Mr. Athena and I are both self-employed, and as such, we pay for our own insurance. However, at some point in the future, one or both of us may end up with more of an employment kind of situations, one that will (hopefully) provide health insurance.
We do use our insurance, primarily because I’m a Type 1 diabetic, and between pump and glucose monitor and supplies and insulin, that adds up to a lot every month. It could potentially make a difference between Job A, Job B, and staying self-employed. I’ve had employer-provided health insurance before, but it was pre-Diabetes and I never used it for much, so I didn’t worry about it too much. Now, though, I’d like to be able to intelligently look at what will be provided, see if it covers my supplies, and what my co-pay/deductible/etc might be.
Is there a way to do that? Should I expect to get certain documentation with an offer letter? How do these things work nowadays? I’d sure hate for one of us to accept a job thinking our health insurance will be covered, only to find that certain things aren’t covered or our out-of-pocket is much larger than expected.
I have always wondered it, but if I ever asked about the benefits while being given an offer, they might tell me the exact number of vacation and sick days I get, but information about the insurance was always “oh, we have a very good policy” :rolleyes:
I work in software, maybe it’s different for other fields, but whenever I ask, I get some generic “oh it’s great”, which may or may not be true and I won’t find out until I actually join the company.
On the other hand, if someone asked me about my insurance plan, the best I would be able to say is who it’s with - although I’d be honest about whether it sucked or not I know my situation is probably different from a lot of people’s.
You don’t want to just ask generally how the plan is. Make a specific request, ideally to someone in HR, to see the medical policy’s benefits summary. I think it’s unlikely many employers would provide it as part of an offer letter, but they’ll have it available if you ask for it and I can’t imagine anyone refusing, assuming they’ve made an offer.
With this type of thing my approach is always to be specific and pithy. After you ask for the details, resist the urge to explain yourself by rambling on about insulin and whatnot, because they’re liable to answer that diabetic supplies are or aren’t covered rather than giving you the complete information you really want.
Yes, ask to speak to HR about their policy, saying you have specific questions. And don’t do this until you’ve got an offer letter in hand. Sure, there are laws about this kind of thing, but asking detailed questions about coverage won’t help get your application to the top of the pile.
Oh yeah, I assume it’s not something you go into until AFTER you have the offer, and the less detail the better. I’d hope, in fact, that I could talk directly to the insurance company and not the organization making the job offer. I don’t necessarily want the HR people knowing anything about my health, other than I care about it.
Oh, another question, since we’re on the subject. It’s extremely likely that any job offer will be from out of state, since we’re software developers working in a town with no high tech. We work remotely. If someplace in California offers me a job, will the insurance be based in California? Will I have a hard time finding local doctors? I seem to recall knowing some people in the opposite situation - they lived in California, but worked for a local (Michigan) company, and that local company gave them Blue Cross/Blue Shield of Michigan, and hell if anyone in California took it.
Or do they do some sort of thing where they’d offer me insurance from my state?
Sheesh, just thinking about all this makes me forget about ever working for someone again. At least being self-employed, I have choices. Expensive choices, but choices.
It varies too much to give a meaningful answer. Some insurers are very local and some have very large networks. I don’t think there’s any really inherent logic to reason out what kind of company would use one or another, especially since price is so important.
Likewise, I would say it’s unlikely that a company would be set up to accomodate your situation. However, if it’s a software developer and their business depends on hiring fantastic developers who are often 100% remote, they may have planned for a way to offer talented people in remote locations useful insurance. So totally possible but not something I would presume. If you’re a valuable hire and their policy is no good for you, you could try to negotiate for something useful but then you’re negotiating.
Good luck getting an answer!
I had BC/BS. I live in one state, but corporate parent (& therefore health insurance) from another state. Tried to get a sleep study done; lab was in a hospital. Since you spend the night, there’s an argument that it’s inpatient; however, since it’s scheduled, there’s the argument that it’s outpatient. Difference was in excess of $1000 out of pocket. Everyone pointed the finger at someone else for an answer. I gave up because in short, I would only be able to find out how much it cost by having it done & waiting for the bill to come in. :smack:`
IME working for a few large multi-state & multi-national companies - they will offer insurance that’s reasonably good for all or nearly all of their onsite employees. That may mean a few different companies if that’s what they need to do to get near full coverage - for example, the company I work for now has BC/BS for most of their USA sites, since the various state BC/BS companies all have reciprocity for in-network doctors & facilities. However, they use Kaiser for their California sites since BC/BS network doctors are few & far between in California.
So if you’re going to be remote workers, and the company doesn’t have a presence in your state, you may be out of luck for finding in-network coverage. They’re not going to set up a new contract with a different provider just to support a few off-site employees.
Good answers, all. Thanks. I guess one thing we’ll keep in mind is when we’re looking, look for places that already have people in a lot of different states, and hopefully they’ll have something that’ll work for us.
I’m curious about what muldoonthief said about BC/BS - would it be safe to assume that since BC/BS of MI has a lot of local docs on their plan, any BC/BS from any state would consider them in-plan? Seems like that’s a pretty common insurer, and that might make my life easier.
Again, IME, yes. I live in Massachusetts, and over the past decade have had BC/BS based in Ohio, Illinois, and someplace else. Any doctor who is in-network for Massachusetts BC/BS is also in-network for those plans. The doctors just file the claims with MA BC/BS as well, and MA BC/BS takes care of sending the claim to the actual plan administrator.
Not always true - and this can vary by state and/or employer.
It is true that, in order to be a member of the Blue Cross Association (BCA) each plan must offer national network type plans (BlueCard PPO Network), it doesn’t mean that a specific employer is purchasing that sort of plan from the local BCBS if that plan has other options available.
There is a clear distinction though and determining if a certain utilizes a local network only vs. a national network should be relatively simple.
It is true though, regardless of the network, the provider of service will submit the claim to the local (host) plan and they transmit the claim to the issuing (home) plan.