I have switched jobs and have the choice between Aetna’s “Open Access Select Plan,” and UHC’s “Choice Plus PPO Plan.” It seems to me that the UHC plan is pretty good but I keep reading 90% coverage on things where as I am reading 100% coverage on the Aetna plan. I am not very good at the research and decision process, so I was hoping someone could give me advise on which one they have experiences with and/or perhaps what things specifically to check???
You’ll want to figure out what the differences in premiums are for each plan as well as the differences in the deductibles. For example, while the Aetna plan might cover everything at 100%, it might have a super high deductible or higher premiums than the other plan, so you may end up paying more or about the same as the UHC plan anyway.
You’ll also want to figure out how the plans differ in your access to physicians. Do they both allow you to see any physician you want, or do you have to stay in their network? Do you need to have a referral to see a specialist?
Also, you’ll want to check to see what percentage of things they’ll cover that you use often. For example, if they cover 100% of things you’ll never use, but not 100% of things you’ll use often (like dr’s. visits, specialist visits, etc.,) you’ll have to weigh that consideration too.
If you have questions about the differences in plans that you can’t answer based on the forms you have, you should be able to contact your HR representative, and they should be able to find out answers for you, or direct you to someone you can ask about them. Good luck! And congrats on the new job!
Every D’s favorite part of a new job! If you use a pump, be sure to check out the Durable Medical Equipment category and go with the higher percentage (hopefully 100%). Some pamphlets will list it while others you may have to call. If you use CGM or want to, see if you can find their policies (some are online) and see which one might be more friendly towards it. Hopefully you won’t need them, but it doesn’t hurt to check differences in co-pays for ER visits and ambulance services or hospital stays. Otherwise, it’s number crunching and see which have the highest out-of-pocket expenses/deductibles.
Many times they’ll be almost identical, and the differences may not matter to you. I’ve had good luck with hmo plans from Harvard Pilgrim, but the company itself can make a difference. I had a decent experience with Aetna’s student plan, but am not familiar with UHC.
Congrats on the new job!!!
Hi Todd, I’ve never had either of those insurances but I’ve learned to look at the scrip copay/deductible. To repeat what was already mentioned, if you are using pump or CGM (or plan to), you also want to compare the DME (durable medical equipment) copay and deductible. It is usually not shown on a simple comparison chart but you might want to dig in whatever literature is available and confirm that they cover pumps/CGM (the booklet I received for my Anthem insurance specifically mentions pumps).
Of course, coverage can vary from one person to the next even within the same insurance company because sometimes the employer and insurance company negotiate separate terms!
Thanks everyone for the feedback. It looks like they both have a zero deductible!!! First good news. The perscription coverage is very close. Anthem says 100% where UHC says 90% after copay. DME says 100% on Anthem and only 90% on UHC, but I don’t see a maximum benefit or anything about my Dexcom. I just got a pump so I’m ok there for now, but the sensors are pretty killer. I think I’ll ask HR if there’s anyway to know if either will cover the Dex, but I’m guessing it’s going to be a crap shoot on that one. Thanks for the input, it’s always reasurring to hear from my fellow pancreas challenged
Your choices are very good! I would pay 30% for pump/CGM after paying $500 deductible.