[citydweller]

BG, thanks for pointing out the arrows, I had thought there were only 4 choices in each metal group, but you’re right, it looks like there are about 9 choices in each group. Now I have to do some more research 🙂

What is the difference between an EPO and PPO?

[citydweller]

The carriers/plans info is available at Covered California.

Click on “Resources”, then click on “Calculating Potential Insurance Cost”, then click “Get Started”.

Next, enter info, # of people in household, income, zip code and age. At the bottom of that page click the yellow button “See my options”.

Next will open a pop-up window with general information, you need to close that pop-up window. Underneath you will see the Bronze/Silver plans available in your area.
Choose the plan you’re interested in and click the “view details” button, then scroll up and click on “view plan benefits”.

At the top of that page you can also click a button that will take you to the Gold/Platinum plans.

In San Diego it looks like the Silver Plans are Anthem Blue Cross EPO, and Health Net, Sharp or Kaiser HMO’s.

[citydweller]

My plan now is to go with the Anthem/Blue Cross Plan Silver 70 EPO, with the monthly premium of $520. Before I sign up through the Marketplace though I will check to see if it’s cheaper to buy directly from Anthem. Does anyone know if plans purchased outside the Marketplace have the rates locked in for 1 year?

The Anthem Silver 70 EPO has a $2,000 deductible and $6,350 max out of pocket. Also, copays are not subject to meeting the deductible, so primary care visits are $45, Urgent care is $60. And 1 annual preventative care visit at no cost.

I appreciate everyone’s feedback here. I’ve had very little experience with medical issues and so have very little knowledge about how insurance works and what all the terms mean. I’ve learned quite a bit an the past few weeks.

[citydweller]

I’m looking at the benefits page of my current policy (Anthem/Blue Cross), it shows a deductible of $2,950 and then “Participating and Non-participating provider Copayment/Coinsurance Maximum” of $8,850. I take this to mean my annual max out of pocket is $11,800. My monthly premium is $752 (and yes, I’m a boomer, mid-50’s)

I’m again looking at the Bronze plans, the Anthem EPO is only $388 per month, which means I would save $4,368 per year just in premium costs and still be able to stay within the Anthem network.

The deductible for this bronze plan is $5,000, which is ok with me if I’m saving over $4,000 in premium payments per year, and would still have to hit my deductible of $2,950 (on my current plan) even after paying $9,024 annual premium.

Also, the bronze plan has an annual max out of pocket of $6,350. Am I missing something, or does it make sense to switch to this lower cost plan?

I really appreciate everyone’s comments. I very seldom have medical bills and so have very little knowledge of how this all works, but I would like the security of knowing I have good coverage if I need it.

[citydweller]

Thanks for all the comments. Yes my current policy is grandfathered in from way back. I was only looking at Kaiser because a friend of mine recently got coverage there and said she was happy with it, but I would hate to switch based on one persons experience.

Thanks to your feedback I took another look at CoveredCA and the “Anthem Multi State Plan Silver 70 EPO” looks better and cheaper than what I have now. $520 month premium, $2,000 deductible, $6,350 max out of pocket, also copays that are not subject to deductible.

I’m assuming that “Multi State” means I would be covered in other states, I’ll have to do some more research.

[citydweller]

I’ve just been looking at the Covered California sight and it appears I don’t qualify for any tax credits (I’m single with good income). However, it looks like I can sign up for the Kaiser Bronze 60 HSA HMO for $392 per month ($4,500 deductible and maximum out of pocket for one person is $6,350). I currently have an individual plan thru Anthem/Blue Cross which costs $720 per month ($2,950 deductible and max out of pocket is $11,810).

It has been years since I’ve even reached my current deductible, so the cheaper plan seems like a good idea.

I have a couple questions, Does anyone have experience with Kaiser and would you recommend it? Also, does “maximum out of pocket” really mean what it says? In other words, once I’ve spent $6,350 in medical bills in one year, is EVERY other bill paid by the insurance?

[citydweller]

[quote=paramount]
Show me where in the Constitution does it state that the federal gov’t can legally confiscate my property and give it to someone else?

Please excuse my “hippie granolaness” but I am not speaking from a legalistic, material, “rational” point of view. I am just trying to make the point from an appreciative, grateful, life is awesome point of view that if I ever reach a point in my life where I am paying tens of thousands of dollars in taxes each year, I will be counting my blessings and joyfully skipping through life, not being bitter and hiring lawyers and debating the legality of it all.

[citydweller]

[quote=spdrun]Paying to benefit this country is one thing. Paying Federal taxes for wars in worthless Middle Eastern toilets is quite another. And no, catching Bin Laden wasn’t worth a single dime.[/quote]

+1 I totally agree!

[citydweller]

[quote=paramount]California has reached a point where the takers easily outnumber the makers.

Are you stating this as a fact or perception? Data please 🙂

[citydweller]

Imagine an ambitious person coming to the US from a foreign country. This person understands that in this country he is offered an incredible opportunity and infrastructure in which he can use his ambition to become very wealthy. He also understands and accepts the fact that once he becomes very successful in this country he will be required to pay large amounts of his wealth back into this system that allowed him to become so successful in the first place. I believe that most ambitious foreigners would jump at this chance. However, those of us born here take for granted the incredible opportunities that are available to us because of this “system”.

I am a gleeful taxpayer. I fantasize about the day when I am so financially successful that I have to pay tens of thousands of dollars in taxes. I feel sorry for the people who have reached that point and are still dissatisfied. They should just pause for a moment, take a deep breath and relax, and allow themselves a moment to appreciate how incredibly fortunate they are to have been born into this incredible country of opportunity.

[citydweller]

I agree, it is thanks to people like flu, who really care about what is going on, that we enjoy abundance. My point was that flu does not seem to be enjoying this abundance we have. Instead, he is worrying about the “future”. I had a very wealthy grandfather but he never enjoyed his abundance and died worrying about the financial well being of his children and grandchildren. I wish I could go back in time and tell him “hey gramps, I’m doing fine, the world did not collapse, relax and enjoy”.

[citydweller]

[quote=flu][quote=spdrun]Meh. It’s basically a return to 1990s tax policies. You know, when this country was actually doing decently and had a balanced budget. Pity we won’t be doing anything about the Pigs in the Pentagon. Eisenhower (a General I may add) was right in his farewell speech.[/quote]

….with 2012 inflated dollars and generally weakened purchasing power…

I guess someone starting out really doesn’t need to invest anymore, because wow… just wow… for younger people starting out now, they aren’t gonna be able to accumulate wealth anywhere close to what some of us older folks have been able to…. Pity….[/quote]

flu, it seems like you’ve been able to accumulate wealth, but I get the sense that you are not happy. You seem to have a lot of complaints about the world we live in.

I personally have not accumulated a lot of wealth, but I have learned to be happy with what I have. I do not begrudge any of the money I pay in taxes. I appreciate that the taxes I have paid during my working years have provided me with this incredibly amazing country we live in.

Every day I can flip a switch and my lights come on, I turn a faucet and clean water comes out, I eat at restaurants and have never gotten food poisoning, I make money and put it in the bank and none of it has ever disappeared, I make monthly payments on my condo and I have never had to defend my right to be here. I could go on and on. It frustrates me that some people can live in this incredible abundance and security that we have in the U.S. and still complain because they think we should have MORE!

[citydweller]

SD R, I think that where our philosophies diverge is that you equate wealth with quality of life. I believe that once basics are met (shelter, food, love), happiness is up to the individual. You can choose to be happy with what you have, or you can choose to believe that you do not have enough yet.

I spent the first 50 years of my life waiting for “just one more thing” before I would allow myself to be happy. But it seemed like there was always one more thing after that.

Maybe it’s just part of growing older (and wiser? lol) but now I am just so happy with all that I have, and I no longer worry about “oh my god!, what if the economy gets worse, what if interest rates go up (or down), what if a republican or democrat gets elected president.

We can choose to worry about the future for our children, but I can remember some of the coolest times of my 20’s and 30’s was sharing a small apartment with my fellow, struggling, retail/fast food cashier friends, and “surviving” on curry rice and hamburger helper. Sometimes we would splurge and go to the video store and rent a movie.

What I’m trying to say is that it’s so important to not get caught up into believing that we need “things” (beyond food, shelter, love) in order to be happy. There is no contest, no points scored for having the best stuff.

Do I totally sound like a liberal??

[citydweller]

I read a great short story once (can’t remember where), but it starts with a homeless man, camped out next to a bank in N.Y. city. He’s very envious of the doorman who wears a clean, warm jacket everyday and gets to spend his days inside the warm, clean bank. Then it goes to the doorman who is very envious of the bank teller, who has his own apartment and doesn’t have to live with his parents, then the bank teller who is very envious of the loan officer who is buying a condo and is engaged to be married. But it turns out the loan officer is very envious of the bank manager who has already paid for his home, is happily married and has his children in college.

It turns out the bank manager is very unhappy because he has had to do some “creative” bookkeeping to keep the bank appearing profitable in order for him to keep his children in college and his wife happy with designer clothes, fancy home, fancy dinner parties, etc.
The final chapter has the bank manager receiving news that his bank is being audited and he realizes that his days at the bank are numbered, all is about to be revealed. He becomes very distressed at the thought of disappointing his wife and children, and at the thought of his social embarrassment. As he leaves the bank he catches sight of the homeless man, sheltered under his pile of blankets and eating a discarded sandwich, and becomes very envious of the simplicity of this mans life.

[citydweller]

” Things will change. People are happy now, but when things do change most of them will hurt. ” Quote – SDR

How do you describe “hurt”? Will they be starving, living in tents? Or will they have to give up their high speed internet and stainless steel appliances?

I’m sorry to sound flippant, but I think a lot of people have lost sight of what happy means.

[Author]

Posts