[ewizabeth]

Hi Everybody,

I'm considering switching insurance to my new work health plan. They provide Cigna for medical, Aetna for dental, and Medco for pharmacy.

This is a OAP plan (higher level than the PPO which is the next cheaper plan.)

Does anybody have any opinions about them, good or bad?

I currently have BC/BS through my DH's union and they charge a very large monthly premium though they have pretty good benefits.

[barb02]

Medco is my pharmacy plan, and I have not had too many problems with them. Occasionally, they will deny coverage on a med until the doctor sends a special request. I had Cigna for insurance for past year until I switched back to HMO.
The reason I switched is because the state has not been paying our premiums so Cigna of course does not cover the bills until they receive the premium for the month of the service. If you did not use doctors in their network, costs were considerably higher. Also all of the doctors I see are in the HMO so it just made sense to switch back. My cost were about three times higher with Cigna than the HMO. Otherwise, I found their website to be fairly easy to use. I guess it would just depend on your costs, deductible, out of pocket max, etc.

[ewizabeth]

The deductible in network is $0 and out of network is $1,000 with a maximum of $3,000.

This would cost me around $1,300 a year and BCBS is costing me over $6,000 for the monthly premiums annually.

They also have an HCSA to pay my out of pocket costs with.

Both of my main doctors are in network so it looks like I might save money with this.

[FluteMaker]

my wife and i have aetna insurance through the avma and medco is the phamacy thing we got with it. im sure it depends on your coverage but on our plan the copay for copaxone was around 1500$/3 months.
aetna has always been pretty good for us. the only time we had trouble getting a claim paid turned out the to be the hospitals fault. (they never sent the bill.)

[mrsD]

I have worked on both sides of the Medco issue. In the past I found it to be the most infuriating drug coverage. They really made their patients jump thru hoops, and at times had insane rules. They were difficult to deal with on the phone, ultra time consuming, at the pharmacy level, and infuriating in general.

But we have also had it as our family plan. No choice. We have Federal Blue Cross thru my husband's job. Medco was dropped 3 yrs ago, but it is back this year. I have to say, they are a bit better than before. But they still give me the heebeejeebees.
They can also be very slow to send your drugs thru the mail.
In the stores we have Caremark, and only Medco for the mail away. (don't ask me why).

One nice thing they did was give us 4 free copays for the mail away per year on generics. This helps with one of my prescriptions. Medco is BIG BIG on generics. So be prepared for that. But one example of infuriating stuff: I had just sent my blood pressure RX to them, and they did not send it. Instead they called me when I was not at home, so I had to return the call and wait on the phone....then to only find out the delay?
What was my email address?? (the forms don't ask for it). Well, it is the same as before! And the person who helped me said it was clearly on my file! STUPID! Things like this are small...when they hold up your order for 2 weeks or more for some other stupid reason, they become infuriating!

[gonnamakeit]

Originally Posted by mrsD

We have Federal Blue Cross thru my husband's job. Medco was dropped 3 yrs ago, but it is back this year. I have to say, they are a bit better than before. But they still give me the heebeejeebees.
They can also be very slow to send your drugs thru the mail.
In the stores we have Caremark, and only Medco for the mail away. (don't ask me why).

I have the same insurance as you. I learned many years ago to not mail-in prescriptions and to use in town pharmacies.

After getting three of my scripts "lost" in the mail, I decided never again to use mail-in anything. Fighting with the new mail-in pharmacies year after year was really disturbing and there has not been a problem once I stopped using them.

gmi

[gonnamakeit]

[QUOTE=ewizabeth;611175]Hi Everybody,

I'm considering switching insurance to my new work health plan. They provide Cigna for medical, Aetna for dental, and Medco for pharmacy.

/QUOTE]


With you just starting a new job, I hope that you are not going to drop your husband's insurance in case you either don't like your new job and want to quit or that you get sick and cannot work.

With most company policies, a person is only allowed to drop or change insurance plans once a year, usually between November and December, so your husband may not be able to drop his anyway in case you want to switch to a new plan.

gmi

[ewizabeth]

I will drop my husband's insurance and go on the new plan. I expect to stay with this company since it's a fortune 100 company known to treat employees well and a good fit for me.

I really only need to know about the experiences of those with these particular plans.

I was the insurance administrator at my last company and understand policies in general, but I don't have experience with Cigna, Aetna or Medco.

[mrsD]

We have used mail away pharmacies for over 20 yrs. Long before the service became common for others.

The plan my husband has started with National RX Services in Tampa Florida back then. Only Medco has been a hassle.
Caremark when we had their mail in service was the fastest in response. I only get a small number thru the mail. I use local pharmacies for my generics typically. Now with the $4 per month offered by Kroger, Target and WalMart, one of my blood pressure drugs is $2.95 for a 3 month RX. That is because the U and C for 90 days for them is $10 on most generics.

But I do get my brand name things, mostly now just my Lidoderm patches from the mail in. Cardizem CD is not on the generic lists locally for the savings, so I am forced to get it from mail away also...but it is now free with the 4 free generic offer Medco is using.

Basically the plans keep changing, they move drugs to new "tiers" so they can charge more, and often require prior authorization for many items. My husband's psoriasis cream requires prior auth. It is just a major hassle, and it keeps changing so every year one has to perhaps go thru new hoops to get certain medications.

MS patients who use expensive biologicals, would have to research the drug plans very carefully, and even then, next year the rules may change AGAIN!

[ewizabeth]

My current insurance has been more of a problem this past year requiring pre-authorization for meds I've taken for years, etc... We have Express Scripts with the BCBS plan and Curascripts for the Copaxone.

I have to call each month to order the Copaxone, etc... That's the main one I'm concerned about. This will actually cost me about half of what the BCBS does now so I'll probably change at the end of the month after I get my next Copaxone shipment.

The tiers cost $25, 75 and $125 depending on if it's generic, preferred or non-preferred for a three month supply. If you get it at the pharmacy it's a maximum of $50 for a one month supply.