I carry an HMO insurance for our family. My husband is offered a PPO thru Beechstreet...?

Question

I've not heard anything good or bad (except the few answers here) about Beechstreet but can't find any of our doctors on their lists. He is being told that having their insurance would help us by lowering our out of pocket expenses. I'm not seeing this. I've heard that having 2 insurances can make things more difficult and really not be all that helpful either. I don't want him to spend $ on premiums if we will not save money in the long run. Does anyone know if having 2 insurances, one being an HMO and the other PPO, helps or hurts?

Answer 1

Beechstreet is a discount plan and not medical insurance. The HMO is truly health insurance. There is no point in having a discount plan especially when you already have an HMO. I don't know of any health insurance plans that will let you take out a policy if you already have coverage. This is further evidence that Beechstreet is only a discount plan designed more for people who can't afford health insurance.

Answer 2

I'd stay with the HMO, also remember if you have children, they are primary under the parent with the earliest birthday in the year.  I had a similar situation a few years ago and it ended up costing me money and extra work.  (My work would not let me drop coverage even if was to my advantage, would,t happen today)

Answer 3

use the HMO. what you need to do is find the right doctor that wll treat you and be concerned about yourhelath. they are there but you have to look. the other one is stupid you dont' need it and it can mess youup big time and sometimes no one will pay cus ethey are thnking someone paid it so just use one that is enough and they are the cheapest.

Answer 4

The person above is incorrect.  Beech Street is *not* a discount plan.

However, its also not the insurance company that would be paying your claims.  Beech Street is a PPO network that is used by TPAs.  (third party administrators)  The claims liability isn't incurred by Beech Street - they price the claim, and the claims administrator makes the payment.

For example, if your husband's self-funded, that means that your husband's actual employer is financially responsible for your medical claims.  Self-funded employers generally contract with a third party administrator (TPA) to handle the claims.  Often, that claims administrator uses the network of a large national PPO.  (Examples of these are Beech Street and PHCS.)

Sounds complicated?  Yeah, I guess it probably does sound a little complicated if you're not used to handling that sort of information all the time.  :)

Anyhow, I've worked for several large medical providers...all of whom have had contracts with Beech Street.  And I have also worked for a large health insurer that used Beech Street as a travel network for people visiting out of state.  They are pretty reliable when it comes to processing the claims and forwarding pricing to the TPA/claims administrator.  Again, keep in mind that the claims administrator is the one who would actually *pay* your claims and administer your benefits.

As far as having 2 insurances goes...it all depends on the benefits offered under each plan and the premiums you'd have to pay.  There are situations where it would be advantageous to have more than one plan.  And there are situations where it wouldn't help you at all.  You really have to do a side by side comparison of your plan options.

Answer 5

The best thing to do is compare the benefits between the two plans.  Typically  PPO's will give you more options in terms of your network of providers.   Therefore I would also compare each provider network to make sure you can see the Doctors of your choice for the least out of pocket expense.

Typically,  changes to group health plans can only happen during the annual enrollment period. (Typically starting in November)

Also, coverage for the children woud follow  the earliest birth month of the parent to determine primary coverage.

Personally, I have two PPO plans in my household  I have a group plan and my wife also has an individual plan with her and my son on it. (*** It is a Long Story***)   For right now, we are keeping both plans despite the $595.00 per month we could save by eliminating my wife's plan.

So the bottom line is compare your plans benefits, networks and costs; then make changes which are appropriate to you.

Answer 6

It's probably going to cost you more in the long run.