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Chuck_G  
#1 Posted : Monday, September 14, 2009 4:15:33 AM(UTC)
Chuck_G

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I have had BC/BS Standard Option for self and family for several years, and have been okay with it. This year, it seems like costs have really gone up. I'm a diabetic and currently taking one generic prescription, and two brand name prescriptions, and my doctor wants to add another brand name prescription.

I'm considering switching health plans this year. I like the coverage with GEHA, but the premium is higher than BC, and it wouldn't give me much relief on my monthly prescriptions. I'm considering APWU or Mail Handlers. Does anyone have any experiences with these other plans?
dhacker56  
#2 Posted : Monday, September 14, 2009 4:59:00 AM(UTC)
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Check out NALC! You only have to become an associate member. $36 per year to be eligible.
Chuck_G  
#3 Posted : Monday, September 14, 2009 11:43:37 PM(UTC)
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Thanks dhacker56. Did you use the mail order pharmacy? My brand prescriptions would work out better with NALC if I went with mail order, I've just never done that before. Anyone have any experience with this?
TopDown  
#4 Posted : Tuesday, September 15, 2009 12:03:52 AM(UTC)
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I signed up for NALC in 2009 for the first time. Injured my back early in 2009 and ended up having surgery in the summer. NALC has paid quickly, sent me statements timely so I could pay my portion timely, and there were no problems.

I did have to explain to each DR office and Hospital that NALC was a federal employee plan that also covered non-postal. None of my sources had a patient covered by NALC before. No problems just extra conversation between me and the person signing me in.

In the past I have used GEHA, BC/BS, and Group Health. I've been very pleased with my NALC coverage. I never used the mail-order prescripton coverage.
dhacker56  
#5 Posted : Tuesday, September 15, 2009 12:57:32 AM(UTC)
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The mail order is handled thru CVS. You can even get your 3 month supply filled at any CVS RX at the same copay charge as thru the mail. Very handy!
Chuck_G  
#6 Posted : Tuesday, September 15, 2009 2:17:06 AM(UTC)
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Thanks dhacker56 and TopDown. I did call and ask about the mail order plan and the Maintenance Choice program. It's a much better deal for me than BC. Looks like NALC is the best choice for me this open season.
dhacker56  
#7 Posted : Tuesday, September 15, 2009 2:22:15 AM(UTC)
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Am in the middle of a dispute with NALC about preventive care. Be sure you call and check ALL aspects of this part of the coverage. All will work out I think and they seem very helpful but it will require an appeal I am afraid.
Spitzy678  
#8 Posted : Thursday, October 15, 2009 12:12:50 PM(UTC)
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I used BCBS from 1977 to 2008. Their premiums were so high, the deductibles were going up, everything was going up. I changed to NALC in 2009. Everything has been great with NALC. I stongly suggest NALC. Yea, you have to pay a yearly fee to join, but $35 or whatever it is is nothing to what BCBS was going to charge over the year. I will be staying with NALC this year!
Chuck_G  
#9 Posted : Thursday, October 22, 2009 9:19:12 PM(UTC)
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Thanks for the relpy Spitzy. I'm pretty set on switching to NALC this year. The deciding factor was the maintanence plus plan for prescriptions. I see they raised their mail order price for name brand drugs from $35 to $65 for a 90 day supply, but even with that change it's still better than what I'm paying per month the BC standard.
jagfan  
#10 Posted : Friday, October 23, 2009 5:37:49 AM(UTC)
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I've had BCBS for over 20 years and have been pleased for the most part with their coverage and extensive PPO network. But their rates are going out of sight. I've done much research on the NALC/CIGNA Healthcare Plan and the benefits offered under it are almost identical to BCBS and their premium is less. Their PPO network is quite vast as well. I use the Mayo Clinic extensively and they are a CIGNA PPO so that really tilts the scale to switch. Even after paying the $36 non postal association fees, my husband and I can save $600 in premiums.

I have an inquiry for those of you who already have NALC. Does your NALC insurance card identify anywhere on it that CIGNA is the benefit provider? If it doesn't, I foresee many questions and a lengthy registration process when presenting it to medical providers and hospitals.
edalder  
#11 Posted : Friday, October 23, 2009 10:10:30 AM(UTC)
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I am in the NALC plan.
Kivi
postalwiz  
#12 Posted : Sunday, October 25, 2009 2:46:18 AM(UTC)
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One thing to remember to be included in the price is the fact that you will have to pay
Union Dues in order to take the NALC insurance. May want to take into consideration.
dhacker56  
#13 Posted : Sunday, October 25, 2009 3:58:49 AM(UTC)
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WOW! those dues are exorbitant. If you were a letter carrier it will cost at most 18$ per YEAR!!! I am paying $10 (.84 per month) If were not a carrier it will cost $36 per year. How much is BC/BS. NALC is 299.74/month
jgb04  
#14 Posted : Sunday, October 25, 2009 9:43:05 AM(UTC)
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I have had the NALC plan this year and have been happy with it. However I did not use it that much. I was wondering if anybody has had the APWU High plan?

Its considerably cheaper ($416 a year for self) then the NALC plan, same PPO network (Cigna). The only real difference i see is that NALC has a $200 admission co pay on a hospital stay and then covers room and board at 100%. With APWU I would pay 10% with no admission co pay. Most of the items covered are at 10% coinsurance rather then a 15% coinsurance as is the case with NALC and BCBS. They also waive $30 of the $35 associate member fee for non postal employees and they allow postal employees to have it without being a member in the union they can do an associate membership.

Just curious if anybody has had this plan and what their experiences were with it good/bad?

I was also looking at the GEHA basic plan which seems to not have such a great network in the New Orleans Area

and the Foreign Service Benefit Plan which uses Coventry as there PPO.

If anybody has had any experience with these it’d be great to hear.
jagfan  
#15 Posted : Sunday, October 25, 2009 9:25:24 PM(UTC)
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quote:
Originally posted by dhacker56:
How much is BC/BS. NALC is 299.74/month


BCBS monthly rates are 175.08 self or 400.97 family. So there is a substantial savings by going with NALC even with the annual membership fee of $36.

I was also checking out the SAMBA plan. There is no membership fee and they also use the CIGNA network. Their coverage differs a bit, but their monthly rates for standard plan are less than NALC, 108.60 self or 248.04 family.
jagfan  
#16 Posted : Sunday, October 25, 2009 9:42:46 PM(UTC)
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NALC pharmacy benefits are a bit fuzzy to me. According to the brochure, you are limited to a 30 day supply and one refill at a retail pharmacy. I have a lung condition that requires me to take antibiotics 10 days per month. That 10 day supply right now costs me less than $1/month and my doctor only has to write one RX for the entire year. If I understand the NALC plan, I'd have to have prior authorization or my doc write an RX every other month. Seems like a hassle for me and the doc. In addition to their regular formulary, they have a CareSelect program but I can't find the drug list for this program. If there is a link, I'm missing it.

Right now I'm also on 4 maintenance drugs, 2 generic and 2 name brand that I get a 90 day supply via mail order. That's convenient and the generics are cheap: $0 for the first four generics but $65 for the name brand.

Anyone using the NALC pharmacy(retail or mail order) please share your experiences. Thanks
dhacker56  
#17 Posted : Sunday, October 25, 2009 10:14:05 PM(UTC)
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Thanx for the suggestion but unfortunately RX charges would make it a non starter. Then the other charges for hospital is too much of a risk.

I just noticed your last post. You should be able to get your DR to write the RX so that you can get a 90 day supply from any CVS at the same cost as the mail order option. Also with regards to the Care Select drug program they will send you the list of drugs in the program if you request it from them at 1888-636-6252. they will also answer your questions. Very helpful I have found out this year.
jagfan  
#18 Posted : Sunday, October 25, 2009 10:44:00 PM(UTC)
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quote:
Originally posted by dhacker56:
Thanx for the suggestion but unfortunately RX charges would make it a non starter. Then the other charges for hospital is too much of a risk.



In the quote above, are you referring to SAMBA?

I found the link to the NALC formularies so I will check to ensure my meds are listed. As far as the 10 day antibiotics I should be able to work something out.
dhacker56  
#19 Posted : Sunday, October 25, 2009 11:05:31 PM(UTC)
dhacker56

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link please?
jagfan  
#20 Posted : Sunday, October 25, 2009 11:27:16 PM(UTC)
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quote:
Originally posted by dhacker56:
link please?


NALC Pharmacy Drug Lists
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