Jesus Said:

I have Anthem Blue Access PPO health insurance and I was wondering if anyone knew if it covers the IUD Mirena?

We Answered:

call and ask them

Andrea Said:

If I have a PPO Health Insurance plan, can I go to any doctor without a referral?

We Answered:

Yes, you can go to any doctor. However, you need find a doctor in the network if possible.

If you go to a doctor that's in the network all you'll pay for the doctor visit is the co-pay. Depending on the policy you may also have other expenses such as lab work. When a doctor is in the network they agree to accept a certain $ amount for a procedure which in most cases is less than the doctor would normally charge. For a simple example; most specialists in my area charge around $200 for a basic visit. The amount they agree to accept from the insurance company is around $120. You'll pay the co-pay for the specialist, usually around $40, and the insurance company will pay $80.

If you go to a doctor that is not in the network the doctor does not agree to accept the same $ amount as an in-network doctor. Also, you'll have to pay the entire charge first and then submit the bill to the insurance company. So to use the above example you'll pay the doctor the $200. You'll then submit the bill and the insurance company will reimburse you $80.

Gina Said:

Is there a good PPO health insurance provider that is known to be better value for an individual.?

We Answered:

A lot will depend on where you live, but in general, at least in California, you will want to look at which carrier is used by the largest number of doctors in your area. Blue Cross tends to be accepted by most doctors in California. A PPO is only as good as the doctors who accept it, so a cheaper one is not necessarily a good deal. You might find cheaper plans, but if no doctors accept it, it's worthless. The other plans you mentioned are good too. Find out what your personal doctor and the hospital near you use, and if everything else is equal, you know which plan to go with.
Wishing you good health,
Kim, a former life/health ins. agent

Lori Said:

PPO Health Insurance acceptance with pre-existing condition?

We Answered:

Talk to them about what they will and won't accept. I was diagnosed with Lupus many years ago while insured with HAP and after my seperation from my ex I lost my insurance. I went on to find a job and was insured by the employer, also through HAP. After my company was bought out I lost that job and my insurance once again. I went without insurance for over 5 years until I got married last year. My husband's insurance through work is Blue Cross Blue Shield of Michigan Community Blue Plan. Even with my pre-existing condition they took me on. I was told this was okay because my pre-existing condition was diagnosed WHILE insured...even if it wasn't with them. Now if I had done to the doctor's uninsured, had been diagnosed, then applied for coverage...it would have been a different story.. At least that's what the insurance rep said. Good luck.

Lori Said:

How much would it cost per year for good PPO health insurance ($20.00 co pay, prescriptions, lab, etc) ?

We Answered:

~~It is going to be expensive due to the older ages (55/61). It's not as expensive though as far as what can happen if you don't have it. The best insurance we found is through www.costco.com which provides excellent rates with the a very good insurance company for individual or small business. Go to member services and they can give you quotes. We worked with a girl who's name is Lisa who was awesome at selecting the plan which works well for us. We also were able to get dental. If you go through Costco pharmacy you do not even have a prescription deductible, just a small copay. You can't get a quote from people here because you will have to give extensive health history to find out premiums and who will accept you. It's free to get quotes so go ahead and contact them, you will be happy you did.