Horizon Basic and Essential EPO Plan
 

Well, after years of not having any health care insurance, I finally did it.

I can't say I'm happy about it as it really is nothing short of a rip off... but me *****ing is NOT why I'm posting.

I just would like to hear what folks think. I'm 34 (almost 35), work out 4-5 days a week and VERY VERY active. Don't smoke, and drink only occasionally. No drugs, etc. (Male)

I got this:

Horizon Basic and Essential EPO Plan

Here are the details about it.

Plan Name
Horizon Basic and Essential EPO Plan
Apply

Plan Type
EPO

Estimated Monthly Cost
$164.46

Primary Care Physician Required
No

Specialist Referrals Required
No

HSA Eligible
No

Out-of-Network Coverage
No

In-Network Coverage
Deductible
None

Coinsurance
None

Out-of-Pocket Limit
None

Office Visit
Primary Doctor
Illness and Injury office visits covered to $700 per covered person per calendar year

Specialist
Illness and Injury office visits covered to $700 per covered person per calendar year

Periodic Health Exam
$50 deductible, 20% coinsurance up to $600 wellness benefit per person per calendar year.

Periodic OB-GYN Exam
$50 deductible, 20% coinsurance up to $600 wellness benefit per person per calendar year.

Well Baby Care
$50 deductible, 20% coinsurance up to $600 wellness benefit per person per calendar year.

Chiropractic
Not Covered

Mental Health
Biologially based mental illness only - 30% Coinsurance, 30 visits per year

Prescription Drugs
Generic
Not Covered
Brand
Not Covered
Non-Formulary
Not Covered
Rx Deductible
None
Mail Order
Not Available

Lab/X-Ray
$500 maximum per covered person per calendar year.

Emergency Room
$100 Copay (waived if admitted)

Outpatient Surgery
$250 Copay

Hospitalization
$500 Copayment per period of confinement (90 days per covered person per calendar year)

Maternity
Pre & Postnatal Office Visit
Pre- and post-natal charges are covered when included in the delivery charge
Labor & Delivery Hospital Stay
$500 Copayment per period of confinement (90 days per covered person per calendar year)

Lifetime Maximum
Unlimited

Additional Information
Will insurance company obtain and pay for medical records?
N/A
eSign
(electronic signature)
Yes

A.M. Best Rating
A-pd
as of 10/08/2004
Edit/Delete Message

That's a lot of money per month but you're self-employed, right? If so it might be the best you can do.

Of course, as soon as you cancel it you'll get appendicitis or something.

Kaiser
 

I work for a small company (25 or less) and I believe our family coverage of Kaiser Permanente runs about $1200 a month. I'm not sure what it is for an individual. So, $165 a month sounds pretty inexpensive. Kaiser is an HMO. I've never heard the term EPO before. Kaiser is okay, but not the best I;ve seen.

The family coverage is truly outrageous. I know quite a few people who can't afford healthcare for their kids.

I pay about $82 a month for my health care, which is through Great West and seems pretty good. I work for a non-profit.

You guys need to look at New Jersey.

$168 is the absolute cheapest you can get.

"Usual" healthcare is $300-$400 a month!

Sucks for me!

Rate increases
 

Everytime the rates have gone up for our group coverage, the company I work for has reduced its contribution. The last time they went up they quit kicking in anything. Fortunately, I get my coverage elsewhere. I am looking for a new job, however. I'm surprised the company can keep anybody here.

I read somewhere that medical debt is the leading cause of bankruptcies now. Anybody know if this is true or not. If so, that's a much different picture than the one the banks have painted in the course of lobbying for the new laws governing bankruptcy.

I don't want to turn this into a political thing... I just want to know if this seems like decent care. From what I understand it is "ok" as long as you stay in-network (there is ZERO coverage unless some SERIOUS ***** happens outside of network.)...