Choosing an insurance company...any favorites or ones you hate?

[ktgrok]

My husband's new job has 4 companies to choose from and four levels of coverage to choose within each company!!!! I'll have a chance this friday to see the details of what they cover, but we will be getting the platinum version of whichever company we choose (which means NO deductible!!!!). Anyway, the options are Aetna, Cigna, Blue Florida (BCBC), and United. I'm leaning United based on what I'm hearing but of course, they are the most expensive. Anyone have any thoughts? 

 

Obviouslyly, I will check which doctors are in network, what the specifics of the plans are, etc, as well. 

[SparklyUnicorn]

BCBS

 

But really go with the configuration that works for your individual situation.  Except Cigna.  Don't touch them with a 10,000 foot pole.

 

Thing with BCBS is that SOOO many providers take them. 

[ILiveInFlipFlops]

I bill insurance for a living, so my response is based on that plus our experience with our own coverage. 

 

We've been happy with our BCBS, but so much of how good they are depends on your local provider. Some are awful, some are great. Aetna seems to be OK, but I think a lot of providers are not in-network with them (if that matters based on the plan you're getting). 

 

I would avoid Cigna like the plague.

 

ETA: Will you have out-of-network coverage, or in-network only? If in-network only, I would recommend BCBS for the reason Sparkly mentioned. If you'll have out-of-network coverage, will you have a deductible for that? 

Edited April 26, 2016 by ILiveInFlipFlops

[ILiveInFlipFlops]

But really go with the configuration that works for your individual situation.  Except Cigna.  Don't touch them with a 10,000 foot pole.

 

:lol:

[ChocolateReignRemix]

My husband's new job has 4 companies to choose from and four levels of coverage to choose within each company!!!! I'll have a chance this friday to see the details of what they cover, but we will be getting the platinum version of whichever company we choose (which means NO deductible!!!!). Anyway, the options are Aetna, Cigna, Blue Florida (BCBC), and United. I'm leaning United based on what I'm hearing but of course, they are the most expensive. Anyone have any thoughts? 

 

Obviouslyly, I will check which doctors are in network, what the specifics of the plans are, etc, as well. 

 

We have had Aetna and United in the past.  We liked United better than Aetna, but both were fine. 

[Stratford]

There's so much variation between plans and states and whatnot that I'd hesitate to recommend anything too specific.  However, based on our experiences with insurance, Aetna was great (everything was covered - and we used that plan a LOT for surgeries and a couple babies - and no hassles ever) and United was a nightmare.  I'm still paying off a huge bill for speech therapy for my youngest that United totally screwed up and then refused to pay.  It was such a massive headache.  

[QueenCat]

Cigna is the only one I've had bad experiences with. I've had all of the ones you mentioned. But really, what probably matters the most is the actual plan. The Blue Cross plan I have might be completely different than the one you're looking at, so you can't really compare.

[SparklyUnicorn]

:lol:

 

I may have possibly worked for them at one point.

 

I always hate to bad mouth companies I might have worked for, but I can't not say something here.  It's THAT bad.

[mamiof5]

I would avoid Cigna like the plague.

Would you mind sharing why? I DREAD insurance ordeals (and we have Cigna). To the OP I was going to answer I hate it all of them, and loved none (when really I can't say that, we have only had Cigna). But I kind of assumed all was the same!! If there are better options out there I'd love to know :)

[ktgrok]

Cigna is the only one I've had bad experiences with. I've had all of the ones you mentioned. But really, what probably matters the most is the actual plan. The Blue Cross plan I have might be completely different than the one you're looking at, so you can't really compare.

 

Very true. 

 

Another factor is we are hoping for another baby and a homebirth,so I know Aetna is a PIA about that. I think Cigna is too. A midwife I don't want to use is in network for Blue Cross, which would mean I couldn't get a network gap exception to use the midwife I want. United might be my best bet. No area midwives are in network, so I can ask for a gap exception, and they don't have a flat ban on homebirth like Aetna. Cigna only covers CNMs, not CPMs. Now, with all of that state law would give me a way to get around it, but not having to deal with that nightmare would be easier. Fighting for a gap exception is bad enough, without adding in other fights. 

 

that said, maybe one of the plans has excellent out of network benefits and then I won't worry about it. Wont be able to see the plans until Friday though. 

[ILiveInFlipFlops]

I may have possibly worked for them at one point.

 

I always hate to bad mouth companies I might have worked for, but I can't not say something here.  It's THAT bad.

 

 

I can't even imagine what that might have been like. I'm only on the billing end of their systems and payables, and I want to tear my hair out and break things when I have to deal with them. 

[mamiof5]

But really go with the configuration that works for your individual situation. Except Cigna. Don't touch them with a 10,000 foot pole.

 

LOL!!! We've had Cigna forever...I LOATHE dealing with insurance! I assumed all was the same :( Need to check if dh's job offers any other options...

[ILiveInFlipFlops]

Would you mind sharing why? I DREAD insurance ordeals (and we have Cigna). To the OP I was going to answer I hate it all of them, and loved none (when really I can't say that, we have only had Cigna). But I kind of assumed all was the same!! If there are better options out there I'd love to know :)

 

 

I'll PM you.

[SparklyUnicorn]

LOL!!! We've had Cigna forever...I LOATHE dealing with insurance! I assumed all was the same :( Need to check if dh's job offers any other options...

 

It's highly possible you have never had a problem with them and never will.  Like anything else.  But I quit without having a replacement job even though that put me in a less than pleasant situation because I felt they did stuff that was not ethical.  They may have managed to stay within the law, but barely.  It was just nasty nasty cut throat tactics to delay payments, deny stuff for bizarre stupid random reasons, etc.  They were terrible towards their employees.  Working for them was like what I imagine working for a sweat shop in Cambodia is like.  I started having panic attacks. 

 

I went and worked for another insurance company and they were nothing like that.  And yes they too wanted to make money like any other for profit company, but they did not do so with shady practices.

Edited April 26, 2016 by SparklyUnicorn

[ILiveInFlipFlops]

It's highly possible you have never had a problem with them and never will...

 

 

This doesn't surprise me. I can totally see it being like that. 

[SparklyUnicorn]

This doesn't surprise me. I can totally see it being like that. 

 

Well yeah if you haven't used them for much.  Or sometimes you just get lucky.

 

Another factor is if the plan is self funded they weren't like that.  What did they care?  They weren't paying for the claims.  No risk to them and so far less effort on finding ways to get out of paying for stuff.

[itsheresomewhere]

Well IMO Cigna was so much better than BCBS (aka in my house blue hell). They really seem to be in denial mode. I can't tell you my true opinion without using colorful words about them. United was not bad nor was Aetna.

[ILiveInFlipFlops]

Well yeah if you haven't used them for much.  Or sometimes you just get lucky.

 

Another factor is if the plan is self funded they weren't like that.  What did they care?  They weren't paying for the claims.  No risk to them and so far less effort on finding ways to get out of paying for stuff.

 

Sorry, I meant that I can see it being the way you described. I just cut the quote in case you decided you wanted to delete part of it for some reason. Not that you should! I was just being more cautious since I still work with them. Who know what they might decide to do if they hunt me down?!  :leaving:

 

:lol:

[SparklyUnicorn]

Sorry, I meant that I can see it being the way you described. I just cut the quote in case you decided you wanted to delete part of it for some reason. Not that you should! I was just being more cautious since I still work with them. Who know what they might decide to do if they hunt me down?!  :leaving:

 

:lol:

 

oh

 

I hear you.

[ktgrok]

 

 

ETA: Will you have out-of-network coverage, or in-network only? If in-network only, I would recommend BCBS for the reason Sparkly mentioned. If you'll have out-of-network coverage, will you have a deductible for that? 

 

I don't know yet...we will find out Friday when he gets access to the online portal thing. Right now it looks like all our regular doctors take United, BCBS, and Aetna at least. Not sure about Cigna. 

[busymotherof4]

Very true.

 

Another factor is we are hoping for another baby and a homebirth,so I know Aetna is a PIA about that. I think Cigna is too. A midwife I don't want to use is in network for Blue Cross, which would mean I couldn't get a network gap exception to use the midwife I want. United might be my best bet. No area midwives are in network, so I can ask for a gap exception, and they don't have a flat ban on homebirth like Aetna. Cigna only covers CNMs, not CPMs. Now, with all of that state law would give me a way to get around it, but not having to deal with that nightmare would be easier. Fighting for a gap exception is bad enough, without adding in other fights.

 

that said, maybe one of the plans has excellent out of network benefits and then I won't worry about it. Wont be able to see the plans until Friday though.

We had a home birth using United. Was a horrible experience. We did get a decent amount out of them in the end but we were one step from the final appeal to get any coverage.

If you use them #1 clarify that you are asking for the gap for the initial new patient visit, prenatal care and birth. They tried to claim that only the prenatal care was asked for. Then upon appeal they decided that only the birth was in network but the prenatal was out of network. I suspect that decision was so they could avoid paying anything. We had a large deductible for the birth portion while only in network prenatal care would be fully covered. We also had separate in network and out of network deductibles. A year after her birth they paid about $2000. If we had started prenatal care sooner or If I remained pregnant longer I could have had the full amount paid ( they paid per visit and I gave birth at 37 weeks)

United had pulled all sorts of stuff to not pay other claims.We have never had issues with BCBS but when we had BCBS our policy specifically stated that it didn't cover home birth. We still have United and it stinks.

[ktgrok]

You know, now that I think bout it, I think it was Cigna that tried to deny my son's broken elbow as a work related injury. He was 6 yrs old. And don't get me started on the time my trip to an ER for conjunctivitis in both eyes (BAD) was denied as "out patient surgery". Woman at insurance tried to act as if maybe I was confused. No, I'd remember if I had surgery, you crazy person. Someone either coded it wrong or you are an idiot. Finally got that cleared up then they denied it as not medically needed. Um, when both eyes turn bright red and painful and you wear contacts and know that vision can be lost from certain infections associated with contacts, it is definitely medically necessary. I even sent documentation and medical journals. they never covered it. Not sure which company that was, actually. 

[kewb]

Having dealt with numerous insurance companies, I can tell you they are all basically the same.  They all have things they suck about and things they are great about. My experience with the platinum plans is that they have in and out of network coverage with a deductible for the out of network stuff.  They will nickel and dime you on the out of network stuff so it will take you until November to meet your deductible.  But then you get two months of reimbursement.

[ktgrok]

We had a home birth using United. Was a horrible experience. We did get a decent amount out of them in the end but we were one step from the final appeal to get any coverage.

If you use them #1 clarify that you are asking for the gap for the initial new patient visit, prenatal care and birth. They tried to claim that only the prenatal care was asked for. Then upon appeal they decided that only the birth was in network but the prenatal was out of network. I suspect that decision was so they could avoid paying anything. We had a large deductible for the birth portion while only in network prenatal care would be fully covered. We also had separate in network and out of network deductibles. A year after her birth they paid about $2000. If we had started prenatal care sooner or If I remained pregnant longer I could have had the full amount paid ( they paid per visit and I gave birth at 37 weeks)

United had pulled all sorts of stuff to not pay other claims.We have never had issues with BCBS but when we had BCBS our policy specifically stated that it didn't cover home birth. We still have United and it stinks.

Ugh. I can imagine. I do know my midwife of choice works with a billing agency now, to submit things. I THINk she said that United was good about paying, but will double check. 

[busymotherof4]

When dealing with insurance I have felt like The scene in the Incredibles. Highly accurate with United.

[SparklyUnicorn]

You know, now that I think bout it, I think it was Cigna that tried to deny my son's broken elbow as a work related injury. He was 6 yrs old. And don't get me started on the time my trip to an ER for conjunctivitis in both eyes (BAD) was denied as "out patient surgery". Woman at insurance tried to act as if maybe I was confused. No, I'd remember if I had surgery, you crazy person. Someone either coded it wrong or you are an idiot. Finally got that cleared up then they denied it as not medically needed. Um, when both eyes turn bright red and painful and you wear contacts and know that vision can be lost from certain infections associated with contacts, it is definitely medically necessary. I even sent documentation and medical journals. they never covered it. Not sure which company that was, actually. 

 

It's common for insurance companies to try and deny for work related injury.  Of course that's especially stupid if it is a 6 year old, but that to me would be a mistake.  Maybe not a fun mistake, but not a terrible rotten mistake. 

The stuff I'm talking about is far worse.  I'm glad I ended up somewhere else to see that they aren't all like that.  What gets me is there was this general attitude there that made me start feeling like I wasn't doing anything that ultimately involved human beings.  So ya know..it's nothing to worry about.  The other company was very big on reminding us that we were in fact dealing with human beings. 

[busymotherof4]

Ugh. I can imagine. I do know my midwife of choice works with a billing agency now, to submit things. I THINk she said that United was good about paying, but will double check.

I think they were just playing their game with us. Deny valid claims left and right. We had higher then average expenses so We were probably tagged. The only reason we got anything paid is that after their final denial and we notified them we were taking to I forget but the outside appeal, they notified us that they did a internal review and ended up covered as stated by their policies. Funny that.

[SparklyUnicorn]

ktgrok, do you know if the company is self funded?

 

 

[ktgrok]

ktgrok, do you know if the company is self funded?

 

I am 90% sure it is not. DH is supposed to ask for me today. But a google search brings their name up in an article about companies that are no longer self funding insurance and instead turning to private networks. So, unless that has changed, they are not. And the fact that we have a total of 16 plans to choose from makes me also think they are not, as all the self funded companies we've been with had maybe 3 plans total. 

 

I'm hoping it is NOT, as Florida law is pretty clear as far as things like home birth coverage, gap exceptions, etc. But self funded companies don't have to follow state law. 

Edited April 26, 2016 by ktgrok

[SparklyUnicorn]

I am 90% sure it is not. DH is supposed to ask for me today. But a google search brings their name up in an article about companies that are no longer self funding insurance and instead turning to private networks. So, unless that has changed, they are not. And the fact that we have a total of 16 plans to choose from makes me also think they are not, as all the self funded companies we've been with had maybe 3 plans total. 

 

I'm hoping it is NOT, as Florida law is pretty clear as far as things like home birth coverage, gap exceptions, etc. But self funded companies don't have to follow state law. 

 

There are still laws they have to follow.  Self funded has it's pluses.  They seem to deny things far less often and you can sometimes appeal to them to pay for something that normally they won't.

 

One major con though is sometimes certain contracts that insurance companies negotiate with providers aren't extended to self funded plans.  So it can mean a higher cost for the person using the insurance.

 

Oh and something that I saw happen a few times when working in insurance was if a company went out of business the outstanding claims could sometimes be denied because essentially there was no money to pay for them.  That's one hell of an unpleasant surprise.

 

I think all this stuff is absolute bull.  I know people hate stuff like obamacare, but really some of this stuff I think needs a major overhaul. 

[BarbecueMom]

I've had all four (DH was a DoD contractor, we changed insurance more than underwear). From best to worst: UHC, BCBS, Aetna, Cigna. Right now we have UHC and have zero problems. DH just had a very expensive surgery and there were no surprises or issues.

[SparklyUnicorn]

sad and glad that was not all in my head

 

 

[Scarlett]

My husband's new job has 4 companies to choose from and four levels of coverage to choose within each company!!!! I'll have a chance this friday to see the details of what they cover, but we will be getting the platinum version of whichever company we choose (which means NO deductible!!!!). Anyway, the options are Aetna, Cigna, Blue Florida (BCBC), and United. I'm leaning United based on what I'm hearing but of course, they are the most expensive. Anyone have any thoughts?

 

Obviouslyly, I will check which doctors are in network, what the specifics of the plans are, etc, as well.

I love BCBS. And my Xh had/ still has United. It was good also. But I do t think it was any. Enter than BCBS.

[QueenCat]

You know, now that I think bout it, I think it was Cigna that tried to deny my son's broken elbow as a work related injury. He was 6 yrs old. And don't get me started on the time my trip to an ER for conjunctivitis in both eyes (BAD) was denied as "out patient surgery". Woman at insurance tried to act as if maybe I was confused. No, I'd remember if I had surgery, you crazy person. Someone either coded it wrong or you are an idiot. Finally got that cleared up then they denied it as not medically needed. Um, when both eyes turn bright red and painful and you wear contacts and know that vision can be lost from certain infections associated with contacts, it is definitely medically necessary. I even sent documentation and medical journals. they never covered it. Not sure which company that was, actually. 

 

That's a whole new level of crazy!

[Guest]

We were with Aetna a number of years ago, and I found them good to work with.  I remember this specifically because my doctor was all freaked out that our company was going with Aetna, so I expected the worst.  But by the end of the first year, even that doctor agreed that it was a good situation.

 

That was years ago, but I do think that a culture is pretty hard to change...  I don't know what effect the OCare laws have had on them.  

 

:0)

[AmandaVT]

I bill insurance for a living, so my response is based on that plus our experience with our own coverage. 

 

We've been happy with our BCBS, but so much of how good they are depends on your local provider. Some are awful, some are great. Aetna seems to be OK, but I think a lot of providers are not in-network with them (if that matters based on the plan you're getting). 

 

I would avoid Cigna like the plague.

 

ETA: Will you have out-of-network coverage, or in-network only? If in-network only, I would recommend BCBS for the reason Sparkly mentioned. If you'll have out-of-network coverage, will you have a deductible for that? 

 

Me too and I agree totally. 

 

Stay away from Cigna. Their customer service is terrible and they pay the least of all the providers we work with. In addition, the members seem to have the highest copays and deductibles. 

 

We don't see a ton of Aetna, but they're easy to work with and the benefits seem pretty good. 

 

BCBS is the easiest by far to deal with, almost everyone takes them around here and  they are easy to access online or by phone.

[Katy]

I've had all of them and BCBS was the best.  Everyone took them and we never had to either personally or have a doctor argue that yes, that emergency hospital stay really was medically necessary. United fought everything.  It was obnoxious.  Really though, it depends on the options. 

 

ETA: Can't speak to Cigna because I don't think we had anything other than preventative care that year.

Edited April 26, 2016 by Katy

[Melinda S in TX]

We have had a lot of major dealing with United, and we are currently with them.

 

For Hannah's cancer, they covered everything, including approving the more expensive proton radiation instead of regular radiation we could get locally.  They also allowed per diem since we had to live in Houston for a month while Hannah received radiation.  They did fight us over a medical stroller for her.  It really seemed like they were trying to drag it out until January 1 when our deductibles start over.

 

For Steven's cancer they covered everything including experimental treatments.

 

For Miriam's epilepsy and autism, they covered "normal" stuff.  They would not pay for a neuro-psych eval that she needed due to brain damage from seizures.  We ended up paying for that, and she was diagnosed with autism and brain damage.

 

For Rebekah's many problems, they have paid for all of the normal stuff.  She is totally tube fed, and they pay for the pump and bags, but won't pay for the formula.  They won't pay for her compounded medications.  They refused to pay for a wheelchair, even though she can't walk.

 

I am getting paperwork all the time to fill out so they can see if it was work/accident related or if we have some other coverage.  I'm glad we have United, but sometimes it can be a pain.

[Rachel]

We have had more than one frustrating experience with Anthem (BCBS) but it is such a big company that I am certain this varies from state to state.

 

We currently have Cigna, we haven't had any issues with our health insurance but they also carry our dental insurance. We have had a very difficult time finding a dentist that accepts Cigna.

 

I would make sure the doctors you see most frequently accept whichever plan you end up selecting.

[ktgrok]

hmm. the only homebirth midwives in town do not do VBAC, so it seems I should be able to get a gap exception no matter what a choose :)

 

At least, I hope so. 

[Carrie12345]

I've had all four (not in Florida, of course) and I've had to stay on top of every single one.  They're all crooks.

 

For me, the bottom line comes down to the total cost of my premiums plus (in-network) OOP maximum.  For the past few years, for the services we want, BC has been our pick.

[vonfirmath]

BCBS

 

But really go with the configuration that works for your individual situation.  Except Cigna.  Don't touch them with a 10,000 foot pole.

 

Thing with BCBS is that SOOO many providers take them. 

 

WE have a combination of United and BCBS.  The actual insurance is BCBS but United "runs" the plan? Somehow. Its odd. We're satisfied. Not platinum though.

[cjzimmer1]

In case you haven't had enough people tell you this, stay away from Cigna. I've had joint but troubles with them. My doctor dropped them many years ago because they were so difficult for her to deal with and she said their reimbursement rates were the worst of any she dealt with. Aetna wasn't great for us because we didn't have many doctor in our area that were covered, if I were in an area with better coverage they would probably have been okay. We've always been happy with BCBS, I don't think United is in our area since I've never seen it offered anywhere.

[RKWAcademy]

I've used United and BCBS of a different state.  Hands down, I'd pick our BCBS any day.  They are more expensive, so I'm with United now.  But I hate it.  They nit-pick every little thing (like refusing to allow 3 mo supply of a normal prescription when BC has allowed it for ages (think Vitamin D and thyroid med)).  Since you're wanting platinum level, you probably want the best.  In my state, that's BCBS.

[Mom23Boys]

We've had BCBS of Louisiana (where we live), BCBS of Illinois and Aetna.

 

BCBS of Louisiana was significantly worse to deal with than BCBS of Illinois. We had to call each and BCBS of LA was a pain it the butt to deal with. BCBS of IL was much better.

 

I had to call BCBS of IL monthly for a while and they were super easy to deal with. There was some kind of coding problem with our speech therapy (btw, the only plan we had that covered speech therapy),but  they quickly fixed it each call. After a few months, between them and the speech therapist's office, they got it straightened.   Very little hold time and very pleasant representatives. 

 

Aetna is what we currently have and we like it, but we haven't had to call about much of anything. It's self-funded by DH's company, so I don't know if that makes a difference. Good coverage for our area and good costumer service when have had to call them.

 

Each plan has been slightly different, but that depends on the contract between the employer and the insurance company. We have the most expensive plan my DH's company offers because it best meets our needs. In our case, it still isn't overly expensive bc his company pays a large portion of the premium.

[*lifeoftheparty*]

...

Edited December 18, 2016 by *lifeoftheparty*