Blue Cross/Blue Shield Christmas Gift to Federal Employees: Surprise, We’re Cutting Your Benefits!
Press release from “DC Patients, Doctors and Healthcare Providers”:
Talk about being a Grinch! On January 1st, more than 4 million federal employees — half of the government workforce — are having their benefits cut by Blue Cross Blue Shield (BCBS).
That’s right, BCBS has drastically altered a plan that millions of federal employees and their families rely upon for their healthcare coverage — and hasn’t bothered to notify anyone. Federal employees have only until December 8th to either switch their insurance plan or face the consequences.
These changes affect all Federal Blue Cross Blue Shield Standard Option plan holders nationwide.
For those affected by these changes, in addition to a 13% increase in premiums, out-of-network benefits for federal employees will be severely curtailed, affecting both emergency and surgical services. The policy change increases a patient’s out-of-pocket cost up to $7,500.00 for each procedure or surgery when using an out-of-network provider, and it imposes up to a $350.00 out-of-pocket cost for care provided by an out-of-network emergency room doctor.
Can you imagine patients trying to find out if their ER doctor or consulting surgical specialist is in-network or out-of-network when they’re having a broken leg set? Patients have the alternative of switching to an in-network doctor and keeping their previous benefits, but then their PPO with higher premiums is really just an HMO in disguise.
On top of that, the Office of Personnel Management describes the changes on page 10 of a 137-page document — burying the bad news!
Despite OPM’s assurances that this benefit cut is actually good news, real patients, doctors and health care providers are upset with Blue Cross Blue Shield and want to take action.
To speak with an affected patient or doctor, please contact: Jason Miller at jmiller@dezenhall.com, or (202) 296-0263 x 136; or contact Gary Meltz at gmeltz@dezenhall.com, or (202) 296-0263 x 166.
SOURCE DC Patients, Doctors and Healthcare Providers
November 30th, 2008 15:02
I am dumping blue cross blue shielf as of Monday.
November 30th, 2008 15:27
My fellows coworkers blue shield will charge more de one hundred dollars each pay period, be alert and switch right away to another provider, I pick Pacificare myself only 27 dollard per pay period and they offer the same benefits that blue shield, open season is on so go for, good bye
November 30th, 2008 18:48
Blue Cross and Blue Shield Basic for postal employees went up over $8 a pay period and increased copayments…. I bet I wasn’t the only one that is dumping them this year. I’m not thrilled w/the alternatives, but they’re less onerous than staying w/BC-BS.
November 30th, 2008 19:51
I HAD bcbs but I switched to NALC/ cigna
December 1st, 2008 06:50
I am switching my bc/bs to mail handlers health plan.
December 1st, 2008 09:10
APWU etc go by % instead of a flat figure. Does anyone know how these % of reasonable and customary charges measure up to BCBS?
December 1st, 2008 09:41
Most (if not all) of the plans are increasing their premiums as they do most years, and coverage changes year-to-year as well. Ignore the sensationalism in the article and research which plan has the best coverage for your individual needs. You should know if your provider/doctor/hospital is an in-service provider before you need services, not when it is an emergency. Be proactive, not reactive! Dont stick with the same plan simply because it is the one you are currently with.
December 1st, 2008 16:23
Most “emergencies” happen when it is unexpected and usually not in the same location as your PPO. Therefore, most people DO NOT know if every Hospital and/or Doctor is a part of the BCBS PPO provider, hince the term “emergency.”
In addition, because BCBS is a NATIONAL Program, it if very difficult to assume that when you are on travel or visting outside your home area, that people carry a national list of PPO providers.
This is an absolute travesty and unrealistic to make their clients ask, if the hospital or Dr is a BCBS PPO provider before you provide “EMERGENCY CARE.” If I could plan every emergency, I would not have to work for the USPS or any federal agency, because I would have a unique skill that would be very marketable and would never have to worry about “an emergency.”
December 1st, 2008 17:54
Not sure who the source is who created such a blog. Seems a bit vague. Do they really understand how insurance works?
The powers that be for the government workforce have to sit down with their insurance carrier options, and there are several options available to federal employees, and discuss what benefits they would like the employees to have and what they are willing to pay for them. Once an AGREEMENT is made then it is presented to the employees. I don’t call informational changes on page 10 of a 137 page document as buried. Maybe if it were on page 125, but not page 10.
A PPO (PREFERRED PROVIDER OPTION) is not an HMO in disguise. An HMO requires referrals and pre-auths that a PPO does not. A PPO gives a member the choice of provider panels. Stay in-plan (in PPO panel) get a better benefit = less out of pocket for the member. Opt-out of PPO and STILL HAVE A BENEFIT – but you pay a little more. You share in the cost. But it is less expensive premium wise. So the wash is less taken out each month and if you opt out of the PPO panel then you pay a little more. No secrets here.
Before you make a change with your healthcare insurer make sure you have all the facts and not just that of some irate East Coast doctors. This article is quoted from “SOURCE DC Patients, Doctors and Healthcare Providers” I’m sure none of these were at the bargaining table between the Federal Employee Program and BCBS. They need to get their facts straight about how insurance works before spouting off such a flamatory Title. It was no surprise to the Office of Personnel Management that came to the agreement with BCBS to manage the FEP benefit program. You may not carry a national list of PPO providers with you but if you’re savvy enough to Blog you can go to the provider finder on the BCBS website and find a PPO provider in every state…….and beyond. Good luck, be informed.
December 2nd, 2008 19:37
Bye BC Hi Aetna
December 3rd, 2008 10:56
The people that negotiate these contracts should be fired.
I am dropping BC/BS because I am getting benefits from another union that I belong to. It has about 3,000 members.
Tufts Health Plan which is a huge provider in the Northeast.
No Co-Pays, No Deductables, Eye Care, and Dental, and 12 Free Massages a year per member. The cost is $12.00 a week or $24 a pay period. That beats the heck out of the $90+ I pay for the family plan with the govt.
How can they negotiate such a bad deal with hundreds of thousands of employees.
It is a shame.
December 4th, 2008 20:56
This is really upsetting. Even if there are lots of other health insurers, Blue Cross Blue Shield is still a major player. There should be some turn.
December 6th, 2008 19:08
BCBS Basic has been a great value for my family.
Plenty of great providers in all specialties we’ve needed.
Colonoscopies were $30 for MD and $40 for preferred hospital outpatient facility.
A needed MRI was covered 100% as was the annual mammograms.
Annual physical including all labs and vaccines was $20 copay at our participating doctor. Will go to $25 in 2009 but still great.
For those unhappy with the Standard plan try the Basic.
December 6th, 2008 23:05
I was in the emergency room Sept 2008 and actually thought to ask if the physician was BC preferred. I got told “all our staff are preferred or participating, don’t worry about it”. Guess what – the physician wasn’t either one and I got socked with more of a bill than expected for his services. To make things worse, he missed the diagnosis and I had a close call and emergency surgery a few days later.
December 7th, 2008 07:48
I have BC Basic. Had open heart surgery 6 months ago. Total cost was $110,000, my out of pocket costs were around $1,000. That would increase this coming year by about $400 because of the $100 a day for the first 5 days of a hospital stay. I still think its a bargain. In my area it’s hard to find a doctor or hospital that doesn’t accept BC/BS.
December 10th, 2008 12:50
where do you look to find other insurance companies for the post office clerk
December 12th, 2008 18:19
What plan is best for someone that needs a hernia operation. I currently have Connecticare but have other options… NALC, BC/BS, Aetna and GEHA. Thank you
December 16th, 2008 19:48
i think this is inhumane. we depend on the insurance industry and you just continuously drop the ball and leave us holding the bag…….i think the federal governmnet should reevaluate this mess. benefits are a very important part of salary b/c the salary is not so much as compared with the civilian counterpart jobs.
i cannot get insurance. i was injured on the job. i happened to have insurance or else i would be without any i also cannot work. i will just have to die i suppose
December 22nd, 2008 11:06
What I can’t understand is how Federal Blue Cross and Blue
Shield can mandate that in an emergency situation-EVEN IF YOU ARE UNCONSCIOUS-you have to pay extra if you just happen to be taken to an out-of-network hospital, and/or be treated by an out-of-network physician.
OPM told me there would have to be a huge premium increase in order to have equal benefits for in-network and out-of-network providers in this specific emergency situation. I told OPM I would be willing to pay a reasonable premium increase for this; I asked OPM why they didn’t calculate the exact premium increase, and then survey Federal Blue Cross and Blue Shield policy holders to see if they would be in favor of it. OPM said they didn’t have the manpower to do that (didn’t they ever hear of the Internet?)
December 23rd, 2008 08:41
It is my understanding that you only have to pay out of network expenses if you CHOOSE an out of network hospital or doctor. In an emergency situation I dont think you would have to pay extra.
December 23rd, 2008 12:14
That’s not what it says on page 124 in the 2009 Blue Cross and Blue Shield Benefits manual
January 6th, 2009 11:01
I have the perfect solution for the emergency situations! Just get a tattoo from your pelvic bone to your sternum that says, “IF YOU ARE NOT A PPO NETWORK PROVIDER, DON’T TOUCH ME!”
That should work as long as you are not unconscious and face down. You would have to tattoo the other side as well. I wonder… Would the tattoo would be a deduction on your taxes or even a compensable expense to submit to your employer, BC/BS or even Flexible Spending?
HA!
At least they have extended the benefit selection period so that we could do more research and compare the plans. How generous of them.
February 25th, 2009 09:04
Hey everyone!
All of the recent talks of the downfall of the economy and loss of jobs has been driving most americans nuts!
I started looking online for some way to get help and discovered that the government gives free grants.
What I would like to know is…. does anyone know what website I can find free government grant application at?
THANKS!
__________
Free Itunes Codes
September 1st, 2009 02:03
It is my understanding that you only have to pay out of network expenses if you CHOOSE an out of network hospital or doctor. In an emergency situation I dont think you would have to pay extra.
Small business auto insurance