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 Post subject: Health insurance plans that cover local providers
Post Posted: Nov 12, 2014 2:45 pm 
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OK, I am doing a little advance research on quality insurers that cover local providers.

HealthOP has entered the marketplace and because they are a very low cost carrier, it has had a very significant impact on tax credits, resulting in an 140 percent increase in my monthly out of pocket payment. My carrier, Kaiser, has had a very modest increase but the real impact is from HealthOP. I have spent many hours on the phone with Connect for Health and DORA sorting this out. To maintain an affordable plan I would need to downgrade my plan significantly (ie change to an unknown doctor, go to a huge deductible...). And it is not that affordable compared to my current plan.

Please do not comment on tax credits. It is not my fault that I have to rely on them. I have worked since I was 14 (I am 59). It is not my fault that I am here being a full time caregiver for a husband with Alzheimer's. Last year every single nickel I made went to provide for caregiving, from people who basically did nothing but watch TV and fix him a sandwich. So now I work when I can, buy my meat out of the "manager's special" bin, and try to get the most cost effective deals that I can, whether it be health insurance or new snow tires. I would absolutely die to be back to work full time!!!! Being the kid of Depression era parents, the motto was "If you can't afford it, you don't need it." I have absorbed that lesson.

Does anyone know about HealthOP? I have never heard of them. They seem to cover some local docs, but would love to hear your experiences. I will probably stick with Kaiser and swallow the increase but am interested in what others may have to say. Thanks in advance!

Stay warm out there!!!


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Nov 12, 2014 3:07 pm 
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Start with your doctors and see what they think? The Co Op is in its second year and by setting the State rate they will gain market share. It's a sign competition is working. Kaiser is good, but are they worth a 140 percent increase in your premium? Kaiser doesnt have a clinic up here. Call the practices that they list, check them out on healthgrades... Call the insurance commissioners office o validated the Co Op's standing. Open enrollment starts Saturday.


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Nov 12, 2014 4:20 pm 
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Thanks!

I live in South Evergreen and use the Evergreen Kaiser clinic. The doctors there, Dr Silaban (my doc) and Dr Ward, are just the very best!

I have done some online checking and see there a couple of Evergreen docs that participate in this plan, as well as Dr Linn in Conifer that many 'cammers think the world of. I am not sure he is accepting new patients, though. I will keep researching. My poor departed Dad had some amusing experiences with Evergreen docs that I would not wish to repeat :)

Thanks again!


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Sep 5, 2015 3:13 pm 
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Hey, Muumydog. I wonder what you ended up doing. We are researching new providers as well and are befuddled.


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Sep 5, 2015 3:43 pm 
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Well, I ended up deciding to work with a broker (free through ConnectforHealth) from Gysin Insurance who steered me away from the COHealthOP. Many co ops have gone bankrupt (see, Nebraska) and so I ended up sticking with Kaiser for a huge premium increase. The care is convenient and very good. The health exchange has many problems but if anyone can clean it up it is Kevin Patterson interim CEO, with whom I have worked for years in many positions. He is a good guy. Good luck to you, cliff dweller. I would skip the cooperative as you would have to go to Arvada or Wheat Ridge to see your Dr. I do not think anyone up here accepts this plan.


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Sep 5, 2015 4:16 pm 
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mummydog-

So sorry to hear of all your troubles with insurance now. I suggest you contact Group Insurance Analysts in Wheat Ridge and see if they can help you. Their website is e-gia.com. They have been most helpful to us for several years- never cost us anything, and I've referred several people to them.


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Sep 5, 2015 5:31 pm 
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Thanks Mummydog. Our home and auto insurance are from a co-OP, so they looked very attractive to me. I sure don't want to go to Arvada or Wheat Ridge. I'm not wild about the idea of Kaiser, either. I guess I'll keep researching. I'll be checking out that link, KRM18. Thanks! The broker I've been working with has been underwhelming.


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Sep 5, 2015 7:39 pm 
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I have the HealthOP and go to Conifer Medical Center. In fact I called CMC before I signed up and asked them which ones they like to work with. I chose Kaiser the year before and that was a disaster for me as you can only go to their Kaiser centers.


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Sep 5, 2015 9:07 pm 
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They don't except the EPO plan and some others, so beware


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Sep 5, 2015 9:37 pm 
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We had United Healthcare Compass this year, and were told that the providers at CMC were part of the plan. Then in July we got a letter that they never were, even though we'd been covered there all year. We had to find a new doctor. It sucks, and I'm furious with UHC. We'll be looking for a different plan next year. I want Dr. Pinsinski back! The doctor we had to see seemed nice enough, but a 9 year doctor/patient relationship is hard to break. :(


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 Post subject: Re: Health insurance plans that cover local providers
Post Posted: Sep 5, 2015 9:54 pm 
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I can see that a lot of insurance companies have an EPO network and a PPO network. The tough decision is if I like my current doctor $300 a month worth? :(


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