Health Insurance, is coverage affected by state? - Montana Owners Club

CountryGuy · 06-24-2005, 02:18 AM

Ok, here is another one, for some of you fulltimers that have changed your legal address.

If you lived, say, in Kansas, when you changed your legal address to Texas, or to South Dakota, did your health insurance coverage change??

I suppose if you are on Medicare, or if you served and retired from the Armed Forces this would not matter to you.

But, say you have a traditional Blue Cross Blue Shield. Did you get switched to Texas or South Dakota BCBS??

IF, you got switched, was there a dramatic difference in the coverage for you??

sreigle · 06-24-2005, 08:18 AM

Carol, if you are in a group plan, such as your former employer's retiree group, then your insurance will remain with whatever insurance company the employer uses. If he uses a Michigan company, including Blue Cross Blue Shield, then yours will be with Michigan.

As for coverage, you will need to look at the various programs offered. While in a stick home we chose the PPO policy which gaves us a favorable deal when using providers (doctors and hospitals, etc.) who contracted in that "network". We paid more upfront if we went "out of network". That worked well when we lived in Kansas where the network was. But for fulltiming we'd be paying the higher upfront costs.

So I switched us to a more traditional policy. We pay a bit more upfront when in Kansas going to those providers in the PPO network but we take a far smaller hit when out of state. The premium in our case is identical on both plans.

If you have BCBS, then when out of state if you go to a doctor/hospital that contracts with their local BCBS then you will get the same deal you would in Michigan. And the provider will submit the claim to their BCBS and that BCBS will work with your BCBS to get the provider paid. If you go to a non-contracting provider then you will pay more.

Our Rx plan is the same as before. Go to any pharmacy contracting with Blue Cross in their area and your deductible is the same as in your home state.

Dental is the same as before, for us. If we go to a contracting dentist we get the better deal than if noncontracting.

I don't know how it works for other insurance companies but this is how it works for us.

richfaa · 06-24-2005, 10:46 AM

We have the Bc/Bs Federal plan and I have Medicare.They stay the same where ever you are or go.I could get my servicing office changed if say we moved to Nevada but all that would change is where the billing is sent.I would check your individual plan for your details

Chaser · 06-29-2005, 07:40 PM

I'm just catching up with MOC news, etc. - just read the item on health insurance- having worked with BCBS in the western states - you take it with you if it is not an HMO - if that's what you have - as suggested prior - switch to straight traditional, pay your copays and deductible - go to any facility participating with that State's BCBS Plan - ask for a copy of any medical charges you incure - so if you get back home and get a bill or a claim rejected for any reason - you don't have to wait for documents to get back to you. Check them for diagnosis and procedure codes - that's what claims payers look at first - then check the normal stuff (address, provider info, etc).

Evy & Mike Orlob
2004 3295RK
2004 Dodge
Retired/RVing/Race Fans

stiles watson · 06-30-2005, 03:35 AM

An ever rising number of us do not have insurance plans that continue into retirement. The Medicare suppliments in general do a fair job of covering the costs that Medicare fails to cover. However, none of them seem to cover Rx in any significant manner. The "Prescription Card" associated with Medicare is a joke.

CountryGuy · 06-30-2005, 04:44 PM

Thanks for all the input and opinions! One reason I asked, is a few years ago (and this certainly could have changed A LOT by now), friends of ours, retired same company as Al, had traditional BCBS in Michigan. Took a Texas address when they went full timing, and were rudely awakened when they were switched to Texas BCBS. Their comment to us, and we are ONLY repeating what they told us, was that the Texas coverage was "less" than what they had in Michigan. It was enough of a difference, that they dropped the Texas address and now have their address at their daughter's home in Michigan. Again, thanks for the comments!

sreigle · 07-04-2005, 05:53 AM

Carol, that was very possible. The system I described to allow you to keep your insurance was designed specifically to answer that particular (and similar) concerns expressed by large companies. They wanted their employees to have the same coverage no matter where they went and the BCBS system in those days did not provide that feature because each BCBS is an independent company tied together only by membership in the national organization. By dictate of the national organization, as a condition for continued membership, that changed and the "ITS" system was developed. One of my responsibilities was to lead the project to install this system at BCBSKS of Kansas. My role in actual development of the national system was very minor, just input to what works and doesn't work for our plan. This system was the reason for the five business trips to Chicago in one year that I mentioned to you awhile back. This system was put into production in 1995, I believe it was.

I assume your friend was in the employer's retiree group and did not go "nongroup". Individual policies (vs. group policies) are a different animal.

CountryGuy · 07-04-2005, 04:49 PM

Thanks Steve

I believe our friend, as we are, is in group coverage.

8.1al · 07-05-2005, 04:19 AM

I am retired from General Motors and am insured thru a Michigan based HMO. When we started fulltiming in Oct. we started using the Escapees mail service in Texas. Our insurance company assured us that using the Texas address was not a problem as did GM.In mid May we received membership cards from Blue Cross of Texas. I called GM retiree and was told that whatever state address I used would be where my insurance came from. I asked about snowbirds and what if they changed their address for the winter. The reply was "If their address is in Fla. then their insurance will be from there". The only solution for me is to keep a Michigan address. This is just GM tho,other companies probably have different rules.

sreigle · 07-05-2005, 08:16 AM

That's interesting, 8.1al. GM must have a different arrangement. Did you keep your identical coverage or did it change. If the same, then the only change was in the ID cards. Mine are still from BCBS Kansas even though we're South Dakota residents. Does GM have active employees in an office in Texas? If so, then that's why you were transferred. That would probably be true for other large companies with branches in other states, too.

Parrothead · 07-05-2005, 08:45 AM

I've been reading with interest all the posts. We have our insurance through CalPERS. California state employees. We can choose several different providers. We have Kaiser right now because we like everything being in one place and our local hospital is horrible. However if we don't stay in Calif. we will need to change to Blue Cross. Kaiser has a good Senior Plan. Does Blue Cross have the same or do you use Medicare? (I just got my Medicare Card - made me feel old for a minute.)

sreigle · 07-05-2005, 09:39 AM

Blue Cross has a coverage that picks up after Medicare. In the Kansas BCBS it's called Plan65. I'm not sure what it is called in California.

By the way, doesn't Kaiser have facilities across the nation?

Montana_2753 · 07-05-2005, 11:07 AM

I work for a Community College and under my plan, a BC/BS PPO, upon retiring, as long as the provider is listed with them they pay 90%. If out of the system then they pay 80%. Fortunately, when I was hired, the contract stated that my medical/dental insurance premium is paid for LIFE, so Medicare will be supplemental (not even that close to "the age" to qualify!!). There is a $100.00 deductible per year for the medical and $0.00 for the dental. Because I will be a resident of Arizona and the BC/BS is for providers in California, I will be locating a primary care physician in Blythe, CA, which is only 20 minutes from Quartzsite. The closest hospital is also in Blythe. For my dental, I will try to keep my present dentist, as I should be able to get to my every-6-month appointments for cleaning, x-rays, etc.

without too much difficulty.

Bruce

Parrothead · 07-05-2005, 03:32 PM

No Kaiser is not across the nation. Only in certain states. They use your zip code to determine if you can have coverage with them as they want you to br fairly close to a facility. For active employees you can use your work address but for retirees it is only home.
Bigskyguy you got a great deal. A lot of public schools use to do that also but budget cuts did away with it. And they cannot do it for board members now.
Happy trails....................

CountryGuy · 07-05-2005, 04:40 PM

8.1al,

That is exactly what happened to our friends, and that is Ford Motor Company.

Guess it comes down to each and every one of us asking a LOT of questions and asking again and again and again. Call that union rep??

Parrothead · 07-05-2005, 05:48 PM

One of the problems with retiree insurance is that the company or entity you worked for may change carriers or do away with benefits for retirees. One of the neat things about CalPERS is this is also my retirement allowance so as long as I stay in at retirement no matter what my district does, I can stay in the CalPERS insurance network. This is one of the areas that I supervised so I made sure I was going to be okay when I retired. You have to look after number 1 because no one else will!
Happy trails.....................

8.1al · 07-06-2005, 10:42 AM

Sometimes you can ask too many questions and give the other person some ideas they couldn't come up with on their own

Montana_2753 · 07-11-2005, 11:22 AM

Parrothead, et al:

The other "insurance" I'm looking into is "Long term care". Have checked with CalPERS, which seems high, and a couple of others. Meeting with my Financial Planner on Wednesday to go over coverages and figures and try to decide what's best for me. (Parrothead: You have to look after number 1 because no one else will!)

Parrothead · 07-11-2005, 02:48 PM

bigskyguy
All long term care policies are high unless you are 20. (I notice you are not!) SCAN (new insurance for seniors) has a live at home plan where they bring care to you if needed. My Mother has it and they clean her house, provide medical supplies (besides RX) and even sent her a toliet seat riser. She pays $8.5 every two weeks to have her house cleaned. If she needs, they will send a nurse. The girl who comes to clean even trimmed her rose bushes last week. If the long term care seems too high, look into a cancer policy (Good Sam has a good one) if the big C runs in your family. It does in both of ours, so we have this policy. Cost $65 twice a year for both of us.
Happy trails.....................

Montana_2005 · 08-03-2005, 09:26 AM

Is there anyone here that has insurance other than cobra/retirement policies? Kevin and I will resign the end of the month... I am not going to go with the cobra plan from BCBS of Ks. Too high.. I see where Escapees has policies, as do other clubs and groups.
any thoughts?

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