BCBS Health Insurance Update 2013-2014 AKA: Whats different and what effect it might it have on you?

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Presentation transcript:

BCBS Health Insurance Update AKA: Whats different and what effect it might it have on you?

BCBS Update Current Plan vs. New Plan Deductible$2,500$3,500 Coinsurance Rate (after deductible)70/30 or 50/5070/30 Max Out of Pocket$7,500$8,500 Preventive Care00 Primary Care Visit$25$35 Specialist Visit50% After Ded**$70 Therapy50% After Ded**$35 or $70 Urgent Care50% After Ded**$70 Emergency Room50% After Ded**$500 Hospital Outpatient50% After Ded**30% After Ded** Ambulatory Surgical50% After Ded**30% After Ded** Hospital Inpatient30% After Ded** Hospital Inpatient Copay$250$0 Vision Exam$0$70 Prescription Coverage Generic Rx$4$10 Name Brand Rx$40/$55/75%*50%*

BCBS Update The Down Side to the New Plan o Deductible is $1000 higher (this would have affected 7 people) o Out of pocket max is $1000 higher (due to the higher deductible) o Primary care co-pay is $35 instead of $25 o Generic drugs have a $10 co-pay ($4 under current plan) o Non-generic drugs are all co-pays of 50% (max of $100 per Rx per month)

BCBS Update The Up Side of the New Plan o Specialist, therapy, urgent care, and emergency department visits all have co-pays now (current plan paid nothing until deductible met) o Specialist/Therapy/Urgent Care $70 o Emergency Room $500 o Hospital outpatient and ambulatory surgery 30/70 after deductible (currently 50/50 after deductible) o No inpatient hospital co-pay (currently $250) o The new plan is about $10,000 more overall, but employee premium will remain at $100 per month for this year

BCBS Update The Up Side of the New Plan (Continued) o Mental health office visits $70 co-pay (currently only after deductible) o Substance abuse services $70 co-pay (currently only after deductible) o Infertility services $35 or $70 co-pay, $5000 lifetime max (currently only after deductible)