Hi All! We currently have Blue Shield of CA for our daughter and though it's expensive because it's an individual policy, the coverage is quite good. We now have a chance to go onto my husband's employer's plan which means switching to an Anthem PPO. Does anyone have experience dealing with Anthem to cover CF related expenses? Do you find them easy to work with? We get our care at UCSF so they would need to be part of the Anthem network. Thanks in advance for any insight anyone might have.
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Insurance Question
- Thread starter Turtle
- Start date
Aboveallislove
Super Moderator
If she is under 6, my main concern about changing insurance would be knowing how they handle things off label.
Hi Turtle,
I had Anthem BCBS of California (PPO) through my husbands previous employer. Bare in mind that each plan is different, even with the same ins. company. However with that being said, our coverage through Anthem was great. Very low copays (the most I paid was $35 for Pulmozyme) and very good customer service the couple times I called them. They even let me fill Pulmozyme locally at a retail pharmacy as opposed to all other plans I've been on, current one included who make me use mail order. They covered admissions and home IVs with no problems. I was very sad to lose our coverage through them when my husband parted ways with the company.
I would guess you are paying quite a hefty monthly premium for the individual plan. My guess is that unless the group plan through your husbands employer is VERY inferior coverage you would probably be better off with it. I'd add up how much you'd be saving in monthly premiums and then weigh that against the deductible/out-of-pocket maximum, copays etc on the new plan and see how it compares.
I've gotta run but let me know if you have any other questions!
Take Care,
Autumn 32 w/CF
I had Anthem BCBS of California (PPO) through my husbands previous employer. Bare in mind that each plan is different, even with the same ins. company. However with that being said, our coverage through Anthem was great. Very low copays (the most I paid was $35 for Pulmozyme) and very good customer service the couple times I called them. They even let me fill Pulmozyme locally at a retail pharmacy as opposed to all other plans I've been on, current one included who make me use mail order. They covered admissions and home IVs with no problems. I was very sad to lose our coverage through them when my husband parted ways with the company.
I would guess you are paying quite a hefty monthly premium for the individual plan. My guess is that unless the group plan through your husbands employer is VERY inferior coverage you would probably be better off with it. I'd add up how much you'd be saving in monthly premiums and then weigh that against the deductible/out-of-pocket maximum, copays etc on the new plan and see how it compares.
I've gotta run but let me know if you have any other questions!
Take Care,
Autumn 32 w/CF
We have been on Anthem Blue Cross of California PPO for the last two years. Previously we had been on Blue Sheild and Health Net. I would say they have been the best of any of them, we have not even needed prior authorizations for many of the medications we needed them for in the past. The only two negatives we have run across is that they would not cover vit k which all other plans cover and is very expensive out of pocket, and they make us get pulmozyme at their mail order pharmacy(but has worked out fine). You should be happy with the switch.