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Medicare and Health Care


*This is a non-medical board. This site shall not be used to seek professional, medical or legal consultation.

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age person with End-Stage Renal Disease (ESRD). There are many different parts to Medicare; with all of these options, it can be confusing.

This forum will allow members to share their experience with medicare and seek advice* on certain medicare-related situations.

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tfcheng  
#1 Posted : Friday, June 08, 2012 2:48:49 AM(UTC)
tfcheng

Rank: Newbie

Groups: Registered
Joined: 6/8/2012(UTC)
Posts: 2

Hi,
   I am a new guy and have to choose my health insurance, and I have narrowed down to BCBS basic and GEHA Std. GEHA std does have a lower premium and so I am leaning towards it now. My medical situation need is that I have a wife and 2yr daughter, and we might want to have another baby this year, so maternity coverage is important to us. None of us go to see doctors very often. I sometimes need to see my family doctor for respiratory infection and my daughter just gets her routine checkups every now and then, and my wife only needs her pap smear. In terms of maternity, GEHA told me the first doctor visit for pregnancy is subject to copay and deductible ($700/yr), and BCBS said if the doctor billed it as "maternity", it's 100% covered. The overall out-of-my-pocket payment seems close between the two, can someone give me some advice? thanks!


ex-military  
#2 Posted : Friday, June 08, 2012 3:48:23 AM(UTC)
ex-military

Rank: Senior Member

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Joined: 1/19/2012(UTC)
Posts: 642

Go with the best coverage, regardless of premium costs.  You have a 2 year and want to have another.  My friend, kids do and will get sick and you will be visiting the doctor much more often than you do now.  This will become especially evident when your children hit daycare or school and get more exposure to other kids.  Personally, I have BCBS Standard.  Just my two cents.
Fed1969  
#3 Posted : Friday, June 08, 2012 3:51:44 AM(UTC)
Fed1969

Rank: Senior Member

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Joined: 10/28/2010(UTC)
Posts: 3,333

I recommend BCBS standard. It cost more, but the government is picking up most the cost.
edalder  
#4 Posted : Saturday, June 09, 2012 2:40:47 AM(UTC)
edalder

Rank: Senior Member

Groups: Registered
Joined: 10/9/2001(UTC)
Posts: 1,541

As with most such questions, the answer is that "it depends".

One thing you should do is check whether GEHA has "in network" physicians in your area. Network physicians can be skimpy in certain areas with GEHA and GEHA really punishes you financially if you go out of network. If your wife prefers to use the services of a particular OB-GYN, make certain that physician is "in-network". This statement applies to both plans.

BCBS basic does not allow you to go out of network, except in an emergency, but their physician networks seem to be a bit larger.

With a young child and another one planned, you do need to realize that maternity care and well baby care will be important issues for you. However, I suspect both plans do well in that area.

GEHA co-pays for brand name drugs can be high. If anyone in your family regularly uses a brand name prescription drug with no generic equivalent, you may want to rethink GEHA.




Kivi
GSclimber  
#5 Posted : Sunday, June 24, 2012 2:08:19 PM(UTC)
GSclimber

Rank: Rookie

Groups: Registered
Joined: 5/27/2012(UTC)
Posts: 38

It really depends on your individual situation, but BCBS standard is a very popular choice.  

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