GetHealthHelp

A Patient Advocate's View

Open Enrollment November 12-25, 2008

2009 VERIZON HEALTH PLANS COMPARATIVE ANALYSIS

 

The GetHealthHelp.com analysis is based on calls we receive to help you choose the right plan for your needs.

IMPORTANT! Members who were covered by the Aetna MEP PPO (185) and the Empire MEP (the old Blue Cross) in 2008 will automatically be enrolled in the MEP HCPPO for 2009.

 The first 2 columns are both for the new plan. The chart shows how you are covered both in and out of network.

Go online between November 12- 25 2008 http://resources.hewitt.com/verizon or call 1-877-275-8947

 ONLY if you want to change your plan selection from last year.

November 9, 2008 Posted by | Uncategorized | Leave a comment

Changes to the Indemnity PPO options

 

PLAN

 

Empire MEP HCPPO

Out of Network

 

Emoire MEP HCPPO

In Network

 

HOW DOCTORS & PATIENTS LIKE

 THIS PLAN

 

A+ BEST for Adults

Preventive Exams for children not covered

 

Your Aetna Doctors should be sure they are in the Empire HCPPO

 

Deductibles and co-pays

 

$250/$625

Out Of Pocket max. increased to $700

 

 

same as in network

co-pays are not counted to deductibles

 

Well Child Care

 

80% after deductible

 

100% immunizations & office visits

 

 

PRESCRIPTION PLAN CHANGES

 

no assignment of benefits

reimbursement only

 

 

% raised for co-pays

 out of pocket raised

 

CAN I USE MY

 OUT OF NETWORK DOCTOR & HOSPITAL

 

 

All doctors are covered

for 80% of office fee after deductible

 

$15 co-pay

$5 co-pay with Medicare

 

ADVANTAGE OF USING IN NETWORK DOCTORS

 

 

Most doctors know this plan and accept  it.

 

 

Co-pays instead of %

 

 

PHYSICAL THERAPY/

CHIROPRACTIC

 

Same as Medical Coverage Out-of-Network

In-Network agrees to managed care limits

 

 

80 % of contracted rate

 

OUT PATIENT MENTAL HEALTH

 

80% after deductible

 

80% after deductible

 
 
 

November 9, 2008 Posted by | Uncategorized | Leave a comment

HMO Options for 2009

 

814.Empire BCBS NY

HMO

 

21.Aetna

 HCN NY

 

847.Aetna HMO

 

822.HIP NY

 

838.HealthNet NY/CT

 

Only doctors at participating hospitals will accept.

Bare Bones Coverage

 

Comprehensive Primary Care at a low cost.

 

Only doctors at participating hospitals will accept.

Bare Bones Coverage

 

VERY GOOD for Preventive Services for children and women’s care.

 

Doctors compare this coverage to Medicare HMO’s. Small Network

 

 

 

  $150 Hospital  co-pay

per admission added  

 

 

NONE

 

  $150 Hospital  co-pay

per admission added

$50 emergency room

 

 

 $100 Hospital  co-pay

per admission added

 

 

 $150 Hospital  co-pay

per admission added

 

no change

 

 

no change

 

 

no change

 

no change

 

no change

 

 

no change

 

 

no change

 

 

NONE

 

 

NONE

 

 

NONE

 

 

NO

 

70% covered after $250 deductible with limits on fees and procedures including hospital care

 

 

NO

 

 

NO

 

 

NO

 

Requires PCP Selection

Limits out of pocket cost

 

No out of Pocket for In Network doctors visits $15 co-pay for specialists

 

Requires PCP Selection

Pay only a $10 co-pay

 for office visits

 

Pay only a $10 co-pay

for office visits.

 

Pay only a $10 co-pay

for office visits.

 

$10 co-pay

 

Limited number of visits both in and out of network b Preauthorization and

 $1500 Annual Max.

 

 

Only limited in-network coverage with

 managed care  limits

 

 

Limited number of visits

in-network $10 co-pay

 

 

Limited number of visits

in-network $10 co-pay

 

 

Approved Services

in-network $10 co-pay

 

Authorization Required

$15 in network 50% out

 

Approved Services

in-network $10 co-pay

 

60 visits limit

in-network $10 co-pay

 

Approved Services

in-network $10 co-pay

November 9, 2008 Posted by | Uncategorized | Leave a comment