Thanks for this! My job switched me from Aetna to Anthem this year, and I was getting confused reading about BCBS. I'm in Philly so this feels extra weird knowing I'd likely be on something else if I lived in another part of PA...
To make it even more confusing on the providers side, there are multiple plans in each state for which docs need to strike up separate contracts. I would say that the differences in every state are akin to MACs, correct? If that is the case, I wonder why it is that MACs don't take on a similar role of auditing as private payors. I've read so much about how CMS is simply too inundated when combating fraud. But you would think the installation of regional MACs could do something about the waste and fraud that is hurting everyone.
Hello Dr Bricker, Thanks for the info.🙉 It sounds like your lapel microphone is not working and all the audio is what's being recorded via your on camera mic. Once you fix that your audio will be as good as the info! 🤓
More specifically I wanted to know if there was a individual plan that Blue Cross offers, even though I live in Brooklyn New York what type of plan would be acceptable for a provider that was based in New Jersey, I have upcoming surgeries I would really love to work with this doctor the problem is that he’s in New Jersey and I am in Brooklyn I just wanted to know what plan does Blue Cross offer to remedy that situation is it a PPO plan only? Or is there other options I read the Blue Cross covers out-of-state doctors I just don’t know which type of plan I would need going forward, the doctor does take Blue Cross Blue Shield I just need one that would cover him because he’s in New Jersey any ideas thank you so much
Lol. My question wasn’t answered here so maybe you’ll catch my comment. If my doctor accepts BCBS does that mean they accept Premera BlueCross? I live in NYC but my employer is based out of Washington and has Premera BlueCross
Yes. The Various Blue Cross companies across the country share the same network. Blue Cross may deny paying your do core for any number of other reasons. Best plan is to call Premera and ask them about the particular doctor, rather than ask the doctor if they take Blue Cross. Thank you for your question. Hope that helps.
So where does FEHB BCBS fit in? It's run directly by BCBS organization? Do they all use the same PBM, or doesn't BCBS now have their own I think Prime Therapeutics?
Hello, I know this was made in 2020; highmark is in NYS Buffalo, and they have many issues. None of the reps can give my office the right info and pass us along to the next call center!
Meant to say you are right when you say "its too complicated" 😅 it wouldn't let me edit the comment. But i sure wish healthcare and health insurance wasn't so complicated 😢
If I live in New York City and I want to see a provider in New Jersey what Blue Cross plan would be good for me? I was told in New York only a Blue Cross PPO plan would be able to do this? Is there another way or does it have to be PPO. I read online that Blue Cross covers you out of state if that is correct what would the appropriate plan would it be for an individual thank you for your time I appreciate the feedback
Great question. If you have the name of a specific doctor, you should be able to check if they are in-network on the insurance company’s website even if you are not a member of that insurance yet. To double check, then call the doctor’s office and ask to speak to billing department or practice manager and CONFIRM that they are in-network with the insurance plan you are considering.
Why does Blue Shield of California you have a ONE STAR D- rating with the BBB? Why do you have a one star rating with 795 reviews on Yelp? How is that ok?
@@ahealthcarez I don't necessarily think so, since it's 36 separate entities and the penalty for an antitrust suit is usually division. Anthem specifically may be a monopoly in part of where it operates, but not the entirety of BCBS
I need some health insurance I just received something from the Internal Revenue Service for health insurance well I need some health insurance, but I may want to purchase Blue Cross I know it's going to cost me about $800 a month. Jesus help me
Health insurance isn't mandated anymore. You won't get fined for not having it. Shop around to find different prices, and see if you qualify for your state's Medicaid as well. Keep in mind that the popular thing these days are high deductible plans- they typically cost a lot less monthly, but will have either a very high deductible or a high out of pocket maximum, or both. Good luck!
.....:) YOU make More Sense in your Explanations, than the Reps on the Phones...!!!!....Thanks....!!!
Thanks so much for watching and for your comment.
Thanks for this! My job switched me from Aetna to Anthem this year, and I was getting confused reading about BCBS. I'm in Philly so this feels extra weird knowing I'd likely be on something else if I lived in another part of PA...
Thank you for watching and for your comment!!
I work for one of the 36 individual Blues and I found this very informative. Thank you.
Thank you for watching and for your feedback.
Do you happen to work for Blue Cross CA? I'm desperate...
@@theianmce No, I’m not in CA.
A+ quality video. Excellent and appreciate the upbeat attitude. Makes it easier to stomach complicated insurance
Thank you for your feedback.
Wonderful video! I had a hard enough time understanding BCBS. Imagine, HCSC. OMG.
Super! Thank you for watching the video!
Thank you so much for this clear explanation. I hope I speak for everyone when I say "Holy shit. That's a LOT."
Yes. Thank you for watching.
When you realize the care of your health is in the hands of corporate America it is scary as fuck.
Good point. Thank you for watching.
Helpfull video, but you skipped Massachusetts. Any I should know?
Thank you for watching and for your feedback.
Nice video sir
Thank you for watching and for your feedback.
To make it even more confusing on the providers side, there are multiple plans in each state for which docs need to strike up separate contracts.
I would say that the differences in every state are akin to MACs, correct? If that is the case, I wonder why it is that MACs don't take on a similar role of auditing as private payors. I've read so much about how CMS is simply too inundated when combating fraud. But you would think the installation of regional MACs could do something about the waste and fraud that is hurting everyone.
Good point. Depends on the state. Pennsylvania has 3 different Blue Cross companies. Texas only has one.
Hello Dr Bricker, Thanks for the info.🙉 It sounds like your lapel microphone is not working and all the audio is what's being recorded via your on camera mic.
Once you fix that your audio will be as good as the info! 🤓
Thank you for your feedback.
More specifically I wanted to know if there was a individual plan that Blue Cross offers, even though I live in Brooklyn New York what type of plan would be acceptable for a provider that was based in New Jersey, I have upcoming surgeries I would really love to work with this doctor the problem is that he’s in New Jersey and I am in Brooklyn I just wanted to know what plan does Blue Cross offer to remedy that situation is it a PPO plan only? Or is there other options I read the Blue Cross covers out-of-state doctors I just don’t know which type of plan I would need going forward, the doctor does take Blue Cross Blue Shield I just need one that would cover him because he’s in New Jersey any ideas thank you so much
Yes, would be PPO. Blue Cross has in-network doctors in other states… but still need to check.
Lol. My question wasn’t answered here so maybe you’ll catch my comment. If my doctor accepts BCBS does that mean they accept Premera BlueCross? I live in NYC but my employer is based out of Washington and has Premera BlueCross
Yes. The Various Blue Cross companies across the country share the same network.
Blue Cross may deny paying your do core for any number of other reasons. Best plan is to call Premera and ask them about the particular doctor, rather than ask the doctor if they take Blue Cross.
Thank you for your question. Hope that helps.
Thank you so much for this! Can BCBS has government as well as private plans?
Yes. Thank you for watching and for your question.
I work in concentrix working for hcsc
Thank you for sharing.
So where does FEHB BCBS fit in? It's run directly by BCBS organization? Do they all use the same PBM, or doesn't BCBS now have their own I think Prime Therapeutics?
Good question. This link describes the relationship somewhat: www.fepblue.org/about-us
In California blue cross blue shield are two separate companies
Thank you for letting me know. Appreciate you watching.
How do I renew my card ?
Call them and ask
Where does Florida fall into?
Great question. They use National Alliance from BCBS of South Carolina as their back office, I believe.
Hello,
I know this was made in 2020; highmark is in NYS Buffalo, and they have many issues. None of the reps can give my office the right info and pass us along to the next call center!
Thank you for sharing your experience. Appreciate you watching.
Meant to say you are right when you say "its too complicated" 😅 it wouldn't let me edit the comment. But i sure wish healthcare and health insurance wasn't so complicated 😢
Thank you for watching and for your comment.
You missed Triple-S in Puerto Rico!!!
Thank you for pointing that out.
If I live in New York City and I want to see a provider in New Jersey what Blue Cross plan would be good for me? I was told in New York only a Blue Cross PPO plan would be able to do this? Is there another way or does it have to be PPO. I read online that Blue Cross covers you out of state if that is correct what would the appropriate plan would it be for an individual thank you for your time I appreciate the feedback
Great question. If you have the name of a specific doctor, you should be able to check if they are in-network on the insurance company’s website even if you are not a member of that insurance yet.
To double check, then call the doctor’s office and ask to speak to billing department or practice manager and CONFIRM that they are in-network with the insurance plan you are considering.
Why does Blue Shield of California you have a ONE STAR D- rating with the BBB? Why do you have a one star rating with 795 reviews on Yelp? How is that ok?
Excellent question.
what just happened. yes my head is spinning.
Understandable. Thank you for watching.
3:03
Thank you for watching.
why is this not a monopoly?
It is. They have had a civil suit against them… interestingly NOT from the Government.
@@ahealthcarez I don't necessarily think so, since it's 36 separate entities and the penalty for an antitrust suit is usually division.
Anthem specifically may be a monopoly in part of where it operates, but not the entirety of BCBS
I need some health insurance I just received something from the Internal Revenue Service for health insurance well I need some health insurance, but I may want to purchase Blue Cross I know it's going to cost me about $800 a month. Jesus help me
HealthSherpa.com is an easy way to see how much subsidy $ you get and you can shop for insurance plans there too.
I have no connection to them.
Health insurance isn't mandated anymore. You won't get fined for not having it. Shop around to find different prices, and see if you qualify for your state's Medicaid as well. Keep in mind that the popular thing these days are high deductible plans- they typically cost a lot less monthly, but will have either a very high deductible or a high out of pocket maximum, or both. Good luck!
Its too complicated 🤯😑
#Agreed
there are better companies and Blue Cross blue Shield
Thank you for your comment.
Who ?
Pinche aseguranza no sirve nunca la aceptan en muchos lugares