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Author Message   amandacat Citizen Username: Amandacat Post Number: 350 Registered: 8-2001 Posted on Monday, January 26, 2004 - 3:07 pm:        I'd very much appreciate any feedback you can share, positive or negative, on the following HMO's: Aetna AmeriHealth Cigna My husband's company is looking to switch health plan providers, and plans with these three were among the most affordable out there.   gozerbrown Citizen Username: Gozerbrown Post Number: 319 Registered: 3-2002 Posted on Monday, January 26, 2004 - 3:31 pm:        As health plans go, can't stand any of 'em! However, we've had the least problems with Aetna, especially if you are able to go the PPO route. (I know you addressed HMO's above...). The PPO option is a little more expensive, if you have the option, but it allows a little more freedom. Currently we have Empire who is simply a nightmare.   Ukealalio Citizen Username: Ukealalio Post Number: 392 Registered: 6-2003 Posted on Monday, January 26, 2004 - 5:45 pm:        Cigna used to be great but a lot of Doctors are not accepting it anymore. I agree with Gozer that they all stink. Seems like were paying more money and they're giving us less care (you may want to ask about the plan your on, if they give Doctors bonuses if they don't refer you to specialists). The top executives of these plans keep getting richer and richer and our care keeps declinng.   amandacat Citizen Username: Amandacat Post Number: 353 Registered: 8-2001 Posted on Tuesday, January 27, 2004 - 2:32 pm:        I thought I'd heard bad things about Aetna in the past, but then I looked at the state's report card on health plans and it seems they actually have some of the best ratings in the state. Guess I was wrong. So, any strong opinions on going with an HMO vs. a PPO or POS plan? I understand that, in theory at least, the more choice you have the better, but you also pay a lot more for that choice in your premiums , and it seems to me that "out of network" coverage is almost always significantly weaker than if you were to stay in-network. Do the benefits actually outweigh the costs involved, do you think? Again, any feedback would really be appreciated.   algebra2 Citizen Username: Algebra2 Post Number: 1585 Registered: 5-2001 Posted on Tuesday, January 27, 2004 - 2:41 pm:        We have been very happy with Aetna. Mine is a HMO/PPO but I have only used the HMO portion. I went through a whole pregnancy and paid only $10! My husband is covered under a different Aetna through his work and he's been happy as well. With my plan I can only see a primary care provider in the city, but he goes to Summit Health Care and raves about them (Dr. Eileen Klein). Within Aetna there are so many different plans -- mine I get all prescriptions for $2.50, with my husbands prescriptions range from $5 to $25. My co-pay is $5 (specialists w/ referral are FREE)and his is $15. It's hard to judge a plan without knowing the specifics but we've been very happy with Aetna   marian Citizen Username: Marian Post Number: 88 Registered: 9-2001 Posted on Wednesday, January 28, 2004 - 12:27 pm:        Hate to jinx my luck with Aetna, but they have been very good to us too. I have a point of service (POS) plan which allows us to go to an in-network doc for a $15 co-pay or an out of network one on a 70/30 split. (After the deductible is met, of course.) Aetna was also EXCELLENT during my pregnancy last year-- covered absolutely everything, no questions asked. They have even covered stuff I never in a million years imagined they'd pay for such as acupuncture for back pain before my son was born and a lactation consultant's home visit afterwards. Believe it or not, they covered SO MUCH stuff last year that I now have a few hundred dollars left in my 2003 health care flexible spending account that I'm struggling to collect receipts for so I don't lose the dough!   gozerbrown Citizen Username: Gozerbrown Post Number: 328 Registered: 3-2002 Posted on Wednesday, January 28, 2004 - 5:07 pm:        We also had pretty good luck when we had Aetna. I had them many years ago when they were affiliatd with US Healthcare, I think, and had some bad experiences). We had the PPO through Aetna and have never had a problem finding good providers (except for a GP, but that's a different story...). Our plan had a deductible which was a real pain in the neck. When the spouse changed jobs, we ended up with Empire (ewwww). We have a PPO again without a deductible. I don't have any experience going out of network with Aetna, because all the specialists (and believe me...last year I had plenty) were fantastic. Marian -- about your FSA, the rules have changed a little for 2003 and you might be able to claim some over-the-counter meds. Check with your administrator.   marian Citizen Username: Marian Post Number: 93 Registered: 9-2001 Posted on Wednesday, January 28, 2004 - 9:49 pm:        Gozerbrown, Thanks for the tip. Yeah, I know the IRS changed the rules halfway through 2003 that you can deduct over-the-counter meds. Problem is that I never saved those receipts 'cause I never thought I'd run out of out-of-pocket medical expenses... I once heard that a good rule of thumb is to estimate what you'll have to claim for the upcoming year then only put 80% of that figure in your FSA to be safe. I thought I did that for last year but you can be damn sure I did it for it for 2004!