross/Blue Shield. I know the whole cheaper rates w/ higher deductibles thing, but I am wondering: WHAT EXPERINCE DO YOU MOMS HAVE WITH THESE COMPANIES? This especially includes having to fight to get them to pay and or doctors having trouble with them paying. We had BCBS before having kids (with another employer) and never had one problem with them. In fact, I was surprised at how I never had any trouble with them. BUT they are more expensive than UNICARE and I am wondering if it is worth it. PLEASE let me know any good or bad experiences you've had with these companies, especially UNICARE. Thanks so much - wow this is stressing me out!

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M.R.

answers from Dallas on

My youngest son has ALWAYS had BCBS and never had a problem and I had it when I was married until over a year ago when are divorce was final. They paid everything.

Good Luck on whatever you decide.
M.

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M.E.

answers from Dallas on

AE,

I am a broker for AMeriplan USa. It is a discount plan. For the entire family you will only pay 39.95 a month. I have enrolled several people and they are thriled with the money they are savings. For example a dental visit is 103.00 and with Ameriplan you only pay $30.00. You can save 50 to 80% off all benefits. At Target $4.00 for generic RX. Chiropractor $38.00 for a massage. So much more.. I have worked in the healthcare field for 7 years as a Social Worker this plan can save you thousands of dollars.

Please call me if you want more information at ###-###-####
or check out their website at www.Ameriplan.com

Good Luck M.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

M.K.

answers from Dallas on

My family is on BCBS & have been for about 20 yrs., since I was a child. When I got pregnant with my first child my husband & I were not married & so we thought his insurance would have covered everything from the hopital on & in fact it was my parent's policy that covered it all even with my husband's insurance. His job has tried other companies & it has been such a struggle to get anything done. I will say that they always seem to go back to BCBS & everyone loves it. My oldest just turned 11 & they still pay for all his well visits & anything else at the pediatrician. I am extremely happy with them & hope we never have to go through change again. Good Luck!!!

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

H.L.

answers from Dallas on

We've been using Unicare for over 6 yrs and have never had a problem. (We are not sick often) However, they do raise their rates every 6 months...but are still cheaper than anything else. I shop around every year to see if I can get a better rate, and haven't found one yet.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

K.A.

answers from Dallas on

My husband works from home, so he and my daughter were on BCBS for 4 years. I was on my insurance at work. BCBS was fine until this last year. They kept raising their rates significantly and failed to cover my daughters three year well child check up. I have heard both good and bad things about Unicare, but I am pretty sure they will not cover a pregnancy, so keep that in mind when choosing. Check the internet for an insurance brokers - they put a group of people together in a pool and shop for insurance as a group to get better rates, etc.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

C.M.

answers from Dallas on

It looks like everybody but me has had good luck with BCBS. We got stuck paying $27,000 worth of medical bills for my husband's reconstructive jaw surgery. His procedure was pre-approved so we started his ortho treatment that cost us $7000 out of pocket. By the time he was ready for surgery his employer had switched from a HMO to a PPO which was supposed to honor all prior authorizations but didn't. His defect was one of the worst our oral surgeon had seen with parts of his jaw bone thinner than a credit card! We even hired an attorney but got no where because BCBS would never release our files. They kept "never receiving" the requests or bumping them around from office to office. Just my opinion ... BCBS stinks!

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

H.M.

answers from Dallas on

As an insurance agent I highly recommend BCBS. However, their individual plans are a lot different than their group plans. You just need to make sure you read the fine print. Good luck.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

T.M.

answers from Dallas on

I am new to this site. One of my clients sent me this link. I read everyones feedback on Blue Cross which I work with and is good but my favorite company that does not ryder pre is Aetna. It covers physical and well checks. But, the best thing is that any blood work or x-rays done at the doctors or specialist office is part of your copay. It is the best individual plan on the market. You can check out my site at www.onestophealthandlife.com
Hope this helps!

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

D.W.

answers from Dallas on

Hello!
We have Unicare- I will say they have paid for everything at the Pedi w/o a problem. They cover well child care up to 6 y/o and all immunizations, even on their basic plan. I had major surgery this year and they have paid for everything they promised after I paid my $2000 deductible.

D.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

R.

answers from Dallas on

I used to feel exactly the same way. The year before I had my car accident I almost switched to a cheaper insurance. I asked the rep why I should stay with their insurance if I could pay less per month and per dr visit by going with someone else. The rep said that I would notice a difference if I were ever in a catastrophic accident. I hung up and thought that will never happen to me, but I better stay with them just in case. When I had my car accident, my insurance paid almost everything. I had several major surgeries. I would have been in debt for the rest of my life. I'm not saying not to switch, just be sure that you read what the insurances would cover in a major accident. It wouldn't have been wise for me to switch b/c of the limits the insurance would have paid and also they wouldn't have paid anyone out of their network.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

S.L.

answers from Dallas on

Hey there,

I just put my daughter & I on a plan thru Unicare. I don't plan to get pregnant this year & we just need the basic coverage & for the "incase of" situations. So my hubby stayed on his from work (since they cover most of his premium), but decided to get on a personal plan for me & the little one just to save some money this year. Anyway. I haven't really had to use it yet, but the agent that I used was very kind & helpful.

Here is his info.
Andrew Weber
Uniplan Financial Services
###-###-####
(mobile) ###-###-####

Hope he can help you & Good Luck w/everything,
S.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

S.M.

answers from Dallas on

I don't really have a preference one or the other, but do know a lot of friends have had good luck with rates through www.ehealthinsurance.com. They have it so you can compare plans from different companies and prices.

Smallavatar-fefd015f3e6a23a79637b7ec8e9ddaa6

S.C.

answers from Dallas on

Call the bookeepers at your doctor and pediatrician's offices and ask them. They are the ones that spend the most time dealing with insurance companies and will probably have some advice.

D.G.

answers from Nashville on

WE have BCBS PPO through my husband's employer- the federal gov't & I have been really pleased with them. A few issues here & there, but overally very good. If you can do a PPO over an HMO plan, I'd really recommend it. In our history, they are much more flexible plans... & we get well-child exams through early childhood!

Good luck!
D.

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