Kevin Knauss: Health, History, Travel, Insurance
Posts related to the coverage and benefits of Health Maintenance Organizations (HMO), how they work, individual, family, small group, Medicare, Medi-Cal.
The value of dental insurance is questionable in the minds of many consumers. And I don’t necessarily disagree with that evaluation. However, the importance of regular dental exams, cleanings, and hygiene cannot be disputed. If dental insurance keeps a person on track with good dental hygiene and habits, they will be spared the expense of expensive dental procedures in the future.
Blue Shield individual and family plans also come with Teladoc for phone call consultations, NursesHelp 24/7 online chat, and the BlueCard program that allows member’s access to providers when they are travelling out-of-network. The plans also include a physician home visit. The home visit, Heal on-demand house calls, is subject to the member’s location. There is also Telebehavioral health benefit that helps members with mental or substance abuse challenges access therapy online with mental health professionals.
Before I start gathering coverage information, I create a table with preferred or “must have” providers, hospitals, and drugs in rows, with the available health plans across the top columns. I then mark which health plan has the providers in-network and if the drugs are covered and at which Tier.
With the loss of the Anthem Blue Cross PPO plans in most of California and the double-digit rate increases on many plans, consumers are starting to look at the HMO plans available to them. There was a time when HMO plans were always more expensive than PPO plans. In the new health insurance landscape of Obamacare, HMO plans are becoming less expensive. But is a HMO plan right for you and your family?
Consumers looking to select a new affordable Care Act health plan will have to carefully consider the benefits and limitations of the different provider networks associated with each plan. In addition to the familiar PPO and HMO designs, many carriers have added the EPO. Which network is best for your family?
