Advertise on Bikeforums.net



User Tag List

Results 1 to 20 of 20
  1. #1
    KombuchaCHIC Shadiyah's Avatar
    Join Date
    Jul 2005
    Location
    SLC,UT
    My Bikes
    Santa Cruz Juliana, 2005 Bianchi Pista
    Posts
    496
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Health Care Gurus! Please Help!

    I am in the process of trying to find a health care plan for Joe and I under our business, and I'm coming across some very confusing information. Does anyone have any recommendations? Also, could anyone tell me what the difference is between an HMO and a PPO?

  2. #2
    Third World Layabout crtreedude's Avatar
    Join Date
    Dec 2005
    Location
    Costa Rica
    My Bikes
    Cannondale F900 and Tandem
    Posts
    3,067
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Just quickly move here and don't worry about it...

  3. #3
    On my TARDIScycle! KingTermite's Avatar
    Join Date
    Jun 2005
    Location
    Eastside Seattlite Termite Mound
    My Bikes
    Trek 520, Trek Navigator 300, Peugeot Versailles PE10DE
    Posts
    3,928
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I certainly know almost nothing, especially from an "employer" point of view. But from a "having the insurance" POV, typically an HMO makes you stay with doctors "in network" (can't see "any" doctor) and usually wants you to get a referral from your Primary Care Physician (PCP) before seeing a "specialist".

    A PPO often lets you see any doctor, maybe a slightly higher co-pay if they are out of network. Also PPOs usually let you see a specialist without going to PCP (and paying their co-pay) just go get a referral.

    I'm doing this from memory, but I think it usually works something like that.
    Quote Originally Posted by coffeecake View Post
    - it's pretty well established that Hitler was an *******.

  4. #4
    Banned. ModoVincere's Avatar
    Join Date
    Aug 2006
    Posts
    1,626
    Mentioned
    1 Post(s)
    Tagged
    0 Thread(s)
    HMO means you go to the Dr's they have in their plan if you want coverage.
    PPO provides a list of preferred providers where they will cover a higher % of the costs because they have negotiated contract prices for the services. You can still go outside the plan and pay a little more under a PPO. Ex. if you go to the PPO Dr., insurance will cover 90%. If you go outside the plan, the insurance co. will pay 70% of the costs.

  5. #5
    KombuchaCHIC Shadiyah's Avatar
    Join Date
    Jul 2005
    Location
    SLC,UT
    My Bikes
    Santa Cruz Juliana, 2005 Bianchi Pista
    Posts
    496
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by crtreedude
    Just quickly move here and don't worry about it...
    That's a good idea, too...but we are snowboarding 3 x's a week. If something were to happen, we would run a risk of screwing ourselves royally.

  6. #6
    KombuchaCHIC Shadiyah's Avatar
    Join Date
    Jul 2005
    Location
    SLC,UT
    My Bikes
    Santa Cruz Juliana, 2005 Bianchi Pista
    Posts
    496
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Thanks KT and Modo! That helps a lot!

  7. #7
    Look 555 fledgling catherine96821's Avatar
    Join Date
    Nov 2006
    Location
    Oahu
    My Bikes
    Vitus road bike, I bought used, graduated to a LOOK 555
    Posts
    313
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    have you considered an HSA?

    http://www.hsabank.com/

    (you still need an insurance policy, but the costs are lower.)

    I am liking mine...

    the money rolls over for one thing, as opposed to being "just gone"
    I use HSA bank.

    I prefer it because if I get a brain tumor, for example, I can go anywhere in America as opposed to being limited to Hawaii. (both an HMO and a PPO would require it here)
    from bondage to spiritual faith, from spiritual faith to great courage, from courage to liberty, from liberty to abundance, from abundance to selfishness, from selfishness to complacency from complacency to apathy, from apathy to dependency, from dependency back to bondage.

  8. #8
    phony collective progress x136's Avatar
    Join Date
    Sep 2006
    Location
    San Hoosey
    My Bikes
    http://velospace.org/user/36663
    Posts
    2,958
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I hope you guys can find some kind of deal. Between when my coverage under my parents' plan expired and I got around to signing up for the company policy, it was costing me $300 a month. (And I can't even consider going without.)

  9. #9
    KombuchaCHIC Shadiyah's Avatar
    Join Date
    Jul 2005
    Location
    SLC,UT
    My Bikes
    Santa Cruz Juliana, 2005 Bianchi Pista
    Posts
    496
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by catherine96821 View Post
    have you considered an HSA?

    http://www.hsabank.com/

    (you still need an insurance policy, but the costs are lower.)

    I am liking mine...

    the money rolls over for one thing, as opposed to being "just gone"
    I use HSA bank.

    I prefer it because if I get a brain tumor, for example, I can go anywhere in America as opposed to being limited to Hawaii. (both an HMO and a PPO would require it here)
    Hmmm I'll look into that...Thanks!

  10. #10
    Senior Member Michigander's Avatar
    Join Date
    May 2005
    My Bikes
    Giant ATX 1200, Schwinn Peleton
    Posts
    1,727
    Mentioned
    10 Post(s)
    Tagged
    0 Thread(s)
    Just move to Canada...
    Bring back the Sig Test!


    (\__/)
    (='.'=)
    (")_(")

  11. #11
    Banned.
    Join Date
    Sep 2003
    Location
    Home alone
    My Bikes
    Trek 4300 X 2. Trek 1000, Trek 6000
    Posts
    6,021
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    HMO-BAD, PPO-Good.

  12. #12
    Non Tribuo Anus Rodentum and off to the next adventure (RIP) Stacey's Avatar
    Join Date
    Dec 2002
    Posts
    9,163
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    HMO, you get a Playboy mag & a cup

    PPO, the nurse comes in.

  13. #13
    Third World Layabout crtreedude's Avatar
    Join Date
    Dec 2005
    Location
    Costa Rica
    My Bikes
    Cannondale F900 and Tandem
    Posts
    3,067
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Heather - since you are planning on living overseas you might check out an International plan. I have heard of people down here who have them.

  14. #14
    phony collective progress x136's Avatar
    Join Date
    Sep 2006
    Location
    San Hoosey
    My Bikes
    http://velospace.org/user/36663
    Posts
    2,958
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by crtreedude View Post
    an International plan.
    I don't know specifically, but that just sounds like an insurance company's perfect excuse to charge you not only for the insurance, but for the barrel they're gonna bend you over.

  15. #15
    The Site Administrator: Currently at home recovering from a couple of strokes,please contact my assistnt admins for forum issues Tom Stormcrowe's Avatar
    Join Date
    Mar 2006
    Location
    South Florida
    My Bikes
    Techna Wheelchair and a Sun EZ 3 Recumbent Trike
    Posts
    16,009
    Mentioned
    10 Post(s)
    Tagged
    4 Thread(s)
    Quote Originally Posted by Shadiyah View Post
    I am in the process of trying to find a health care plan for Joe and I under our business, and I'm coming across some very confusing information. Does anyone have any recommendations? Also, could anyone tell me what the difference is between an HMO and a PPO?
    HMO is a health Maintenance Organization

    PPO is a preferred provider org.

    Of the two, PPO is usually better, you have more control as most HMO's won't go outside the organization unless you are way outside their network geographically.
    Last edited by Tom Stormcrowe; 01-15-08 at 07:05 PM.
    on light duty due to illness; please contact my assistants for forum issues. They are Siu Blue Wind, or CbadRider or the other 3 star folk. I am currently at home recovering from a couple of strokes. I am making good progress, happily.


    . “He who fights with monsters might take care lest he thereby become a monster. And if you gaze for long into an abyss, the abyss gazes also into you.”- Fredrick Nietzsche

    "We can judge the heart of a man by his treatment of animals." - Immanuel Kant

  16. #16
    That darn Yankee TexasGuy's Avatar
    Join Date
    Jun 2005
    Location
    West West Fort Worth
    My Bikes
    Mongoose XR-100, Eros Bianchi
    Posts
    4,272
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by catherine96821 View Post
    have you considered an HSA?

    http://www.hsabank.com/

    (you still need an insurance policy, but the costs are lower.)

    I am liking mine...

    the money rolls over for one thing, as opposed to being "just gone"
    I use HSA bank.

    I prefer it because if I get a brain tumor, for example, I can go anywhere in America as opposed to being limited to Hawaii. (both an HMO and a PPO would require it here)
    The only thing I don't quite understand is aside from the Tax-Deductibleness up to 2850~ a year this seems exactly like a savings account.
    Is that observation pretty accurate? or is there something else big that I am missing.
    Life is about hanging onto what you think is important and finding out what really is important.
    "Stop Ruining my joke!", "No, a joke implies humor attached at no additional cost"
    So many sayings, so little sig space.

  17. #17
    That darn Yankee TexasGuy's Avatar
    Join Date
    Jun 2005
    Location
    West West Fort Worth
    My Bikes
    Mongoose XR-100, Eros Bianchi
    Posts
    4,272
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Shadiyah View Post
    I am in the process of trying to find a health care plan for Joe and I under our business, and I'm coming across some very confusing information. Does anyone have any recommendations? Also, could anyone tell me what the difference is between an HMO and a PPO?
    An interesting thing to note and this is something I am seeing some smaller businesses who are unable to force Health Care Providers to give them as competitive rates:
    You go with say Blue Cross & Blue Shield or UHC with a LARGE deductible and then you get a 2nd tiny company who's sole function is to pick up the amount of the deductible. It doesn't work out quite as well as it should but it's supposed to be alot more affordable if you're not CitiBank and able to negotiate Complete medical/dental/etc with $0 deductible for 380~ a month .
    Life is about hanging onto what you think is important and finding out what really is important.
    "Stop Ruining my joke!", "No, a joke implies humor attached at no additional cost"
    So many sayings, so little sig space.

  18. #18
    Third World Layabout crtreedude's Avatar
    Join Date
    Dec 2005
    Location
    Costa Rica
    My Bikes
    Cannondale F900 and Tandem
    Posts
    3,067
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by x136 View Post
    I don't know specifically, but that just sounds like an insurance company's perfect excuse to charge you not only for the insurance, but for the barrel they're gonna bend you over.
    It tends to be a lot cheaper if the place where you are going to be living (like Costa Rica) is a lot cheaper. They go with the odds like all insurance companies. If I remember right, it might be as low as 1,000 dollars a year - yep, per year. This is because health care here is so much cheaper.

  19. #19
    slow as I ever was Ex Pres's Avatar
    Join Date
    Dec 2007
    Location
    an imposter living in the 35223
    Posts
    5,626
    Mentioned
    4 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by TexasGuy View Post
    The only thing I don't quite understand is aside from the Tax-Deductibleness up to 2850~ a year this seems exactly like a savings account.
    Is that observation pretty accurate? or is there something else big that I am missing.

    You're right, it's a savings account with the caveat that you've got to spend it on medical care eventually. But you can use it for co-pays, deductibles, eyeglasses, etc, so you can find a way to use it pretty easily.
    72 special CNC ___________ 72 Frejus (ala Legnano) __73 Holdsworth Record
    78 Raleigh Professional_____ 80 Ranson_____________ 80 unknown French (SS)
    82 Peugeot PXN10_________83 Trek 620 (nee 600)____ 85 Gianni Motta
    85 Trek 560______________88 Guerciotti GLX
    90 Miele Gara_____________02 Casati Dardo (g/blue)__02 Casati Dardo (y/blk)
    03 Casati Dardo___________08 BF IRO (fixed)________10 Vassago Fisticuff (IGH)

  20. #20
    Third World Layabout crtreedude's Avatar
    Join Date
    Dec 2005
    Location
    Costa Rica
    My Bikes
    Cannondale F900 and Tandem
    Posts
    3,067
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I just checked this site out (not a recommendation)

    http://www.healthcareinternational.com

    For Amy and I with a 1,000 dollar deductable it would be 2,000 for the year.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •