I currently have a PPO plan with FloridaBlue. In the marketplace it corresponds to a gold plan, with the largest network they have in the state.
It’s great, but the premiums suck. I buy it on my own, self-employed.
I’m thinking about switching to a bronze plan. I have enough savings to be able to pay higher deductibles, coinsurance percentage, and higher max out of pocket if one of us gets seriously ill during a calendar year.
In other words, I can assume more risk if that results in monthly savings on premiums.
But I have one concern. A while back I remember one nurse or administrative assistant (not sure who it was) at some medical office was telling me during chit-chat that generally speaking the better the policy the more likely they are to approve some expensive procedure, like an MRI. And the cheaper the plan, the more likely they are to deny it.
Is there any truth to that?
All else being equal (same insurance company, same network, same type of coverage), would a bronze plan result in more denials than a gold plan?
It makes no sense to me, since with a bronze plan I would be paying a higher share of the cost of the procedure. But maybe there is something I don’t know.
So please help me out. It’s time to start picking a plan for the next year.
submitted by /u/uRh3f5BfFgjw74FGv3gf
[link] [comments]I currently have a PPO plan with FloridaBlue. In the marketplace it corresponds to a gold plan, with the largest network they have in the state. It’s great, but the premiums suck. I buy it on my own, self-employed. I’m thinking about switching to a bronze plan. I have enough savings to be able to pay higher deductibles, coinsurance percentage, and higher max out of pocket if one of us gets seriously ill during a calendar year. In other words, I can assume more risk if that results in monthly savings on premiums. But I have one concern. A while back I remember one nurse or administrative assistant (not sure who it was) at some medical office was telling me during chit-chat that generally speaking the better the policy the more likely they are to approve some expensive procedure, like an MRI. And the cheaper the plan, the more likely they are to deny it. Is there any truth to that? All else being equal (same insurance company, same network, same type of coverage), would a bronze plan result in more denials than a gold plan? It makes no sense to me, since with a bronze plan I would be paying a higher share of the cost of the procedure. But maybe there is something I don’t know. So please help me out. It’s time to start picking a plan for the next year. submitted by /u/uRh3f5BfFgjw74FGv3gf [link] [comments]Read Morer/HealthInsurance