Nationwide Health Insurance

[sandsys]

3 hours ago, Barbaraok said:

They self-insure and BCBS administers the program

That's what we had until Medicare kicked in. I'm glad Dave was able to work for one company all those years to qualify for this excellent benefit.

Linda

[Blues]

On 9/30/2018 at 10:33 AM, Big Greg said:

I drove a school bus for 10+ years and that allowed me to get BCBS Advantage medical insurance only after I retired.  This benefit was not available while I was driving as the job was considered part time.  After driving the equivalent of 10 full time years and retiring, Michigan School Employees Retirement policy has been good across the USA. even as a SD resident.   Greg

Thanks for the explanation.  In the future, it would probably be helpful to say that the plan you have with a nationwide network isn't available to the general public. 

 

On 9/30/2018 at 11:33 AM, Barbaraok said:

Again, this is a benefit that isn't available to people who didn't work for a specific employer/belong to a specific group.  I will tell you that the Michigan School Employees Retirement group is self-insured.  BCBS administers the program and it is different from any BCBS insurance program open to the public.  

I think you mean the plan is self-funded.  That means claims are paid out of the company's own funds (possibly backed by a stop-loss insurance policy that the company buys), and the plans are usually administered by a company like Blue Cross. 

Here's a terrifying tidbit about self-funded plans:  they are exempt from state protections against surprise billing and balance billing--the practice that causes patients to end up owing astronomical amounts because services were provided by out-of-network providers.

Not all states have laws protecting consumers from this, and everybody's at risk in the states that don't have those laws.  But in the states that do have those laws, people with regular health insurance are protected, but people with health insurance that is self-funded (60% of people who get health insurance through a job) are not protected because self-insured plans are regulated at the federal level (ERISA) and there is no prohibition on surprise or balance billing, even for emergency care, under ERISA.

https://www.npr.org/sections/health-shots/2018/08/27/640891882/life-threatening-heart-attack-leaves-teacher-with-108-951-bill

This guy did everything right-- he even "asked from his hospital bed whether his health insurance would cover all of this."  I have no doubt that if NPR hadn't run his story, the hospital would never have offered to lower its bill from $108,951.31 to $782.29, and even then, the offer was a "financial assistance discount," contingent on his submitting an application for a discount based on his household finances.  Nothing about balance billing, or whether the charges were appropriate (another outrage revealed in the story)--just a discretionary offer no doubt helped along by a bunch of bad publicity.

 

 

[ToddF]

Thanks for the link to the rvers insurance exchange. I just signed up for the telemedicine program. It is the answer to the worry of how to get healthcare advice on the road. I travel a lot (not FT) and look forward to this service. I seldom need medical care but it is comforting to know this option exists.

Their website is very informative.