SHBP Open Enrollment almost over

Well, folks the time is winding down.. anybody wanna share which plan they decided on and why? 

I went with Cigna HRA because at least I know what I'm dealing with.  I was orignally going with UHC HRA but I was a little afraid of the unknown.  At least with Cigna,  they have everything spelled out already.

I also am using my flex benefits and having about $150 taken out of my payroll per month for the General Health Savings Account.  I plan on using this money (which will $1800) to cover the out of pocket monies... ie deductible, co-pays, etc.  This money is available on Jan.1 and I won't have to worry about coming up with any large sums.

This has been one of the biggest decisions I've had to make in my life.  It has been very frustrating and kind of scary.

Anyone else wanna share?

I decided on the Cigna HRA. This was based on the fact that they offer more choices in doctors, and the customer service people were nicer and more informed about wls coverage. It also seemed like I would pay less out of pocket than the High Deductible option. I also chose the Health Savings Account (thanks to the suggestion of the Cigna rep). I am undecided whether to take the short term disability.  What do you think?

The United plan offers basically the same benefit at the same cost, but they didn't seem as informed as the Cigna people.

I really think it sucks that they (both plans) only offer doctors in Atlanta. Even though I live only 20 minutes from downtown Atlanta, I sympathize with everyone who is so far away. Hopefully they will work on this for next year's plan.

The out of pocket for the HDHP and the HRA for the surgery is about the same.  I chose the HRA because of the difference in what you pay for drugs though.. it's a little better with HRA. 

I have not really checked into the short term disability though.  Maybe I should do some research on that right now.

You're right in that both plans are pretty much the same.. I just went with Cigna because they had it already mapped out what they were offering. 

I live abour 2 hours from Atlanta so yeah it does suck.. Sucks eggs in fact.  But what can you do?

Have you considered we will probably have to stick with the HRA from now on, since the HMO will probably never cover your fills for lap band or any other follow up stuff for any other wls.

Is the HRA is going to cover the supervised diet visits and the psychological testing?

If the state goes back to not covering wls will we have to pay out of pocket for follow up? I guess I shouldn't worry so much, but it's a point to consider.

Well the thing is.. I kind of like the HRA.. it's not a bad plan at all.. it covers all of the same things.. at the same rates as the HMO.  So, I will probably stick with the HRA from now on

As to your other questions about if they change the coverage.. I haven't the slighest clue.

Based on my wife's past experience, I would say no.  She had her surgery the last day before the exclusion took effect.  Any followups and such were covered and at the time we had the Blue Choice HMO.

I have had the UHC HRA this past year.  I am sticking with them because I know the beast i am dealing with.  The plus comes when you use reach your out of pocket max, and with comorbidities and surgery you will, they pay 100% for all things that are covered.  I have not paid for a prescription since the end of Feb.  We have approx. 15 that get filled each month and I pay 0$

Me, too! We are just on opposite sides of the state. It is 90 miles to get to Emory Crawford Long.

I went with the Cigna HRA. I chose it for several reasons, but these were the main two:
1. I can go ahead and get started with my 6month superivsed diet.
2. They were more knowledgeable about what was required.

I had not thought about taking disability. I am hoping to be ready for surgery at the beginning of June and not have to take time off since I am a teacher.

I went with Cigna HRA also.  I have already started the 6 months of supervised weight loss and don't want to lose any more time.  I set up my spending account to cover the out of pocket expense.

i have chosen the Cigna HRA (for now...I might change my mind before Monday).  I'm not worried about setting up a Health Savings Account.  While not easy, it would be easier for me to come up with a chunk of change to pay the deductible than have it taken in drips and drabs from my take home pay.  I have enough issues making ends meet with my take home pay.  And I do take short term disability due to other medical issues.

The other thing, i can't speak if you get a lap band, but for RNY, follow ups with the surgeon should be able to continue at a basic copay rate (on the PPO or HMO) as long as the surgeon is in network regardless of whether or not State of GA continues to cover WLS.  Earlier this year, when I started this process, they paid for my initial consultation with the surgeon...I paid $25 copay.  It was just an office visit,  not listed as WLS.  It should work the same way for follow up...just an office visit.

-Elli