Health Insurance from ACSA

[cltypes]

What is the name of your state? Texas

I'm going to be attending school at Rhodes College (which is in Memphis, TN), and they require health insurance. I don't have health insurance, and I was searching around for the least expensive health insurance I could find (without it being total crap). I found this one health insurance from the American College Student Association. It costs $516 for 9 months of coverage (the length of one school year). The price seems fair, and i couldn't really find anything less expensive. I'm 18 years old and I'll be a sophmore in college. No one else in my family has health insurance, the only reason I will be getting it is because the college requires it.

I was just wondering if this ACSA organization is legit, and if the health insurance from them is legit.
This is the summary of benefits file they have posted: [url]https://www.acsa.com/plans/healthapp/2007/2101/22/sob.pdf[/url]


If anyone can help me out, it would be much appreciated. Thank you

[TIMMAAYY]

If you are healthy, which I am assuing you are... I would get something other than that plan. It has all kinds of limits on specific incidents, and if you end up needing it anywhere besides the university, it may not be accepted.

My suggestion would be to get an individual policy. For 57 bucks a month ( the price of the ACSA plan ) you can do better with an individual policy. And keep it once you get it, even in the summer. Once you graduate and get a job, you will most likely obtain insurance from your employer... but that's a whole 'nother topic.

Check ehealthinsurance.com for rates based on the zipcode of where you will reside ( TN ). There are numerous plans from Aetna, Humana, and Blue Cross that have much higher levels of benefits for the same money. A serious accident or illness could rack up quite a bill, much more than the capped benefit amount on the ACSA plans.

[cltypes]

Thanks TIMMAAYY, I checked out the website, though I have a few questions. All the plans that were affordable were from Blue Cross Blue Shield of Texas. I called the support number they have listed, and they told me that the thing with BCBS is that it's all different in every state, they're not linked, they're like franchises. So if i were to get a BCBS plan, I wouldn't be able to really use it over in TN.
So I asked the guy what if i just purchased health insurance for TN only, and have it start in mid August, and he said I could do that too, though I would have to have an address of residence there (which I won't get till later this year). Also, the college requires proof of insurance to be mailed in by June 15.
So, as of right now, it seems that i'm stuck with the ACSA plan, unless there's any other way to do this.

[TIMMAAYY]

As long as you go to an IN NETWORK Blue Cross Blue Shield provider.... in ANY state, your claims are processed as in network. So if you obtain your insurance in Texas with Anthem-BCBS, and you go to an IN NETWORK provider with BCBS of Tennessee, it won't make any difference.

You can check for a list of providers with each state BCBS or Anthem BCBS website. The plans offered from state to state may not be the same, but being IN NETWORK is the same regardless. The key thing is IN NETWORK with BCBS.

[Betty]

I agree. I never heard of not being able to use BCBS in a state other than where it was purchased as long as you go to a BCBS in network provider.

[cltypes]

I called BCBS and asked them if my insurance would be valid in states other than Texas. The lady said that the only thing it would cover is ER expenses, which seemed kind of weird. So I called again to see if another representative would have a different response, but he said the same.

Haha, i now kinda understand why my dad always said health insurance is pointless.

[TIMMAAYY]

That's incorrect.

I have worked this out in the past for others. As long as you go to a BCBS IN NETWORK provider, it will be the same no matter where you are. If you have an emergency, you can pretty much go anywhere and it will be "in network". This is just for emergencies. Doctor visits, Urgent Care, etc. you must be in network.

[cltypes]

http://img369.imageshack.us/img369/8997/untitledjk9.png

That's the plan I was considering, and I read the title to the reps. Am i just looking at the wrong plan then or what?

[TIMMAAYY]

I couldn't tell you, other than maybe you are explaining your situation wrong, or they are idiots ( and there are a lot of them... my Anthem commission rep once tried to tell me that COBRA was a carrier! ).

I have talked to several of the BCBS people in other states, as well as states where BCBS is under the Anthem name. As long as you have BCBS ( Blue Cross Lue Shield ), any doctor in any state that takes Blue Cross Blue Shield will know how to handle your insurance card. It tells them where to send the claims. Your claims will be handled as "in network" for any povider ( doctor, hospital, etc ) than accepts Blue Cross Blue Shield.

If you simply called ehealthinsurance and talked to a salesperson, lord only knows what they might tell you.

BTW, is that plan for Texas? I wanted to check something out for you.

[cltypes]

thanks so much for the help TIMMAAYY, I'd be completely lost without you lol.

Yes, the plan in the picture is for Texas, i went to [url]http://www.bcbs.com/[/url] and typed in zipcode 78613. The only thing that sorta seems iffy about the plan that i took a screenshot of is the deductible...$2500? Meaning, if i were to get sick or something, and went to the doctor, then I would have to pay full cost if the cost of the visit is 2500 or less (which it most definitely will be)...so doesn't that kind of make health insurance useful only if something major happens, like surgery or something?

[TIMMAAYY]

That's why I wanted to check something out for you.

What you have there is a nice high deductible HSA plan. If you understand what an HSA is and how to use it, it's nice. If you don't, you will judt be confused. The other thing about it that has me wondering is that it shows prescription drug copays.... which are not part of an HSA plan by definition. Odd. Although, they seem kind of high.

An HSA compatible insurance plan allows you to set up a Health Savings Account at your local bank, and withdraw money from that account for health insurance costs. It allows you extra tax savings if you put extra money into it that you don't spend. I'll check on some other plan options for you. I'll get back to you shortly. If I am looking at the Anthem site correctly, I don't believe they are an Anthem state, just BCBS.

[TIMMAAYY]

Here are your next best options...
_______________________________________________________

PPO Select Choice (Plan I to VIII)

Lifetime Benefit: $5 Million
Physician/Hospital Network: BlueChoice or BlueCard PPO
Individual Out-of-Pocket Expense Limit: Deductible plus $3,000
Office Visit Co-pay: $25

Coinsurance: 80% Coverage

Deductible Rx Drug Coverage Select Monthly Premium
$250 $10 Generic, $30 Preferred, $45 Non-Preferred $189.00
$500 $10 Generic, $30 Preferred, $45 Non-Preferred $156.00
$1,000 $10 Generic, $30 Preferred, $45 Non-Preferred $136.00
$1,500 $10 Generic, $30 Preferred, $45 Non-Preferred $111.00
$2,500 $10 Generic, $30 Preferred, $45 Non-Preferred $100.00
$3,500 $10 Generic, $30 Preferred, $45 Non-Preferred $89.00
$5,000 $10 Generic, $30 Preferred, $45 Non-Preferred $79.00 ______________________________________________________________

For $79 a month, you would have an office visit for $25. That's a "copay". That means a simple trip to the doctor to get checked out and get a prescription, would cost $25.

Let me explain how insurance works, before you completely freak out.

Insurance is not free. Think of it as legalized gambling, and it will make more sense to you.

The plan you looked up above, has a deductible of $2,500, but no office visit copay. That's ok. It's still insurance. Insurance is a stop loss. That's all it is for.... the extra fluff that comes with it.... those are "benefits". Try to keep these two things separate.

As you can see from above, that $25 office copay costs you about $25 more per month, just to have.... and it has a higher risk on the back end in the event something major happens to you.

Office visits aren't that expensive in the grand scheme of things. You will still get the network discount.... from BCBS. A person walking in with no insurance may have to pay the entire bll from the doctor on their own... whatever the doctor would normally charge. With insurance, you get the "discounted rate". That means, what would normally be a $100 office visit, the doctor can only charge YOU $57 ( or whatever the discounted rate is ) for the visit. Don't bank on the $57 figure... that's just an example. The key thing is that you will get discounted pricing for your visits because of using a doctor who is "in network"; that doctor has contracted with BCBS and accepted their billing terms.

The other plan I found for you DOES have an office visit copay. But, you are going to pay for it every month regardless. Remember what I said about legalized gambling? Welcome to the table. That $25 office visit means that every time you go and pay $25 to the doctor, BCBS will have to kick in the rest for you...whatever the balance is. And they aren't going to lose that game. They simply charge you for it ahead of time.

Realistically, I'd go with the HSA plan you found. You don't have to set up an HSA account to use it, but you can if you want to do so. In regards to your original questions about the deductible, yes, you will have to meet that until the insurance kicks in.... but that's what it is FOR. Just like insurance for your car.... do you pay insurance for oil changes? Do you pay insurance to fix the little scratch you got on the door? No and no. These are little things ( office visits ) that you can handle yourself rather than pay the insurance company to pay for you.

BUT.... when that $20,000 accident happens to your car... you aren't out $20,000. You are out the deductible. Same with health insurance. Handle the small stuff yourself. Let the insurance take care of the big stuff. That's how it should be bought.

[TIMMAAYY]

I was just reading the fine print on the ACSA plans....


The best plan has a $100 deductible per illness/injury. That means every time you go to the doctor, you are on the hook for the first $100 anyway. And you will probably be billed the whole amount, not a discounted rate. There is no "network". If they don't take the insurance, you have to just pay it and then submit all your bills and paperwork to the company and get reimbursed. (pain in the arse)

It also looks like United Healthcare administers their paperwork.

I'd still go with an individual plan. It's the overall best choice, and you can keep it after you graduate, until you find a job that offers you insurance and benefits.

[cltypes]

That explanation made things a lot more clear, much appreciated. I'm going to go ahead and go with the BCBS plan that I posted earlier. I figure i'll probably hardly visit the doctor anyway, all I really need is something that has coverage that's worth paying for, and so I can show proof of insurance. As for the whole whether they accept it out of state or not dealio, i'll go with what you said, you seem to be far more knowledgeable about this stuff than the reps on the phone lol.
Thanks a lot for the help. I was actually considering just going to the local college bc of all this insurance junk that was coming up for Rhodes, had I not gotten the help here.

Thanks again

[TIMMAAYY]

Call Blue Cross of Tennessee and tell them your situation,that you will be getting a Blue Cross of Texas plan, and you want to make sure that any insurance needs there will be considered "in network", as long as you go to an "in network" provider. I have talked to them in the past about another situation similar to yours. If you talked to a customer service rep, you could get some wrong information pretty easily. Ask for someone who can help you with a question about the BCBS network and providers in other states that have BCBS.

You can search for network providers on their website, too... a list of providers. (hospitals, doctors, labs, etc. ).