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SAMBA vs BCBS
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jagfan View Drop Down
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Joined: 06 Dec 2007
Posts: 43 		Post Options Post Options   Quote jagfan Quote  Post ReplyReply Direct Link To This Post Topic: SAMBA vs BCBS
    Posted: 18 Nov 2009 at 7:12am
Originally posted by Nearly a pro

Nalc charges 25% for co surgeons as in book.
 
Nearly...
On page 42 of the NALC brochure, I read, "The Plan allowance for an assistant surgeon will not exceed 25% of our allowance for the surgeon."  Patient pays 15% of this allowance.  It is customary that allowances for an asst surgeon are not as high as the primary surgeon.  Can you share where the 25% copay for asst surgeons is cited? 
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DazedNCo-Fuzed View Drop Down
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Location: Georgia
Posts: 1 		Post Options Post Options   Quote DazedNCo-Fuzed Quote  Post ReplyReply Direct Link To This Post Posted: Yesterday at 2:52pm
This forum is a GOLD MINE of great information!!!  I am so glad to have found it.  I have been trying to make a decently informed decision about switching health insurance companies since I observed that MHBP's standard option premium is going through the roof in 2010.  . . .But now my eyes may be permanently crossed.  Dead  LOL
 
I must find a way now to afford some long-overdue dental and vision coverage for myself and my husband, so the monthly cost of our healthcare premiums must be cut.  I am happy to say, though, that we have pretty much decided to go with United Concordia for our dental coverage and United Healthcare Vision.  Wink
 
I guess I am simply fishing here for some fresh perspective on healthcare coverage.  If there's anyone else out there who is familiar with MHBP's standard option coverage as compared to the others in this state (Georgia), I'd love to get some new opinions.
 
I have been heavily considering SAMBA's standard option because the premium looks reasonable, and the coverage seems to be similar to MHBP's standard option.  . . .Any advice?  I know that SAMBA is a Cigna company, and I've heard quite a few different stories about them denying coverage for some procedures as well as a few other not-so-great things.  ALL input is much appreciated!!!
 
NALC's (only high option?) premium is way too far out of our price range.  Needless to say, it's out.
 
BCBS's basic option premium is affordable, but their coverage has always been too hit-and-miss, IMHO.  I mean, God forbid you ever got in a jam and end up using an out-of-network doctor, hospital or other provider.  Yikes!  We did actually have BCBS a looong time ago, and all I remember is that we couldn't wait to switch from it.  And anyhow, our hospital of choice and other providers have shared recently that BCBS doesn't pay worth a flip.
 
GEHA's standard option doesn't appear to pay very well for a hosptial stay, inpatient surgery or Level II or Level III Rx.  I'm thinking that an unexpected surgery with them would eat us up in coinsurance bills from everyone including the surgeon, his assistant, the anesthesiologist, the lab and the radiologist to the hospital, itself.  EEK!
 
The only other PPO that I haven't had the time to check out yet is APWU (only high option?).  However, the overview of its coverage already doesn't entice me any more than GEHA's standard option.
 
Anyway, it's just the 2 of us now (in our early 40s), he is the sole federal employee (retired) annuitant, and we're both in reasonably good health.  He's had some knee surgeries in the past, but neither of us are EXPECTING to need any major medical care anytime very soon (of course, it's always the unexpected that will get you!).
 
Thanks!  Wink
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Nearly a pro View Drop Down
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Joined: 17 Nov 2009
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Posts: 11 		Post Options Post Options   Quote Nearly a pro Quote  Post ReplyReply Direct Link To This Post Posted: Yesterday at 8:06pm
 I agree the Insurance is getting so complex it is harder to determine what is a decent deal or not. I too thought Samaba is a well organized plan but I am deciding against it due to the prescription being not too well covered even though the rest of plan seems pretty good. I had NALC this past year and found their coverage was decent. But I will be returning to BCBS standard even though its sky high because it keeps the catastrophic low and because most medical billing offices seem to know how to bill BCBS, I found mistakes are less likely and extra premium is paying for better administrative..useful if surgery or big ticket item is neededWink
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fedman53 View Drop Down
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Joined: 19 Aug 2009
Posts: 27 		Post Options Post Options   Quote fedman53 Quote  Post ReplyReply Direct Link To This Post Posted: Today at 11:26am
I have a sub-question about SAMBA vs BCBS (or any other plan). I currently have BCBS-BASIC which has worked well for me. I've been looking at SAMBA because dependent daughter turns 22 in 2010 (will continue to be dependent through 2010). SAMBA offers coverage for 22 - 27 yo's for $120 per pay period. With BCBS TCC would be about $190 per pay period. Anyone used this SAMBA option or have ideas for other options?
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