Anybody have this through the marketplace? Pros? Cons? Experience?
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Scott & White HMO Plan
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Last: 4 yr ago by jphil1
Had it a few years ago but dropped it after their premiums went up 30% in one year.
Pro: none
Con: you MUST see S&W doctors.
Con: you MUST see S&W doctors.
All of my docs are S&W docs. However, it is very problematic if you travel. Which we do. And why we didn't choose either S&W Medicare plan.dubi said:
Pro: none
Con: you MUST see S&W doctors.
Exactly the same with me I have the mutual of omaha plan G supplement and love it I see all the S&W folks paying a copay and I never do, far better than a S&W advantage plan especially when you travel a lot
Anyone have suggestions for finding a plan not in the marketplace? My wife and I are both self-employed. Went through the marketplace this past year, and I am not impressed. We got the highest Blue Cross Blue Shield plan we could. At the end of the stay, it's still an HMO.
vmiaptetr said:
Anyone have suggestions for finding a plan not in the marketplace? My wife and I are both self-employed. Went through the marketplace this past year, and I am not impressed. We got the highest Blue Cross Blue Shield plan we could. At the end of the stay, it's still an HMO.
Can you form your own small group? Can you buy group coverage through a client? Just a couple of ideas. ACA has destroyed individual coverage.
The federal government was never meant to be this powerful.
Have you looked into a health share?
https://hsaforamerica.com/blog/the-hsa-for-america-healthshare-plan-comparison-2020-update/
https://hsaforamerica.com/blog/the-hsa-for-america-healthshare-plan-comparison-2020-update/
I have ambetter from the marketplace. My St Joe doc takes it. No complaints yet.
Agreed. We have dealt with private insurance for over 30 years. What the ACA did to our coverage has been criminal. After years now paying unprecedented premiums for max deductibles only a. major event could meet we have revamped our private company literally in order to buy decent health insurance for our employees and family. We will go from BCBS HMO that sucks to the PPO's. Finding a way to create a small group is your only hope on this. Or start working for someone else.LOYAL AG said:vmiaptetr said:
Anyone have suggestions for finding a plan not in the marketplace? My wife and I are both self-employed. Went through the marketplace this past year, and I am not impressed. We got the highest Blue Cross Blue Shield plan we could. At the end of the stay, it's still an HMO.
Can you form your own small group? Can you buy group coverage through a client? Just a couple of ideas. ACA has destroyed individual coverage.
I have BC/BS - I do see a couple of S&W doctors (they take BC/BS) because there are not many dermatologists my insurance will take here in town. And there are hardly any neurologists in town.
Those 2 doctors are good. But I cannot imagine being on the S&W plan.
The dermatologist has a 9 month wait to get in if you don't already have your next appt scheduled. The neurologist has a 6 month wait....
What is the wait for some of the other specialties? No thank you.
Those 2 doctors are good. But I cannot imagine being on the S&W plan.
The dermatologist has a 9 month wait to get in if you don't already have your next appt scheduled. The neurologist has a 6 month wait....
What is the wait for some of the other specialties? No thank you.
FAT SEXY said:trouble said:
Have you looked into a health share?
https://hsaforamerica.com/blog/the-hsa-for-america-healthshare-plan-comparison-2020-update/
Most of those require you to attend regular church services?
I wouldn't say must anymore. Ours makes you sign a pretty vague "statement of faith" but there's no follow-up beyond that.
I could write a 5-page letter on this, bottom line, health care in America is a struggle at best. as a new person on Medicare and self-employed for the last 20 years, (socialized medicine) Medicare, whatever you call it, shines a bright light on how bad our system is just an example, one doctor billed 450.00 to Medicare they paid 4.75 and of course it was accepted without question I assume the cash pay for that procedure would have been probably about 300.00 and of course I would have paid it because with a high deductible policy I had no choice, so we have a system that punishes the middle class while they raise a family and can only afford high deductible policies, yet when you are fortunate to turn 65 no matter your net worth you get a 99% discount on procedures
In the post-war 1940's, we as a society decided that in lieu of pay increases, we would accept employers providing health insurance for employees. These plans were essentially major medical plans that covered extravagant medical expenses for surgeries and accidents. Preventative healthcare did not exist, nor did expensive medications and treatments. A trip to the doctor might be $25 and medications were few and those that existed were inexpensive. Both were paid with cash. Other countries decided to tax citizens to provide "socialized"/ government-controlled healthcare.
This US system worked fine until life-saving medications and treatments, tests, and preventative care were developed and demanded by patients and providers. At that point, healthcare costs exploded. And employers passed more healthcare costs on to the employees. Add in for-profit health plans and PBMs and cost have spiraled out of control.
It can be argued our system is the best. In 45 years of working in the biopharmaceutical industry, I'm no longer convinced. Our system may be broken. And as the only industrialized country in the world that has a for-profit, employer-based system, maybe we're wrong.
I'm thrilled to be on Medicare now.
This US system worked fine until life-saving medications and treatments, tests, and preventative care were developed and demanded by patients and providers. At that point, healthcare costs exploded. And employers passed more healthcare costs on to the employees. Add in for-profit health plans and PBMs and cost have spiraled out of control.
It can be argued our system is the best. In 45 years of working in the biopharmaceutical industry, I'm no longer convinced. Our system may be broken. And as the only industrialized country in the world that has a for-profit, employer-based system, maybe we're wrong.
I'm thrilled to be on Medicare now.
Been self-employed for the past 7.5 years and signed up with Liberty Health Share. I was very happy with them at first, but I no longer recommend them due to administrative delays in processing medical bills. I have recently switched to Sedera Health Share, which I like so far.
Health Share is basically non-profit health insurance. With Sedera you present yourself as a self-pay patient. Sedera will then deposit the money needed to pay your medical expenses into your debit account.
Here is a good comparison article on the various Health Share organizations:
https://ochnahealth.com/health-cost-sharing/
Health Share is basically non-profit health insurance. With Sedera you present yourself as a self-pay patient. Sedera will then deposit the money needed to pay your medical expenses into your debit account.
Here is a good comparison article on the various Health Share organizations:
https://ochnahealth.com/health-cost-sharing/
I researched health share accounts prior to my retirement and getting on Medicare, so I never could figure out where they took the cost basis for the procedure from, because the latest example for me is my cardiologist ordered a nuclear stress test, they billed 13,000.00 Medicare paid 1400.00
We need to look into that one. We're still with Liberty for now but they took forever to pay my youngest's NICU bills.
we have exactly the same G supplement and have no problem anywherehappyinBCS said:
Exactly the same with me I have the mutual of omaha plan G supplement and love it I see all the S&W folks paying a copay and I never do, far better than a S&W advantage plan especially when you travel a lot
AG'73