Pine Ridge Florida Blue Cross Insurance
Buying a health insurance policy in Pine Ridge Florida Blue Cross Insurance on your own can be tricky. There’s a lot of pressure to choose the right plan, especially since you’ll be stuck with it until the next Open Enrollment period in late 2016.
Looking through the 29 available plans on Pine Ridge Florida Blue Cross Insurance website was giving me some serious anxiety. I’m not sure I’m the only one either.
What’s the difference between Pine Ridge Florida Blue Cross Insurance Options, Pine Ridge Florida Blue Cross Insurance Care, and Pine Ridge Florida Blue Cross Insurance Select? Is one type of plan better than the others? What does Select, Options and Care even mean?
I did some serious digging and asking around and here’s what I found out about Pine Ridge Florida Blue Cross Insurance core plan options.
They’re Just Nicknames For Networks
Pine Ridge Florida Blue Cross Insurance Options, BlueCare, and BlueSelect are essentially nicknames for the type of networks you’ll be joining. Here are the network breakdowns for each plan:
- Pine Ridge Blue Cross Options PPO/EPO is Florida Blue’s largest network with over 36,000 doctors, 250 hospitals and all major pharmacy chains. Out-of-network coverage in or outside of Florida for most services.
- Pine Ridge Blue Cross Care HMO has over 29,000 doctors, 231 hospitals and all major pharmacy chains. No coverage for out-of-network services outside of Florida, except in an emergency.
- Pine Ridge Blue Cross Select PPO/EPO is Florida Blue’s smallest network with over 13,000 doctors, 79 hospitals and all major pharmacy chains except Walgreens. Out-of-network coverage in or outside of Florida for many services.
All you need to know about a network is that it’s a group of physicians, hospitals and other health care providers that has agreed to lower negotiated charges through Pine Ridge Florida Blue Cross Insurance. That means typically you’ll end up paying less money when you visit providers within your plan’s network.
OK! My next step is to figure out …
Is My Doctor In-Network?
This is a common mistake that many don’t think to check before picking out a new Pine Ridge fl health plan.
Make sure your doctor or specialist is in-network with the specific plan and network that you’re looking at. This critical step could end up saving you thousands in out-of-pocket medical bills.
To see if your doctor is in-network, check Pine Ridge Florida Blue Cross Insurance Florida Blue’s provider directory. Florida Blue use to include their provider directory when viewing and comparing plans on their old website, but for some reason they have removed that option with their new website.
Here’s Pine Ridge Florida Blue Cross Insurance old website with provider search (aka “Is My Doctor Covered”) included as a My recommendation is to open up Pine Ridge Florida Blue Cross Insurance provider directory first before looking at plans and search the main doctors, specialists and hospitals you frequently use.
Your primary care physician isn’t in Pine Ridge Florida Blue Cross Insurance Select? Well, that makes things easy, doesn’t it? Time to look at BlueOptions and Palmbay Florida Blue Insurance Care. Now when you go to Melbourne Florida Blue Insurance site to select a plan, you can choose the networks you know your provider(s) is a part of.
If all of this sounds like way too much work or too overwhelming to deal with on your own, you have options. In fact, we are one of your options.
Our team of licensed agents can help you determine if your doctor is in-network and talk through your plan options based on your specific needs and budget. Plus, you’ll have a dedicated agent to call/email with questions or problems. The best part? There’s no extra cost. The price you pay for your Pine Ridge Florida Blue Cross Insurance plan remains the same whether you use an agent or buy a plan on your own.
In 2013, the CDC estimated that Americans were seeking access to preventive services at only half the recommended rate.
They also noted that chronic disease accounted for most Americans’ deaths (7 out of 10!).
Not to mention, these chronic diseases cost a fortune to manage and treat. The CDC estimated that heart disease, cancer and diabetes accounted for 75% of American health care spending.
An overarching goal of the ACA is to improve public health. Encouraging Americans to eat healthy, exercise, and receive preventive care sounds easy. But fresh produce, gym memberships, and doctor visits are all expensive.
Removing the cost barriers of receiving preventive services increases the likelihood that they will be demanded.
Thus, free preventive care is a benefit of the ACA that has great potential to improve our overall health and wellbeing.
What types of preventive services are covered?
There are over 50 specific services now covered by ACA-compliant plans free of charge. This means that doctors’ offices cannot charge a co-payment or co-insurance for these services.
There are three categories of preventive health services: services for adults, for children, and for women.
Preventive health services for adults include cancer screenings, blood pressure, cholesterol, and Type-II diabetes screenings. These should be sought by adults to prevent the manifestation of lifestyle diseases. Based on the results of such screenings, doctors may encourage at-risk adults to participate in intervention programs.
Preventive health services for children include immunizations, oral health assessments, vision and hearing screenings, and behavioral assessments. Many of the listed services in this category will be sought by parents at their child’s pediatrician’s office. Pediatric dental and vision services are newly added benefits to Merritt Island fl ACA-compliant plans.
Preventive health services for women include breast cancer screenings, contraceptives, and well-woman visits. Many of the listed services in this category will be sought by women at their gynecologist’s office. Based on the results of such screenings, doctors may encourage at-risk women to participate in intervention programs. It’s important to note that many of the preventive health services for women are for those who are or may become pregnant.
How do you go about receiving preventive care?
Most preventive care services are carried out by primary care physicians (PCPs). A PCP can be a family doctor (for most adults), gynecologists for women, and pediatricians for kids. A PCP is the doctor you visit most frequently and who has the most detailed version of your medical history.
Most preventive services are recommended by age, frequency, and medical history. For example, women ages 65 or older should seek a bone mineral density screening annually. Such Pine Ridge Florida health services may be performed at annual wellness visits or during physical exams. Some plans may also recommend dental and vision exams, and you should check with your provider to make sure these are covered, because these are useful to many folks.
Keep in mind that, for these services to qualify as preventive care, they must be delivered by a network provider. Also, make sure your current plan is a non-grandfathered plan to ensure that it follows new ACA preventive care guidelines.
Preventive care tips
- Check with your health plan before you receive the service. If you’re a member of a Pine Ridge Florida Blue Cross Insurance plan, check out their 2014 Preventive Care Guidelines;
- Make certain that your doctor files a preventive service as such. If any extra services are rendered in addition to the preventive test during the visit, you may be billed for them, but you should not be billed for the preventive test;
- Keep track of the preventive care that you receive to stay on top of your health;
- Exercise regularly and eat well – these are the two best ways to stay healthy, after all!
The health insurance world has been in constant flux since the implementation of the palmbay fl ACA in 2010. The end of the first open enrollment period for the Health Insurance Marketplace yielded a lot of numbers. Everyone knows that over 8 million people bought plans on the exchanges. But not everyone has heard the numbers in the following 15 surprising statistics about contemporary American health insurance!
- 129 million American adults and 17.6 million American children have preexisting conditions, like asthma or diabetes. This means that half of the population has some type of pre existing condition. Luckily, the ACA contains provisions that prevent insurance companies from discriminating against those with preexisting conditions.
- One quarter of people who qualified for premium subsidies during the inaugural open enrollment period did not have bank accounts. I’m not really sure how I ever lived without my bank’s iPhone app, so this one really surprised me!
Source: Jackson Hewitt via Wonkblog
- Health care spending directly related to the ACA (now that more people have and use insurance), saved the U.S. economy from recording a negative growth rate in the first business quarter of 2014. Health care spending increased at a 9.9% annual rate, contributing 1.1 percentage points to GDP growth.
Source: Reuters via NAHU
- The ACA levied a 10% federal excise on tanning services. This is sometimes it’s called the “Snooki” tax, after the tanned reality TV star.
- More than half, or 52%, of Americans approve of “health insurance surcharges” being added to their bills at businesses, like restaurants, to help fund employees’ insurance policies.
Source: Bankrate.com via LifeHealthPro
- The Centers for Medicare & Medicaid Services (CMS) expects the number of individual health insurance policy holders to reach 31 million by 2020.
- Small businesses with fewer than 100 employees make up 98% of all American employers.
Source: SBA.gov via BenefitsPro
- There are 8.5 million uninsured American adults that could be eligible for the federal Medicaid program. 90% of these (7.6 million) are excluded from Medicaid because their states did not take money from the federal government to expand the program.
- The spending on health insurance premiums in the U.S. in 2012 was $917 billion – that’s higher than the gross domestic product of Switzerland, which in 2012 was $631 billion!
Source: CMS.gov & World Bank
- During the first open enrollment period for the federal Health Insurance Marketplace, Florida enrolled nearly 1 million people. It notably outperformed Texas, which has a larger population and more uninsured residents.
Source: HHS via KFF
- Roughly $89.4 billion in uncompensated care was provided in 2013. Uncompensated care is care that is sought by the uninsured. 60% of uncompensated care is provided by hospital emergency rooms.
Source: Health Affairs/the Urban Institute
- Of the 8 million people who selected Marketplace plans during open enrollment, 65% of them chose a silver metal level plan, and 85% of them purchased a plan with financial assistance.
- Despite an eligibility rate of 88%, only 66% of employees eligible to purchase employer-provided benefits actually did so in 2013. This is due largely to the fact that young workers are less likely to accept benefits because they can stay on their parents’ plans until age 26.
- A South Florida ophthalmologist received $21 million in 2012 from the tax-payer funded Medicare program — more than any other doctor in the country. Needless to say, the FBI is checking him out.
Source: CNBC (video) and KHN
- 60% of employers offering employee wellness programs claimed that these programs allowed for reduced healthcare costs. More employers and employees are embracing these wellness programs because healthy workers are happy workers!