Hi, the issue is pretty simple but I can’t find any info online.
Our family has had Kaiser HMO for…about 20 years through my husband’s employer. He pays maybe $75/month for the whole family. We’re all really healthy. It’s been a great deal.
However, we live in an area that is not known for great health care (at Kaiser or anywhere else in the region) and as we’re rising into middle age, we’re still healthy but can imagine we might eventually develop some health problems. (My best friend died of cancer last year, and it really made us think of how life is short and “things happen.”)
So also, my employer also offers — free of charge, even if I put the whole family on it — a high-deductible Blue Cross PPO, with no geographical limits. The deductible is $3,000 per person, after that it’s a typical 20% payment, and there’s a maximum out of pocket of $6,350 per person or $12,700 for the family for the year.
In earlier years, I’ve always waived any coverage, because I couldn’t imagine using it, and didn’t want to waste my employer’s money.
However, if (God forbid) any of us developed a rare or complicated health condition, it might be nice to have that other coverage waiting in the wings, like for a second opinion, or to travel out of the area to a major university health center or something. If spending $12,700 might save a family member’s life to get excellent care out of the area, of course we would use that insurance.
So the idea is, the family would keep Kaiser for the routine stuff as long as we remain healthy, but also have this high-deductible Blue Cross PPO if anything catastrophic happened — or also if our kids leave the Kaiser coverage area before they’re 26, it would come in handy for them, too, to continue coverage.
My question is: Is there a downside to taking both health plans? One friend said she believes if I took the policy, it would become my primary policy and I’d be stuck using a high-deductible PPO and not have the option to use Kaiser — but is that true? That doesn’t seem right?
I understand how that would be the case if we had two “regular” insurance policies. In that case, they would bill mine first, and then my husband’s second. But if one is an HMO, and there’s zero overlap between providers or plans, it seems like there’s no way I wouldn’t be allowed to keep using Kaiser if I want, and I’m still kept on the plan?
So does anyone know how this works? I don’t want to take the free high-deductible policy, if it means I’d have to start using it instead of Kaiser, or if Kaiser would bill Blue Cross and then stick me with a $3000 deductible every year? Thanks!
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Hi, the issue is pretty simple but I can’t find any info online. Our family has had Kaiser HMO for…about 20 years through my husband’s employer. He pays maybe $75/month for the whole family. We’re all really healthy. It’s been a great deal. However, we live in an area that is not known for great health care (at Kaiser or anywhere else in the region) and as we’re rising into middle age, we’re still healthy but can imagine we might eventually develop some health problems. (My best friend died of cancer last year, and it really made us think of how life is short and “things happen.”) So also, my employer also offers — free of charge, even if I put the whole family on it — a high-deductible Blue Cross PPO, with no geographical limits. The deductible is $3,000 per person, after that it’s a typical 20% payment, and there’s a maximum out of pocket of $6,350 per person or $12,700 for the family for the year. In earlier years, I’ve always waived any coverage, because I couldn’t imagine using it, and didn’t want to waste my employer’s money. However, if (God forbid) any of us developed a rare or complicated health condition, it might be nice to have that other coverage waiting in the wings, like for a second opinion, or to travel out of the area to a major university health center or something. If spending $12,700 might save a family member’s life to get excellent care out of the area, of course we would use that insurance. So the idea is, the family would keep Kaiser for the routine stuff as long as we remain healthy, but also have this high-deductible Blue Cross PPO if anything catastrophic happened — or also if our kids leave the Kaiser coverage area before they’re 26, it would come in handy for them, too, to continue coverage. My question is: Is there a downside to taking both health plans? One friend said she believes if I took the policy, it would become my primary policy and I’d be stuck using a high-deductible PPO and not have the option to use Kaiser — but is that true? That doesn’t seem right? I understand how that would be the case if we had two “regular” insurance policies. In that case, they would bill mine first, and then my husband’s second. But if one is an HMO, and there’s zero overlap between providers or plans, it seems like there’s no way I wouldn’t be allowed to keep using Kaiser if I want, and I’m still kept on the plan? So does anyone know how this works? I don’t want to take the free high-deductible policy, if it means I’d have to start using it instead of Kaiser, or if Kaiser would bill Blue Cross and then stick me with a $3000 deductible every year? Thanks!
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