VA: Choosing Medical Insurance

OrganizedChaos, LVN · Aug 23, 2015

I don't know anything about the VA & their plans but I would choose a PPO over an HMO.

My mom has an HMO she has to call her insurance company & have them switch her PCP if she changes. Also, if she needs to see a specialist she needs a referral from her PCP. I have a PPO & I don't have to do any of that. If I want to change PCP's I can just go without having to call my insurance & see a specialist without needing any referrals from my PCP.

Good luck making your decision!

tabisadelta · Aug 23, 2015

I don't know anything about the VA & their plans but I would choose a PPO over an HMO.
My mom has an HMO she has to call her insurance company & have them switch her PCP if she changes. Also, if she needs to see a specialist she needs a referral from her PCP. I have a PPO & I don't have to do any of that. If I want to change PCP's I can just go without having to call my insurance & see a specialist without needing any referrals from my PCP.
Good luck making your decision!

Thanks, that is more convenient. That helps!

pfchang · Aug 23, 2015

You will likely save money with many of the VA plans. There is a comparison tool available online which allows you to enter the criteria important to you, such as needing family coverage as opposed to needing a plan just for you. There is also a place to enter that you do not want to have to go through a referral process for everything (HMO), and many other things that help determine the best options for your individual situation. I don't know if this tool is available before your first day, though.

i agree with the poster above who said HMOs are too restrictive. Working in healthcare myself, I am very appreciative of my healthcare providers and do not want change them or be restricted as to whom I can see. A co-worker moved to my VA a few months ago, chose HMO, and has had a very hard time getting care and appts for her daughters type 1 diabetes. Doctors either don't take the HMO or don't have appts soon, etc. then getting the referral and appt for an endocrinologist has been an ongoing struggle. She will be changing insurance as son as the opportunity is there which will be Jan1.

Kaiser is a different story. It's an HMO but people in my area are pleased with their care for the most part. Some love it, some complain but it's different than a regular HMO. I use GEHA and have been very pleased. Some co- workers use BCBS bc that's what is most familiar to them but I don't operate that way. I used the tool and it took awhile but I am happy with them.

Your benefits won't start your first day on the job. They should start approx 2-3 weeks after your start date with the next pay period after you submit your forms. I spent some time reviewing the plans the first few nights of my first week and submitted the forms before the end of the first week. You can wait longer to submit your forms but that will delay when your VA healthcare insurance will start. Hope this helps.

TNT_RN09, BSN, RN · Aug 23, 2015

We chose the blue cross blue shield basic plan because it was the most affordable for my family and it has no deductible. Plus the network is very large so finding a specialist,hospital etc would be easy.

tabisadelta · Aug 23, 2015

You will likely save money with many of the VA plans. There is a comparison tool available online which allows you to enter the criteria important to you, such as needing family coverage as opposed to needing a plan just for you. There is also a place to enter that you do not want to have to go through a referral process for everything (HMO), and many other things that help determine the best options for your individual situation. I don't know if this tool is available before your first day, though.
i agree with the poster above who said HMOs are too restrictive. Working in healthcare myself, I am very appreciative of my healthcare providers and do not want change them or be restricted as to whom I can see. A co-worker moved to my VA a few months ago, chose HMO, and has had a very hard time getting care and appts for her daughters type 1 diabetes. Doctors either don't take the HMO or don't have appts soon, etc. then getting the referral and appt for an endocrinologist has been an ongoing struggle. She will be changing insurance as son as the opportunity is there which will be Jan1.
Kaiser is a different story. It's an HMO but people in my area are pleased with their care for the most part. Some love it, some complain but it's different than a regular HMO. I use GEHA and have been very pleased. Some co- workers use BCBS bc that's what is most familiar to them but I don't operate that way. I used the tool and it took awhile but I am happy with them.
Your benefits won't start your first day on the job. They should start approx 2-3 weeks after your start date with the next pay period after you submit your forms. I spent some time reviewing the plans the first few nights of my first week and submitted the forms before the end of the first week. You can wait longer to submit your forms but that will delay when your VA healthcare insurance will start. Hope this helps.

That makes sense. The recruiter said that there would be a comparison chart. I couldn't find it. Hopefully I can access it during orientation. That should make it a lot easier.

Editorial Team / Moderator · Aug 24, 2015

We chose the blue cross blue shield basic plan because it was the most affordable for my family and it has no deductible. Plus the network is very large so finding a specialist,hospital etc would be easy.

Federal service (Army civilian) has this same plan. It's the one I chose as well, seems excellent!

elkpark · Aug 24, 2015

Of course, if you have physicians with whom you already have a relationship that you want to continue, you'll want to make sure to select a plan that covers seeing them.

RNsRWe, ASN, RN · Aug 26, 2015

I found that the biggest advantage to having a plan through a Federal group is that there is enough buying power to make the monthly costs manageable. I laugh --no, really, I LAUGH-- when I hear someone say that Federal employees get free health insurance! Yah....I'm not the President, or a member of Congress or the House, LOL.

Anyway, one of the major reasons I came to this position was BECAUSE I couldn't afford the insurance premiums in the private sector for the same coverage.

The "Benefits Guy" here makes it very clear in orientation, "do not call me and ask what kind of insurance you should get. I don't know. And don't get the insurance your friend told you to get because SHE likes it...when you're unhappy, I don't want to hear about it"!

IOW, only YOU know what plan is best for you and your family. Some people have fewer monthly prescriptions, for instance, and don't mind higher co-pays for a reduction in the total fee. Others have so many scripts that they would rather pay a bit more for the premium so their copays are less. Then there are deductibles: some plans, some carriers, will have low deductibles or NO deductibles, BUT you can expect to pay more out of pocket for each incident. Others will have higher deductibles, but the cost of the premium paid each month makes it worthwhile (for them).

YOU know the likelihood your covered family members are going to have use of the ED, radiology, inpatient stays. YOU know who has several drugs each month, or none. What their risk factors are, their co-morbid, chronic conditions (if any). NO ONE can tell you for sure what you should get unless they go over with you, specifically, all your past medical bills and financial statements for the last several years.

You do your best guesswork based on what you know, a comparison chart laid out in front of you (I did it on the computer so I could quickly switch in and out of screens and choices).

I chose to NOT get the dental plan, any of them, because the out of pocket expense for individual visits would cost me/my family significantly LESS per year than the monthly premiums. I figured if I got nailed with an unusual expense now and then, it'd STILL be less than sucking my premiums out every month regardless. So far, I've definitely saved money.

My medical coverage allows for a small amount of vision coverage as well. If your family wears glasses, consider that, too. Not all plans have this coverage.

Good luck! And remember, you can ALWAYS change carriers later on, annually, during Open Enrollment. You're not hooked to a carrier for life!

tabisadelta · Aug 26, 2015

I found that the biggest advantage to having a plan through a Federal group is that there is enough buying power to make the monthly costs manageable. I laugh --no, really, I LAUGH-- when I hear someone say that Federal employees get free health insurance! Yah....I'm not the President, or a member of Congress or the House, LOL.
Anyway, one of the major reasons I came to this position was BECAUSE I couldn't afford the insurance premiums in the private sector for the same coverage.
The "Benefits Guy" here makes it very clear in orientation, "do not call me and ask what kind of insurance you should get. I don't know. And don't get the insurance your friend told you to get because SHE likes it...when you're unhappy, I don't want to hear about it"!
IOW, only YOU know what plan is best for you and your family. Some people have fewer monthly prescriptions, for instance, and don't mind higher co-pays for a reduction in the total fee. Others have so many scripts that they would rather pay a bit more for the premium so their copays are less. Then there are deductibles: some plans, some carriers, will have low deductibles or NO deductibles, BUT you can expect to pay more out of pocket for each incident. Others will have higher deductibles, but the cost of the premium paid each month makes it worthwhile (for them).
YOU know the likelihood your covered family members are going to have use of the ED, radiology, inpatient stays. YOU know who has several drugs each month, or none. What their risk factors are, their co-morbid, chronic conditions (if any). NO ONE can tell you for sure what you should get unless they go over with you, specifically, all your past medical bills and financial statements for the last several years.
You do your best guesswork based on what you know, a comparison chart laid out in front of you (I did it on the computer so I could quickly switch in and out of screens and choices).
I chose to NOT get the dental plan, any of them, because the out of pocket expense for individual visits would cost me/my family significantly LESS per year than the monthly premiums. I figured if I got nailed with an unusual expense now and then, it'd STILL be less than sucking my premiums out every month regardless. So far, I've definitely saved money.
My medical coverage allows for a small amount of vision coverage as well. If your family wears glasses, consider that, too. Not all plans have this coverage.
Good luck! And remember, you can ALWAYS change carriers later on, annually, during Open Enrollment. You're not hooked to a carrier for life!

Great advice! My husband and I will have to sit down and make an educated decision. Thanks!