BCBS Preferred Gold PPO 707 vs Aetna CVS Health PPO

Plan Benefits Forum
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So my son’s providers aren’t covered by BCBS and but they are covered by Aetna CVS Health PPO.

My gut instinct is to use Aetna only for my son and only go with BCBS for the rest of the family.

Anybody have experience with BCBS or Aetna from the Exchange Marketplace in Illinois?

For reference I’m coming off Cobra which was a United Healthcare Employer Sponsored Choice Plus PPO Plan which has cost me $3000 per month since last September. Consider the above plans the monthly cost looks like it will be just over $2000 which is considerably cheaper than the lower quality plan my new employer would be offering for 3.5k a month that has significantly smaller network covered here in Illinois because they are based out of state.

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In my state, Aetna CVS Health PPO has a small network, and most hospitals do not accept it. However, they do accept BCBS TX, which is owned by HCSC out of IL, and also owns BCBS IL. Additionally, Aetna’s prescription formulary list is much smaller compared to BCBS.

Aetna also left the individual market in my state for a while and then returned, which might be contributing to the issue.

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3

In Illinois, I care about Lurie and Northwestern. Lurie accepts only Aetna CVS for exchange plans, while Northwestern Medicine accepts both. However, I’m hesitant to put my whole family on Aetna CVS since BCBS generally has fewer issues.

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4

COBRA is usually very expensive because your job typically covers most of the cost. You and your family end up paying the full price of the plan.

As a small business owner, I recommend looking at other options:

  • ACA: If you have a Qualifying Life Event (QLE), you can find a plan through the ACA, and it’s based on your income.
  • PPO: This is not written in medical terms but offers stronger benefits.
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5

That is incorrect and only partial information.

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Yes, I’m working on that. The two plans I mentioned are both exchange plans. I’m considering these now that COBRA is ending. The COBRA plan covered both me and my family for providers. My new employer offers Oxford Liberty Network, but it costs more than my previous employer’s COBRA plan and has a much smaller network.

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Before Cobra or lost of coverage your employer covers a percentage

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8

I’ve never had Aetna, but it’s a national plan and likely solid.

However, I have two concerns: Are you sure you have an enrollment period for the marketplace now, or are you thinking of the open enrollment at the end of the year?

Also, why have Aetna just for your son? It might be cheaper to have everyone on one plan.

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9

Buy a HDHP and fund the HSA. This is the least expensive way to provide health insurance, with costs being premiums plus claims.

First, check the network, then look at the out-of-pocket max. You should be able to cut costs significantly, even without a premium subsidy.

If anyone is expected to reach their out-of-pocket max, calculate the numbers and consider reducing the out-of-pocket max. For example, in a renewal I’m working on, a $2000 reduction in the out-of-pocket max saves about $1000 in premiums. Unless you expect to hit the max, it’s better to save on premiums.

Learn how HSAs work. You don’t need to itemize to get tax savings, and the HSA is a great tool for accumulating funds if you pay incidental costs out of pocket.

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10

In my opinion if there are health issues go with the cobra or an ACA plan. But if not definitely go PPO route. I hope this saves you time and money

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Cobra is running out. I’ve paid $3k month for it since last September but this September end will be 18 months when I started Cobra.