Do you have PPO or HMO insurance?

[forward2007]

Do you spend the extra $$$ if you can afford it for the PPO insurance so you have more options in terms of Dr's to choose from or do you stick with HMO insurance? I am in the middle of deciding from my work benefits right now which to choose. With my former HMO insurance I had to pay out of pocket to see the Neurologist I was recommended to see. But the PPO insurance would pay to see him.

 

[skillefer]

I have PPO....If I went with the HMO that my district offers, it would be cheaper, but I'd have to drive a half an hour to get to the doctor..... And, as you pointed out, there's more doctor choice with my PPO. That, and I would have to make appointments weeks in advance. Right now, I can get in to see the doctor in about one week max. That includes my neurologist, dentist, primary care, and eye doctor. The ENT takes a while to schedule...but that's about 2 weeks as he's the only ENT in my town.

 

[RobinN]

We have an HMO. We checked into switching to a PPO but it would have been around $1000 mo to do this. I continue to learn my way around the insurance fiasco, and so far have been given adequate care with some searching. I don't have problems with appointments, but I do have a problem with what they are allowed to suggest in terms of treatment. They are very, very careful about what they say.

 

[forward2007]

I just chose the PPO option. It will cost me $86.91 out of ever bi-weekly check instead of having over $1000 to put in a 401K or to spend on a vacation or something else.

 

[hawke86]

I don't have a HMO or PPO.

 

[skillefer]

Yeah Forward, but just think of it this way.....you're probably going to make good use of your insurance. HEaven knows I do. And your only paying $86 every two weeks? Good Heavens! I pay close to $400 per month! Of course, the last couple of months, my hubby and I have probably used it to the maximum advantage.....He got all 4 wisdom teeth pulled, visited urgent care for strep and a prescription to go with the visit...then there's my 2 visits to urgent care, the 3 presciptions for those visits, the 2 visits to the ENT, the visit to the neurologist, the MRI, the blood work (twice), the visit to my primary care physician, and the two visits to the eye doctor. Not to mention my 2 prescriptions every month...Yeah, I think I got my money's worth.

 

[tinathesingergirl]

I have had HMO's in the past when i was diagnosed with epilepsy I actully had a store manager at Nike whose daughter had epilepsy and I asked him at open enrollment time which plan was better the HMO or the PPO with the Epilepsy and he said by far the PPO with all of the testing and medication he had had both with his daughter and said that the PPO was far better. Get the PPO its usually only a little more out of your paycheck but the headaches it will save you later will be worth it. I know it has me. I am able to go to any doctor, any hospital including Mayo clinic. My co-pays are like 20 for gp's and 30 for specs all in all not too bad. If I consider going w/o its a nightmare just the cost of drugs with my dosages..... and I am on generic

 

[Ruth]

I don't have a HMO or PPO.

Hawke, how do you get by without insurance? Or do you have another type of insurance?

I have a HMO. I have a top quality doctor who has reffered me to a top-notch neurologist.

 

[jyearta]

I have BC/BS open access HMO.

With open access I don't have to get a referral to a specil?

My co-pay is $50.00

 

[Chelsea]

I have BCBS of FL OpenAccess PPO; I pay $68.05 biweekly, and my cpy for neuro is $25.00. I went to the Urg Care this morning (for sinus/ear infxn), and my cpy was $40.00 -- it must have gone up. PPO is by far wiser for me. There are more in-network providers and my LTG is only ~$5.81/mon. My out-of-pocket ded is $1500.00. I am very fortunate; I remember the days b4 ins, when I went to the Health Dept and LTG was ~$480.00/mon (w/discount).

 

[tinathesingergirl]

Chelsea, I may have to look at that, Do you pay for that privately? That is certainly less than what I pay through my employer. Are you retired? That may explain the diffrernce in price as well. Especially if you are getting medicare as well. $40 seems a bit steep though I try to avoid urgent care centers as a general rule they tend to be more expensive and the last time i ended up in the ER becasue of a drug they gave me for a sinus infection. Ended up in status seizure mode. So I go to my reg PCP instead. Besides that shes cheaper and she knows her drugs. And so does her partner Who happens to be really cute.

 

[cazzy]

thank god i use nhs

 

[Ruth]

What is BCBS? Cazzy what is nhs?

I have a Blue Shield HMO from my husband's retirement. My co-pay is $10 for doctor's visits and $50 for ER or Hospilisation.

 

[Janus]

I have medicare. I am in "early retirement" with this 'different ability'. It sucks here in this small town, most will not even see me. My neurology clinic stopped seeing us all together. I miss Seattle, where I still have to bus to for good care. But, no co-pays accept on Meds.

 

[Ruth]

Janus,

Medical insurance is so important. If I were you, I would move back to Seattle.

What is "this different ability" that no doctor will see you?

 

[RobinN]

I am now looking into new insurance for myself, and I am considering a Health Savings Plan. Though it actually depends on whether or not the new U.S. Health plan will be implemented. I have been told it will not be accepted as insurance under Obamacare. I would be fined if I did not buy "insurance".
Health Savings Plans are more for the big ticket items. I would cover the first $4,500./yr and pay $300/mo. Anything over that amount is covered. So I would just keep a savings account with $5000 ready for any medical needs. I have been working to get myself very healthy, so I don't imagine I would need to spend much each year.

 

[Chelsea]

@ Tinathesingergirl. No, lol, I am not retired. I will be 29 this Christmas Eve. I recv'd a threat of termination today b/c of an accommodations request for an emergency plan @ my workplace just in case. I was asked, "will these szs take 15 min or 20 hr out of the week? we have to consider whether or not this takes time away from production." I wont be able to afford COBRA, so we'll see what plays out. Awful day #wanttocry Best, CNN

 

[tinathesingergirl]

Oh Geez thats too bad sorry to hear about that.... I've been really lucky I guess with Nike with my accomodations request. Plus my seizures happen so infrequently (knock on wood) I have never had one at work either. The last time I had a seizure before last week it was 9 months previous. Mine are realted to my menses cycle. so once a month I am a walking time bomb I never never know If I am gonna have a gran mal or not no auras or anything down for the count & hope the meds hold out. Docs can't find a thing on the scans. Very Frustrating. On waitlist for Mayo and Tampa General for level 4 centers since the 4 centers in Orlando only handle pediatrics.

 

[Chelsea]

Spoke to Supervisor Today

She said the General Manager needs the ADA accomodations request before they can go ahead with anything. I put in for PTO time for Monday's appointment, but didn't receive any response, and ended up leaving after a partial seizure. Because I had nowhere to go (and it would impact production), and I knew I had an aura, I went downstairs to sit on a bench (next to traffic)--which could have turned out a lot worse. onder: I need better control, so I can function up to work's standards. Supervisor said there was plenty of {select bad word} to do at work that doesn't involve constancy on the phones. I am wiped after having an ear infection, dealing with my employer, and making hard life choices this week. I did go to a local Epilepsy Foundation Support Group last night. They presented on VNS.