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About Linda Woolsteen
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I can help you with questions about health insurance. If you feel your insurance company is mistreating you. Are they telling you they are checking eligibity, pre-existing, etc. Or you just don`t understand how your insurance works or don`t understand what a PPO is.. I can help you.

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One company I worked for I was the underwriter for the Academy of Medicine of Cleveland and the Ohio Bar Association. I was also a supervisor of our customer service department.

 
   

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Health Plan Administration - Help


Expert: Linda Woolsteen - 4/5/2005

Question
Hi Mrs. Pennington,

I turn 25 this month and although I am still in graduate school I am about to lose medical insurance.  Are there any alternative medical plans?  BCBS wanted to charge me about 200 bucks a month and but being a college student, I don't exactly have that kind of money every month.  I am looking for any insurance companies or specific plans.  Any suggestions are welcome

Thank you

Mike


Answer
Hi, sorry for the delay.  For some reason, I did not get an email that there was a question here for me.

Well, you probably already know about student insurance.  Usually, the college has student insurance that you can take out and they have brochures in the office usually.

If you are to old for the student insurance, then you'll have to get an individual policy.  HMO's are usually the cheapest ( like Kaiser) but then you have to go to them and their doctors.  You cannot go to the hospital down the street or your regular doctors, thus the reason most people do not like HMO's.

My company was just bought out and I was searching for Health insurance myself.  Initially, I selected United Healthcare (individual they issue apparently under the name of Golden Rule).  I selected a $2500 deductible with 100% coinsurance.  I don't really have any major health issues so I figured, worse case scenario, I could put the $2500 on a credit card if I had to and then the rest is paid at 100% and I wouldn't have to mess around with 20% here and there on a lot of different bills.  The higher your deductible of course the lower your premium.

You have to look at what is important to you.  I would always get a copay RX card.  Prescriptions can be $800 or more nowadays unless you are able to get generic, whereas, even if you do not have a RX card you can get routinely now in most drug stores for like $4.00.  So, that helps.

If you go with a PPO plan, as long as their PPO network is a national network, it wouldn't matter if they are based in like here, Ohio.  I opted on Medical Mutual of Ohio (MMO).  The PPO network is First Health which is a national network, so no matter where I go, I will be able to find providers that are in network.  If you get a PPO plan, you want to always go with doctors, hospitals, etc. that are in the network.  That is the purpose of having a PPO plan and it is up to YOU, the insured, to make sure that the doctors, hospitals, etc. that you see are in YOUR network.  

I believe with a RX copay card, dental and a $500 ded.  My fiance's, son, who is 20 cost us approx. $262 or so a month.  

Belonging, to Associations can get you reduced rates.  Most professional associations offer health care coverage through the Association.  

I am 43.  I checked with approx. 3 different companies,  MMO, United HealthCare and Aetna.  United Healthcare had the best rate I found, but they also excluded my headaches and denied me a RX card.  I wasn't happy with that since I do not have, nor have not had any headaches in over a year and nowadays, you have got to have a RX card, I feel.  So, I applied at MMO.  They approved me, they did not exclude any coverage for my headaches nor deny me a RX card, but they did rate me up a little.  Which means they gave me a slightly higher premium rate due to my past history of headaches.  I like Aetna.  When I have had them before, they were always good at paying and not giving you any problems.  But, their premiums tend to be a little higher.

I hope I have helped some and am not to late with this reply.  Any other questions, just let me know.

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